Women who are breastfeeding need access to family planning information and services to help them choose a contraceptive method that allows them to sustain breastfeeding and that is safe for the breastfeeding child.
Data from an operations research study of all family planning service delivery sites in Senegal were used to assess the management of contraceptive services for lactating women visiting the clinics for the first time.
At the time of the site visits, nearly 60% of the women visiting the family planning clinics for the first time were breastfeeding. Although most providers knew the correct advice to give breastfeeding women, 21% of the women were not asked their breastfeeding status during the clinic visit, and more than one-third accepted estrogen-containing contraceptives (which are not recommended for breastfeeding women). Overall, estrogen-containing contraceptives were less likely to have been accepted by breastfeeding women than by women who were not breastfeeding; however, among women known by the provider to be breastfeeding, estrogen-containing methods and progestin-only pills were accepted at the same frequency as among women who were not asked their breastfeeding status.
In order to meet the needs of breastfeeding women, providers must have correct information about the appropriate use of all contraceptive methods during lactation. Additionally, the reasons that providers do not ascertain breastfeeding status or give appropriate contraceptive advice to lactating women need to be identified.
International Family Planning Perspectives, 1998, 24(4):188-190
Karen Stein is program associate and Beverly Winikoff is senior associate and program director at the Population Council, New York. Diana Measham is a doctoral student at the University of California/Berkeley School of Public Health Berkeley, CA, USA, and a consultant to international reproductive health programs. The authors would like to acknowledge Wellstart International's Expanded Promotion of Breastfeeding Program, the Population Council's Robert H. Ebert Program on Critical Issues in Reproductive Health and the U.S. Agency for International Development for their financial support. The authors thank members of the Africa Operations Research/Technical Assistance II Project for their collaboration, especially Kate Miller for her painstaking work on data analysis, and acknowledge Joseph Harris, Virginia Kallianes, Stacy Melvin and Andrea Scadron for their assistance.