Open Access Journal of Contraception (Sep 2023)

Effectiveness of Lactational Amenorrhea Method in Ethiopia: A Multi-Center Prospective Cohort Study

  • Eticha TG,
  • Girma S,
  • Mamo G,
  • Asefa F,
  • Birhanu A,
  • Taye B,
  • Alemu A,
  • Nigussie K,
  • Gedefaw A,
  • Genet T,
  • Amenu D,
  • Mekuria T,
  • Tura AK

Journal volume & issue
Vol. Volume 14
pp. 149 – 157

Abstract

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Tadesse Gure Eticha,1 Sagni Girma,2 Galana Mamo,3 Fekede Asefa,3 Abdi Birhanu,4 Bedasa Taye,3 Addisu Alemu,3 Kabtamu Nigussie,2 Abel Gedefaw,5 Tinsae Genet,6 Demisew Amenu,7 Thomas Mekuria,8 Abera Kenay Tura2 1Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 2School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 3School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 4School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; 5School of Medicine, College of Health and Medical Sciences, Hawassa University, Hawassa, Ethiopia; 6School of Medicine, College of Health and Medical Sciences, University of Gondar, Gondar, Ethiopia; 7School of Medicine, College of Health and Medical Sciences, Jimma University, Jimma, Ethiopia; 8School of Medicine, St. Paul’s Millennium Medical College Hospital, Addis Ababa, EthiopiaCorrespondence: Tadesse Gure Eticha, Department of Obstetrics and Gynecology, School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia, Tel +251913868714, Email [email protected]: Although the lactational amenorrhea method (LAM) is one of the most commonly used contraception methods during the first six months of a woman’s postpartum period, there has been little research on its effectiveness in general and particularly in Ethiopia. The purpose of this study was to evaluate the effectiveness of LAM and the experiences of Ethiopian women who used it.Methods: This was a multi-center prospective cohort study of postpartum women from five Ethiopian regions and one city administration. All pregnant women who gave birth in these randomly selected hospitals and five health centers directly referring to the hospitals were invited to the study if they selected LAM and were followed monthly at home. Each month, trained researchers visited the woman at her home and collected information about breast feeding, the return of menses, the resumption of sex, the use of another contraceptive, and a pregnancy test using urine human chorionic gonadotropin (hCG). Women who reported starting new contraceptive methods, resumption of menses, starting complementary feeding, neonatal death, getting pregnant, or refusing were excluded from the cohort. The data were collected using ODK Collect and exported to Stata 14 for analysis.Results: Among the 2162 women who selected LAM as a contraceptive, 2022 were enrolled in the cohort study, and 901 completed the follow-up. At the end of the sixth month, eight women got pregnant, corresponding to an effectiveness of 99.1%. More than half of the cohort were excluded from the follow-up for reasons of transitioning to other types of contraception, resumption of menses, or refusal to follow-up.Conclusion: The effectiveness of LAM is high and should be recommended for postpartum women, with proper counseling provided. A study should be conducted to examine the effectiveness of breast feeding as a contraceptive beyond the Bellagio consensus.Keywords: effectiveness, lactation amenorrhea, contraception, breast-feeding, postpartum Ethiopia

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