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  • Title: Contraceptive use during lactation in developing countries.
    Author: Pebley AR, Goldberg HI, Menken J.
    Journal: Stud Fam Plann; 1985; 16(1):40-51. PubMed ID: 3983981.
    Abstract:
    Contraceptive use by breastfeeding women in developing countries has led to concern about potentially harmful effects of steroid contraceptives on the health of breastfed children. In this paper, breastfeeding women's use of the pill and hormonal injections is investigated using survey data from 17 Latin American, Asian, and African countries. The results indicate that while the proportions of breastfeeding women who use these methods were small in most countries at the time of the surveys, the proportion using the pill was not inconsequential. In general, younger lactating women with higher education and more live births who live in urban areas are more likely to use the pill than other breastfeeding women. Contraceptive use by breastfeeding women in developing countries has led to concern about potentially harmful effects of steroid contraceptives on the health of breastfed children. In this paper, breastfeeding, women's use of the pill, IUD, and hormonal injections is investigated using survey data from 17 Latin American, Asian, and African countries. The results indicate that while the proportions of breastfeeding women who use these methods were small in most countries at the time of the surveys, the proportion using the pill was not inconsequential. In general, younger lactating women with higher education and more live births who live in urban areas are more likely to use the pill than other breastfeeding women. The data for this study come from 2 series of surveys carried out during the last decade. For 14 of the countries, data come from surveys conducted by each country under the auspices of the World Fertility Survey (WFS). In each survey women aged 15-49 (20-49 in Costa Rica and Panama) were interviewed. This analysis includes only ever married women. Each survey contained a variety of questions on a woman's pregnancy and birth history, marital history, educational and employment background and contraceptive use. Findings show that in several countries a relatively large number of women use the pill in the 1st 3 months of lactation, the period during which an infant depends on breastfeeding for most or all of his diet. Indonesia's samples are unusual. About 20% of Indonesian women who were breastfeeding at the interview were also using the pill. Indonesian women who are lactating also use the IUD more frequently than women in other countries. The source of contraceptive supply clearly indicates the need for better information on where lactating women obtain contraceptives, if oral contraceptives are in fact shown to be harmful to breastfed infants. A crucial factor, not considered in this paper, is the change currently occurring in the traditional pattern of breastfeeding and contraceptive use in many developing countries. If the breastfeeding incidence continues to decline as contraceptive use increases, more frequent contraceptive use among breastfeeding women will probably result, but the number of breastfeeding women will decrease (as in Costa Rica).
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