(18) Another particular focus of this analysis is the lactational amenorrhea method, a method used by fewer than 1% of married women in Ouagadougou, according to the 2010 DHS.
We classified correct use of modern methods (the lactational amenorrhea method, the Standard Days method, hormonal and surgical methods, condom) as safe, and traditional family planning method use (periodic abstinence, withdrawal) and improperly used modern methods (for example, inconsistent condom use) as entailing some risk.
Only three women knew that women have a very low risk of pregnancy in the first six months of a birth if they are amenorrheic and breast-feed exclusively (lactational amenorrhea method), but none used this method.
Finally, while we initially believed that a better promotion of the lactational amenorrhea method could strongly affect postpartum family planning, our conclusion is more modest.
Women using the lactational amenorrhea method are expected to switch to another family planning method when they reach six months postpartum (or before that date, if they stop breast-feeding exclusively or start their menses).
The dependence of postpartum women on such traditional practices as postpartum abstinence and prolonged breast-feeding without having correct knowledge of the lactational amenorrhea method also leads to short intervals between pregnancies.
To address this issue, the Population Council, in collaboration with Lala Lajpat Rai Memorial Medical College, Meerut, conducted operations research to assess the feasibility and effectiveness of a behavior change communication intervention using community workers from the Family Welfare Program to promote postpartum contraception and the lactational amenorrhea method to young pregnant women in rural areas of Uttar Pradesh.
(No activities other than those of the government-run health program were conducted in the comparison areas.) Using communication materials (leaflets, posters, wall paintings and booklets), workers educated all pregnant women registered for the study and their mother-in-law or the oldest female family member on healthy timing and spacing of pregnancy (first pregnancy should be delayed until age 18, women should wait at least 24 months after a live birth and six months after an abortion or miscarriage before planning their next pregnancy), postpartum care, the lactational amenorrhea method and postpartum contraception.
Prior to training, 14% of the community workers correctly answered all questions except the question on the lactational amenorrhea method (no one knew the method before training began).
Ability to mention all three conditions of the lactational amenorrhea method was not included in the logistic regression because only 0.2% of women in the comparison group knew about the method al four months postpartum.
Notes: Female-only methods include the pill, IUD, injectable and implant; couple methods include male and female condoms, the diaphragm, foam, jelly, withdrawal, the lactational amenorrhea method
and periodic abstinence.