LAM method of natural contraception-How useful is Lactation ameno method of contraception:

 

It is estimated that about 40% of pregnancies in the world are unintended and that the major part of these are unwanted.

Barriers to contraceptive use are many in number : social taboo, Rumors and myths surrounding contraception’s, minor side effects of OCP or IUCDs ,  culture, personal, associated medl disorder and many others reasons are there for not using contraceptives. There are several reasons no or ineffective contraception is used to prevent these pregnancies, including difficulty in obtaining contraceptives.

What about LAM procedure( The lactational amenorrhoea method (LAM))?? Ans It  is a contraceptive method where the mother is informed and supported in how to use breastfeeding for contraception. LAM is available and accessible to many women.

Objectives

To assess the effectiveness of LAM, as defined in the 1988 Bellagio Consensus statement, as a contraceptive method in fully breastfeeding women, who remain amenorrheic, using pregnancy and menstruation life tables.

Out of 459 potentially relevant studies, 159 investigated the risk of pregnancy during LAM or lactational amenorrhoea. Our inclusion criteria were as follows: prospective study; cases (intervention group) and, if available, controls, had to be sexually active; pregnancy had to be confirmed by physical examination or a pregnancy test. Our endpoints were life table menstruation rates and life table pregnancy rates. We included 15 studies reporting on 11 intervention groups and three control groups. We identified one additional uncontrolled study in the 2007 update and one additional controlled study in this 2015 update.

Main results

For the primary outcome, pregnancy, two controlled studies of LAM users reported life table pregnancy rates at six months of 0.45% and 2.45%, one controlled study reported 5% pregnancies in the absence of life table rates per month, and eight uncontrolled studies of LAM users reported pregnancy rates of 0% to 7.5%. Life table pregnancy rates for fully breastfeeding women who were amenorrheic but not using any contraceptive method were 0.88% in one study and 0.9% to 1.2% (95% confidence interval 0.0 to 2.4) in a second study, depending on the definition of menstruation used. The life table menstruation rate at six months in all studies varied between 11.1% and 39.4%.