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Training of Roma Health Mediators in Reproductive Health

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Tra<strong>in</strong>er document<br />

NATURAL FAMILY PLANNING METHODS (presentation)<br />

LACTATIONAL AMENORRHEA METHOD (LAM)<br />

LAM (Lactation = breastfeed<strong>in</strong>g. Amenorrhea = absence <strong>of</strong> menses. M=method) is a<br />

family plann<strong>in</strong>g method for breastfeed<strong>in</strong>g mothers which provides natural protection<br />

aga<strong>in</strong>st pregnancy for up to 6 months after birth.<br />

Mechanism <strong>of</strong> Action<br />

Lactational Amenorrhea Method can be used by breastfeed<strong>in</strong>g women and is based on the<br />

physiological <strong>in</strong>fertility dur<strong>in</strong>g this time, demonstrated by the absence <strong>of</strong> menses.<br />

Women’s fertility is reduced because they do not ovulate. Without ovulation, fertilization<br />

and pregnancy cannot take place.<br />

Effectiveness<br />

If us<strong>in</strong>g the LAM perfectly, only 1 woman out <strong>of</strong> 200 women will get pregnant <strong>in</strong> the first<br />

6 months after childbirth. As commonly used, 2 women out <strong>of</strong> 100 may become pregnant<br />

<strong>in</strong> the first 6 months.<br />

In order for LAM to be effective, the woman must meet the follow<strong>in</strong>g criteria:<br />

• She is less than six months postpartum<br />

• She is amenorrheic (she has had no menstrual periods)<br />

• She is fully and regularly breastfeed<strong>in</strong>g, without giv<strong>in</strong>g the baby any other food<br />

The woman should start another contraceptive method before any <strong>of</strong> the three criteria<br />

expire. A woman needs an alternative method before 6 weeks postpartum to beg<strong>in</strong><br />

immediately if she should menstruate or reduce breastfeed<strong>in</strong>g <strong>in</strong>tensity.<br />

Advantages<br />

• Can be used immediately after delivery<br />

• Is very convenient for the mother who breastfeeds dur<strong>in</strong>g the first 6 months after<br />

delivery<br />

• Requires no prescription<br />

• Has no side effects or precautions<br />

• Is economical (free <strong>of</strong> charge)<br />

• Requires no chemical substances or mechanical devices<br />

• Helps protect the <strong>in</strong>fant from diarrhea and other <strong>in</strong>fectious diseases<br />

Disadvantages/Limitations<br />

• Can be used only dur<strong>in</strong>g the postpartum period<br />

• May be difficult for woman to ma<strong>in</strong>ta<strong>in</strong> a pattern <strong>of</strong> fully or almost fully<br />

breastfeed<strong>in</strong>g<br />

• Provides no protection aga<strong>in</strong>st STD/HIV<br />

• In HIV-positive mothers, the babies have the risk <strong>of</strong> <strong>in</strong>fection through<br />

breastfeed<strong>in</strong>g<br />

56<br />

RFHI/JSI <strong>Roma</strong>nia <strong>Tra<strong>in</strong><strong>in</strong>g</strong> <strong>of</strong> RHMs <strong>in</strong> <strong>Reproductive</strong> <strong>Health</strong> Session 4: FP Methods

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