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Article
Efficacy of a New Postpartum Transition Protocol for Avoiding Pregnancy
Journal of the American Board of Family Medicine
  • Thomas Bouchard, University of Calgary
  • Richard Fehring, Marquette University
  • Mary Schneider, Marquette University
Document Type
Article
Language
eng
Format of Original
10 p.
Publication Date
1-1-2013
Publisher
American Board of Family Medicine
Original Item ID
doi: 10.3122/jabfm.2013.01.120126
Abstract

Introduction: The postpartum period is a challenging time for family planning, especially for women who breastfeed. Breastfeeding delays the return of menses (lactational amenorrhea), but ovulation often occurs before first menses. For this reason, a protocol was developed to assist women in identifying their return of fertility postpartum to avoid pregnancy.

Methods: In this prospective, 12-month, longitudinal cohort study, 198 postpartum women aged 20 to 45 years (mean age, 30.2 years) were taught a protocol for avoiding pregnancy with either online or in-person instruction. A hand-held fertility monitor was used to identify the fertile period by testing for urinary changes in estrogen and luteinizing hormone, and the results were tracked on a web site. During lactational amenorrhea, urine testing was done in 20-day intervals. When menses returned, the monitor was reset at the onset of each new menstrual cycle. Participants were instructed to avoid intercourse during the identified fertile period. Kaplan-Meier survival analysis was used to calculate unintentional pregnancy rates through the first 12 months postpartum.

Results: There were 8 unintended pregnancies per 100 women at 12 months postpartum. With correct use, there were 2 unintended pregnancies per 100 women at 12 months.

Conclusion: The online postpartum protocol may effectively assist a select group of women in avoiding pregnancy during the transition to regular menstrual cycles.

Comments

Published version. Journal of the American Board of Family Medicine, Vol. 26, No.1 (January 2013): 35-44. DOI: 10.3122/jabfm.2013.01.120126. © American Board of Family Medicine 2014. Used with permission.

Citation Information
Thomas Bouchard, Richard Fehring and Mary Schneider. "Efficacy of a New Postpartum Transition Protocol for Avoiding Pregnancy" Journal of the American Board of Family Medicine (2013) ISSN: 1558-7118
Available at: http://works.bepress.com/richard_fehring/53/