Context

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.

Methods

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.

Results

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.

Conclusions

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