Behavioral Methods continued...

Breastfeeding
 
After the birth of a child, certain hormones prevent a woman from ovulating and releasing eggs if she is breastfeeding. The length of time hormones are suppressed varies. It depends on how often the woman breastfeeds and the length of time since the baby’s birth. Ovulation usually returns after 6 months despite continuous nursing. 

Breastfeeding used for birth control is also called the lactational amenorrhea method (LAM), meaning breastfeeding prevents your body from producing the hormones that cause ovulation (release of an egg) and a return to fertility. Some women feel this is an adequate form of birth control. ACOG states, "Exclusive breastfeeding helps prevent pregnancy for the first 6 months after delivery, but should be relied on only temporarily and when it meets carefully observed criteria of the lactational amenorrhea method (LAM)." 

ACOG recommends that for best impact on fertility, women should breastfeed at least every 4 hours during the day and every 6 hours at night. Any feedings the infant is given aside from breastfeeding should not be more than 5-10% of the total the child consumes. For instance, one formula feeding out of every 10 might increase the chance of fertility returning. If this schedule cannot be followed, consider using an additional form of birth control. When the menstrual period returns after pregnancy, another form of birth control is needed.

• How effective:  ACOG reports this method to be 98% effective in the first 6 months after delivery if the above criteria are met. Once menstrual bleeding resumes, the risk of pregnancy increases greatly.
   
• Advantages: A woman has no periods during this time.   
  
  
• Disadvantages: When a woman is fertile again is uncertain. Frequent breastfeeding may be inconvenient. This method should not be used if the mother is HIV positive. This method does not protect against STDs.

Douching
 
Douching is a method of rinsing out the vagina. Women use water or vinegar or solutions purchased at a drug store and spray these solutions into the vagina with a bottle or tubing. It has long been thought that women need to clean their vaginas and reduce odor. Some women douche after their menstrual periods or after sex to avoid getting a sexually transmitted disease. Some think douching after sex will prevent pregnancy.
 

• Douching is not recommended. Douching changes the delicate chemical balance in the vagina and may allow an infection to grow or spread an infection into other pelvic organs such as the uterus. This method does not protect against STDs. Douching may actually increase the chance of developing pelvic inflammatory disease and transmitting STDs. 
  
  
• Douching after sex does not prevent pregnancy. In fact, the practice can increase a woman’s chance for developing an ectopic pregnancy, a serious condition that can be life threatening, by causing an infection in the reproductive organs.