Continues from previous page

Resumption of periods and fertility

Once the periods start again after delivery, the woman should assume that she is ovulating and therefore capable of conceiving. This is regardless of whether she is breast-feeding or not.

Contraception for a breast-feeding mother

There are several contraception alternatives for a breast-feeding mother shortly. In summary, these are:

· Both male and female barrier methods

· Oral progestogen (progestin) preparations

· Injectable progestogen preparations

· Intrauterine devices

· Spermicidal preparations and, finally

· ‘Natural’ family planning.

Barrier contraception methods

The most widely used is the male condom. For a fully breast-feeding woman, properly used condoms should be just about sufficient in the first six months.

The female barrier methods include the diaphragm, the cervical cap and vaginal sheath (female condom). These, properly used are comparable to the male condom in effectiveness, for those who are fully breast-feeding. They are usually readily available from family planning clinics.

It is important to remember that a diaphragm cannot be fitted until at least four weeks after delivery. The same applies to the cervical cap. With both of these, a spermicidal cream should be used as well.

The progestin-only contraceptive pill (mini-pill)

This is the most popular form of postnatal contraception among women who are breast-feeding. It is popularly known as the "mini-pill" or P.O.P.

The mini-pill has the advantage of not affecting milk production in any way. However, it calls for an element of discipline because, to work effectively; the pill has to be taken at regular times each day.

There may be irregular menstruation with use of the mini-pill. Overall, it is very effective when used appropriately.

The injectable form of contraception

Depo-Provera® is the grand old duke of injectable progestogens (progestins). It is administered every twelve weeks and is an extremely effective contraceptive. However, like its oral cousin, the mini-pill, it can cause irregular vaginal bleeding, especially in the first three months. Thereafter, the tendency is to have no period at all. It does not interfere with milk production and is regarded to be safe for breast-feeding.

It is important to ensure that the injections are given on a strictly regular basis, for maximum effectiveness.

Noristerat® is another injectable contraceptive. This one has to be repeated every 8 weeks.

Continues next page