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PubMed1981

Contraception and lactation.

Lactation worldwide is estimated to prevent more births than all organized family planning programs, and thus has a definite contraceptive action. In addition, it contributes to better infant nutrition and well-being. In some societies women do not cohabit while lactating and therefore need no contraception. This situation is being eroded, and in any case does not apply generally. The risk of pregnancy increases with the length of lactation, and thus some form of added contraception needs to be adopted during lactation. Because of the nutritional value of lactation, the CMC deprecates the exploitative commercial advertising and promotion of bottlefeeding that exists in many parts of the world. It recommends that the IPPF and its member associations should actively promote breastfeeding. Since pregnancy can occur during lactation, additional contraception is desired. It should be remembered that IUDs, spermicides, mechanical methods, depot medroxyprogesterone acetate, progestagen-only oral contraceptives (OCs), and sterilization have no adverse effects on lactation. Evidence is accumulating that combined OCs have an adverse effect on the quantity and possibly the quality of breastmilk. Therefore, much greater caution should be exercised in distributing combined OCs than previously. Combined OCs should not be started until lactation is well established, and ideally not before 6 months or until the infant is weaned, whichever occurs 1st. If, however, no alternative contraception is available then OCs may be used earlier.

Breast Feeding↗
PubMed1983

[Clinical comparison of four types of IUDs made in China].

In order to compare the clinical efficacy of 4 types China made IUDs, this paper reported the study of a total of 1227 cases who, from January 1973 to June 1975, had used 1 of the 4 types of IUDs -- the stainless steel ring, metallic plastic mixed ring, metallic and silastic copper-shaped devices. The study was not a random allocation but was done, 1 type by 1, during the period. Life table method and logrank test were used to calculate and analyze the different events among these 4 types. 1147 cases were followed up for more than 5 years. The 5-year followup rate was 93.48%. Patients using these 4 types were comparable among themselves since the distribution of their age, gravida, para, and time of insertion were the same or quite similar. Study results were as follows: the cumulative pregnancy rates of the 2 copper V-shaped IUDs were significantly lower than that of the steel and mixed ring (p0.01); the cumulative expulsion rate of the steel ring was comparatively high, but there was no statistical difference compared with the others; bleeding was the main cause of medical removals; there was a higher cumulative medical removal rate of the V-shaped than that of the ring-shaped and also a significant difference between them (p0.01). However, at every year, the year-cumulative continuation rates were similar despite the difference of the events of discontinuation rates. The fact that 51.72-62.29% of the subjects continued to wear these IUDs indicated that the efficacy of the 4 types of IUDs was satisfactory even after a 5-year course.

Birth Rate↗