I find it so amazing that women's bodies go through so many hormonal changes both during pregnancy itself and within the postpartum period. During the postpartum period, ovulation can be prevented simply by hormonal changes that come from exclusively breastfeeding, which is referred to as lactation amenorrhea. While this method of pregnancy prevention can be extremely effective, it is important to pair it with a specific NFP method in order to chart your cycle to know when ovulation has resumed. Today, I am going to help you understand more about lactation amenorrhea in general as well as how you can effectively use NFP during this unique phase of life so that you can recognize when ovulation has occurred even before the first postpartum menstruation.
Understanding Lactation Amenorrhea
Lactation amenorrhea refers to the natural period of infertility that occurs when a mother exclusively breastfeeds her baby. This process is nature's way of spacing pregnancies, allowing a mother's body time to recover before conceiving again. The principle behind lactation amenorrhea as a form of avoiding pregnancy lies in the relationship between breastfeeding and hormonal activity. Prolactin, the hormone responsible for milk production, also suppresses the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are necessary for ovulation. Normally, when FSH rises an egg starts preparing for ovulation within the ovaries, and then the LH surge triggers ovulation to actually occur. If both FSH and LH ore inhibited by prolactin, then ovulation will be prevented.
Using Lactation Amenorrhea for Avoiding Pregnancy
For lactation amenorrhea to be effective as a natural contraceptive method, certain conditions must be met:
Exclusive Breastfeeding: The baby receives only breast milk, without any supplementary feeding of formula.
Frequent Feedings: Nursing at least every 4 hours during the day and every 6 hours at night.
No Menstruation: The absence of menstrual periods postpartum. Therefore, as soon as your period returns after delivery, you can no longer reliably use lactation amenorrhea as a method to avoid pregnancy.
Under these conditions, the Lactational Amenorrhea Method (LAM) can be over 98% effective during the first six months postpartum.
Integrating NFP While Breastfeeding
As your body transitions from lactation amenorrhea back to fertility, NFP can be an invaluable tool for tracking signs of returning ovulation. Tracking your cycle will help allow you to understand when your fertile window is starting and when ovulation occurs prior to the return of your first period. just waiting until your first period resumes may be too late since ovulation (and possible conception) precede a menstrual period. Here's how NFP can be used to help you track your fertile window and return of ovulation:
The Cervical Mucus Method Postpartum
How to Use: Postpartum, monitor the texture, color, and volume of cervical mucus daily. After childbirth and during breastfeeding, you may notice that mucus is scant or absent due to elevated prolactin levels. However, as fertility returns, mucus will increase in volume and change to a clear, stretchy consistency that resembles raw egg whites, which indicates increased fertility.
Challenges: Breastfeeding and hormonal fluctuations can cause variations in mucus consistency, making it harder to interpret. Postpartum hormonal adjustments might also lead to episodes of mucus that resemble fertile mucus, even when ovulation isn’t imminent.
When to Start Checking: Begin observing cervical mucus as soon as possible after childbirth, understanding that changes in mucus may not signify returning fertility until breastfeeding frequency decreases or stops. Initially, postpartum bleeding (lochia) may be mistaken for menstrual bleeding, but monitoring should continue, keeping an eye out for the first signs of fertile mucus.
Click here to learn more about the cervical mucus method.
The BBT Method During the Postpartum Period
How to Use: Measure your basal body temperature at the same time each morning before getting out of bed. A sustained rise in BBT typically indicates ovulation has occurred.
Challenges: The postpartum period can disrupt sleep patterns, making it difficult to get consistent BBT readings. Additionally, night feedings and hormonal changes can affect temperature regulation, leading to less reliable BBT data.
When to Start Tracking: It’s advisable to start tracking BBT once you experience more consistent sleep patterns or when night feedings are reduced, though interpreting the data may still be challenging until menstrual cycles regularize. Additionally, You must start tracking your BBT at least as soon as fertile quality cervical mucus production begins. The observation of fertile cervical mucus indicates the start of your fertile window, and then tracking BBT will confirm the return of ovulation.
Click here to learn more about the BBT and sympto-thermal method. Natural Cycles and TempDrop are great apps to use for this method during the postpartum period since they make irregular sleep patterns less of an issue.
The Sympto-Hormonal Method Postpartum
How to Use: This method combines the observation of physical signs of fertility, like cervical mucus, with the measurement of hormones (usually LH) in urine. LH testing can help predict ovulation by identifying the surge that precedes it. Additionally, with certain urine hormone tests, they will also detect a rise in estrogen, which indicates the start of the fertile window.
Challenges: Hormonal fluctuations common in the postpartum period can lead to false surges or elevated baseline levels of LH, which complicates ovulation test interpretation. Additionally, the return of ovulation can occur before the first postpartum menstruation. This is why being able to determine the start of the fertile window is so crucial prior to identifying your first ovulation postpartum. Reaching the point of ovulation could mean that you have already conceived if you happened to have sex 5 days prior to that ovulation day.
When to Start Checking: Begin using ovulation predictor kits (OPKs) when you notice changes in cervical mucus that suggest increasing fertility, or based on guidance from a healthcare provider familiar with postpartum fertility.
Click here to learn more about the sympto-hormonal method. ClearBlue fertility monitor and the Mira Fertility app are great resources to use for tracking your hormone levels with this method.
Adapting to Postpartum Fertility Signs
Postpartum, the signs of fertility may present differently than they did pre-pregnancy. For example, you might experience:
Cervical Mucus: More prolonged periods of seemingly fertile mucus without ovulation, as the body gradually returns to its regular ovulatory patterns.
BBT Variability: More frequent shifts in BBT not related to ovulation, reflecting hormonal adjustments and interrupted sleep.
Hormonal Fluctuations: Variability in hormonal levels that might not immediately result in ovulation, even if OPKs show a surge.
Recommendations for Effective Postpartum NFP
Patience and Persistence: Understand that tracking fertility signs postpartum requires patience. Hormonal levels and physical signs of fertility will gradually normalize, but this takes time.
Education and Support: Consult with a healthcare provider or an NFP instructor who can offer personalized guidance and support as you navigate postpartum fertility tracking. Click here for helpful links to different NFP instructors and NFP-only physicians in your area.
Comprehensive Tracking: Utilize a combination of NFP methods for a more accurate understanding of your fertility. This approach is especially beneficial during the postpartum period when individual signs may be less reliable.
Record Keeping: Maintain detailed records of your observations. Over time, patterns may emerge that can help you more accurately identify your fertile window.
Conclusion
Breastfeeding offers a natural period of reduced fertility, but it is essential to understand its limitations and the criteria required for it to serve as an effective method of pregnancy avoidance. As you navigate this postpartum period, integrating NFP techniques to monitor the signs of returning fertility can help you to make informed decisions about family planning. Embracing this time with knowledge and awareness allows your to understand your body's natural cycles, ensuring that the transition back to full fertility is managed with confidence and ease.
Check out the Resources page in order to learn about more apps, products and helpful links in order to make navigating your NFP journey as easy as possible.
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