Acceptance of lactational amenorrhoea for family planning after postpartum counseling

Abstract

Objective To determine the impact of postpartum counseling on the acceptance of lactational amenorrhoea method (LAM) for family planning.

Methods In a prospective cross-sectional study 1490 postpartum women were included. Women who accepted or refused LAM for family planning were identified by means of a written survey. Twelve socio-demographic and clinical variables were included as predictors in a logistic regression analysis, the acceptance or refusal of LAM was the dependent variable; an Alpha level was set at 0.05.

Results There were 807 (54.2%) women who accepted LAM as a contraceptive method; 683 (45.8%) refused it. Main reasons for accepting LAM were: conviction following counseling (54.4%) and use of LAM initially before switching to another contraceptive modality (18.3%). Main reasons for LAM refusal were: belief that the method was unsafe (62.2%) and fear of some undesirable effect on health (15.8%). In the logistic regression analysis the variables occupation outside the home (P = 0.01) and previous knowledge of LAM (P < 0.001) emerged as predictors of LAM acceptance.

Conclusions Postpartum counseling of LAM had a very positive impact on its acceptance. Although it is recommended that information about LAM be given antenatally, in some settings postpartum counseling could improve its acceptance rate.

Keywords:

• Postpartum
• Lactation
• Amenorrhoea
• Family planning
• Contraception
• Counseling