Acceptance of lactational amenorrhoea for family planning after postpartum counseling.

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.