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Postpartum and breastfeeding transition- HELP!

Updated: Apr 17, 2023

Babies are one of God's greatest gifts. And the postpartum and breastfeeding transition is a difficult time for couples to discern when they are fertile. In fact, several research articles have been published demonstrating the disconnect between hormonal fluctuations and the symptoms of fertility a woman is used to charting while using NFP. You are not alone, and you are not crazy! It IS hard figuring out if you are fertile or not during this transition.


WHY is it so hard?

This is an excellent question. In my experience, each woman has a very different hormonal landscape when it comes to the postpartum/breastfeeding transition. A woman’s body is hardwired to directly and indirectly suppress fertility when she is breastfeeding, however the extent to which she is infertile is dependent upon many factors. Due to the multifactorial nature of these biofeedback mechanisms, it is very difficult to observe and chart what is going on hormonally in the postpartum woman’s body. In fact, one study indicates that the traditional signs of fertility (specifically cervical mucus) only correctly correlated with actual hormonal changes during the postpartum/breastfeeding transition 40% of the time!


How Marquette is different

What are couples to do? There are a lot of really good reasons to avoid a pregnancy in the first year postpartum. From supporting the current baby continuing to breastfeed, to allowing the woman’s body to fully heal from pregnancy and birth, the reasons are numerous. There is a very real concern that the frustrations and fears couples experience during this transition can lead to couples using alternative, non-Church approved, means of spacing children. To recap the basic Catholic Church teaching on sexual morality, the unitive act can never be separated from the procreative act. Meaning, while not every act of intercourse has to have the intention of conceiving, every act must have the possibility, however small, of conceiving (for further reading, see Humanae Vitae). Couples who have very serious reasons for avoiding a pregnancy in the first year postpartum could find themselves tempted to use contraception or find themselves unnecessarily abstaining out of fear of conceiving because they do not have confidence in the woman’s fertility status. To be clear, these are not morally equivalent, but neither one is best for the couple.


Here is how the Marquette method of NFP is different. While most studies on the efficacy of using NFP during the postpartum transition used markers such as cervical mucus and basal body temperature, Marquette utilizes technology to actually get a glimpse into the woman’s real time fertility status. The Clear Blue Fertility Monitor checks the woman’s urine for two hormone metabolites that indicate fertility- estrogen and luteinizing hormone, or LH. As a woman’s (each individual woman’s) fertility returns during this transition period, she gets an objective data point that lets her know her fertility is returning. The researchers at Marquette University have developed an evidence-based protocol for avoiding pregnancy during the postpartum transition using the data collected from the Clear Blue monitor. Couples can now, with 99% confidence in the first 6 months, successfully avoid pregnancy with the reliable, objective information provided by their monitor. Yes, there is still an abstinence component. Yes, you do have to remember to test and use the monitor and chart correctly. But what a revolutionary way to approach NFP?! This is truly a game changer.

Maybe you are pregnant now and hoping to avoid a pregnancy in the first year postpartum. Maybe you’ve experienced a pregnancy sooner than you anticipated in using other methods of NFP. Maybe you have a difficult time interpreting the natural signs of fertility. If this is you, I would be so happy to join you in your NFP journey. I am here to educate you in the Marquette Method for postpartum and breastfeeding, to walk with you on the journey and answer any questions you may have along the way. This is truly a challenging time to use NFP. Why not have a trained nurse who understands this transition walk with you and help you along the way?



References:

Brown, J.B., P. Harrisson, and M.A. Smith, “A study of returning fertility after childbirth and during lactation by measurement of urinary oestrogen and pregnanediol excretion and cervical mucus production,” Journal of Biosocial Science (Suppl.) 9 (1985): 5-23.


Diaz, S., P. Miranda, H. Cardenas, et al., “Relative contributions of anovulation and luteal phase defect to the reduced pregnancy rate of breastfeeding women,” Fertility and Sterility, 58 (1992): 498-503.


Hatherley, L. “Lactation and postpartum infertility: the use-effectiveness of natural family planning (NFP) after term pregnancy,” Clinical Reproduction and Fertility 3 (1985): 319-334.


Howard M.P. and J.B. Stanford, “Pregnancy probabilities during use of the Creighton model fertility care system,” Archives of Family Medicine 8 (1999): 391-402.


Kennedy, K. I., B. A. Gross, S. Parenteau-Carreaus, A. M. Flynn, J. B. Brown, and C. M. Visness. 1995. Breastfeeding and the symptothermal method. Studies in Family Planning 26:107-115.


Labbok, M. H., V. Hight-Laukaran, and A.E. Peterson, et al., “Multicenter study of the Lactational Amenorrhea Method (LAM): I. Efficacy, duration, and implications for clinical applications” Contraception 55 (1999): 327-336.


Labbok, M. H., R. Y. Stallings, F. Shah, A. Perez, H. Klaus, M. Jacobson, et. al. 1991. Ovulation method use during breastfeeding: is there increased risk of unplanned pregnancy? American Journal of Obstetrics and Gynecology 165(Suppl): 2031--2036.


Lewis, P.R., J.B. Brown, M.B. Renfree, and R.V. Short, “The resumption of ovulation and menstruation in a well-nourished population of women breastfeeding for an extended period of time,” Fertility and Sterility 55 (1991): 529-536.


Li, W. and Y. Qiu, “Relation of supplementary feeding to resumption of menstruation and ovulation in lactating postpartum women,” Chinese Medical Journal 120 (2007): 868-870.


Tomaselli, G.A., M. Guida, and S. Palomba, et al., “Using complete breast-feeding and lactational amenorrhea as birth spacing methods,” Contraception 61 (April, 2000): 253-257.


Zinaman, M. and W. Stevenson, “Efficacy of the symptothermal method of natural family planning in lactating women after the return of menses,” American Journal of Obstetrics and Gynecology 165 (Suppl) (1991): 2037-2039.

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