Fertility after childbirth and during breastfeeding
Having a child together is definitive proof of a couple's fertility. So how soon after childbirth will the mother’s fertility return? What influences its return? Can Natural Family Planning help the couple identify the return of fertility following childbirth?
These are all important questions to ask after childbirth. Natural Family Planning can help the couple identify the return of fertility following childbirth. If NFP has been used before pregnancy and the woman is experienced and confident in observing her signs of ovulation, it will be easier to detect the return of her fertility after childbirth.
Following childbirth, all women produce a large quantity of prolactin, which is the hormone that stimulates milk production and suppresses ovulation. There is a physiological period of infertility where the usual signs of fertility are not present. The return of fertility after delivery depends on the re-activation of hormones that stimulate the ovaries. The return of fertility is influenced by whether the woman breastfeeds or not, and if she breastfeeds, by the intensity of the contact between mother and child.
What happens if Baby is Bottle Fed?
For a mother who is not breastfeeding, the quantity of prolactin decreases rapidly. The first menstrual-like bleeding usually returns about six or seven weeks after childbirth. The first ovulation can either happen before or after the first bleeding. If it happens before the first bleeding, this ovulation can occur as soon as the fourth week following childbirth.
What happens if Baby is Breastfed?
Breastfeeding influences the centers in the brain that control fertility (the hypothalamus and the pituitary). It stimulates the production of prolactin, a hormone that, in addition to stimulating milk production, will block fertility for some months. The more a woman breastfeeds, the greater the amount of prolactin released. The duration and intensity of breastfeeding are the main factors that determine when fertility will return.
Ovulation may occur as early as the fifth week post partum for a mother who breastfeeds for one month only, even if menstruation has not yet returned.
If a baby is growing normally, and receives no solids or liquids other than breast milk, then provided that there has been no bleeding yet, natural infertility is certain up to the sixth week following childbirth.
How Reliable is Breastfeeding as a Form of Family Planning?
Research has shown that breastfeeding delays the return of fertility, however, certain conditions must be met before science considers it an effective means of family planning. Serena’s medical advisor, Dr. Suzanne Parenteau-Carreau, was part of the international team of researchers who documented the criteria for using the natural infertility of breastfeeding in developing LAM (Lactational Amenorrhea Method). Women who are interested in using the natural protection of breastfeeding to avoid pregnancy can contact Serena for detailed information about LAM.
Lactational Amenorrhea Method (LAM)
LAM is a temporary natural family planning method that is 98% effective if three criteria are simultaneously and strictly met*:
1. The mother is fully breastfeeding (at least six feedings within 24 hours, no regular supplementation, and no interval longer than six hours between feedings); and
2. The baby is less than six months old; and
3. The mother's menstrual periods have not returned
* Each of these criteria includes certain exceptions that require precise explanations. Before using LAM, we recommend that you contact a Serena teacher-couple who can provide you with more detailed information. In addition, if circumstances cause a break in one of the conditions just mentioned, Serena's expertise and guidance can help you to know if LAM can continue to be effective.
Contact Serena for further information.
Sympto-Thermal Method after Childbirth
Once the LAM criteria are no longer applicable (for example, when you bleed or introduce solids), contact Serena. The Sympto-Thermal Method can help you to detect the return of fertility. If a woman is already experienced in evaluating her fertile signs and recording temperature, the Sympto-Thermal Method during breastfeeding will be easier. Regular follow-up from your Serena teacher-couple is available and encouraged. With the expertise and guidance from your teacher-couple, the Sympto-Thermal Method of natural family planning can continue to be not only effective, but a source of support and growth for a couple.