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  • Title: Breastfeeding and the return of fertility.
    Author: Kippley JF.
    Journal: CCL News; 1978; 4(4):5. PubMed ID: 12335447.
    Abstract:
    3 types of uncertainties lead some mothers to wean early, and others to decide against breastfeeding, involving indications of fertility by condition of the cervical mucus: uncertainty as to when fertility will return even with no positive indications, ambiguity due to a tacky, less fertile type of mucus, and uncertainty as to when ovulation will occur with presence of the more fertile type of mucus. In the 1st and 3rd cases, chances of pregnancy are estimated in the 1% range, with no signs of fertility while breastfeeding. Conversely, abstinence during periods of fertile mucus is necessary. Several suggestions are helpful in the case of less fertile mucus interspersed with patches of fertile mucus. The color of the vaginal wall helps indicate the level of fertility; increased nursing may render the woman infertile; and a continuing less fertile mucus for at least 3 weeks may enable couples to have coitus with a low risk of pregnancy. The surprise pregnancy rate during breastfeeding is estimated to be 3-4%/100 woman years. However, firm data is not yet available, and couples seeking to avoid pregnancy can be counseled as to specific times to abstain from coitus, based on the theory that it takes a certain number of days of higher estrogen levels to induce ovulation, and that only 1 or 2 days of fertile mucus would not reflect sufficient estrogen activity for ovulation. Testing of couples open to such guidelines is recommended.
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