Postpartum charting is arguably the hardest time to chart. If you have never charted before, it can be even more daunting. It is highly recommended to learn FAM from an instructor in the postpartum time if you want to rely on the method for unprotected sex. Even then, postpartum efficacy tends to be at least slightly lower than regular charting efficacy with perfect use, while typical use efficacy can be as low as 80-90% effective.
[Originally written by Fiona Fox, edited and updated by Katie Pryjmak and Leslie Rewis]
Note: Fiona is a self-taught fertility awareness user since 2004 with a specific focus in PP ROF (Postpartum Return Of Fertility), LAM (Lactational Amenorrhea Method) and Ecological Breastfeeding (EBF).
This document does not replace independent learning or time spent with an instructor – if you are totally new to FAM it is necessary to learn about your cycle (even if you’re not in them) the “whys” and “whats” of fertility and putting the knowledge into practice with the rules of FAM (whether TTA or TTC is the only way to use this method successfully!)
Recommended reading includes:
- Taking Charge Of Your Fertility by Toni Weschler
- The Garden of Fertility by Katie Singer
- The Seven Standards of Ecological Breastfeeding: The Frequency Factor by Sheila Kippley (catholic NFP)
- NFPTA Breastfeeding/LAM PDF download: goo.gl/qx8Jpg
- NFPTA Charting Overview/Rules: goo.gl/GKsjQa (credit: Lucy Povey)
FOR BREASTFEEDING MOMS
- Sixth-week bleed
- Lactational Amenorrhea Method (LAM)
- Ecological Breastfeeding (EBF)
“Sixth-week bleed”
“In a recent study, where postpartum bleeding in nursing mothers was evaluated, any bleed, less than 56 days [8 weeks] into the postpartum period was considered a sixth-week bleed, if it was separated from the lochia (post-birth vaginal discharge) by at least four days where no bleeding occurred. A little over one-fourth of all breastfeeding mothers in this study experienced a sixth-week bleed, though only 10 percent of these women actually resumed their period at this time. In this study of 485 nursing mothers, it was found that the average duration of lochia is 27 days. It is not affected by the frequency of nursing. It is common for postpartum bleeding to stop and restart. Postpartum bleeding is still considered to be lochia if it is has continued without an episode of at least four bleeding-free days. If bleeding begins less than four days after it has stopped it is still considered to be one episode. When a nursing mother does experience a sixth-week bleed, there is more likelihood that she will experience an earlier return of ovulation and her menses. (Visness C.M. et al. The duration and character of postpartum bleeding among breast-feeding women. Obstet Gynecology 1997;89:159-63)”
485/4=121.25
10% of 121.25 is 12.125
12.125 is 2.5% of 485
(of the 485 breastfeeding women in this study only 2.5% resumed their cycle by 56 days PP)
Lactational Amenorrhea Method (LAM)
98% effective with typical use for the first 6 months if no spotting or bleeding has occured after 56 days (8 weeks PP) and baby receives NO other supplementation of formula, food or water.
If you use this method, you should:
Exclusively breastfeed on demand, both day and night. Since hormonal changes in a woman’s body help suppress estrogen while breastfeeding, it is important to breastfeed on demand, night and day, in order to rely on LAM as an effective method of avoiding. An occasional taste of food or other liquid is permitted, it should never replace a breastfeed. Like supplementation, sleeping through the night can give a woman’s body a long interval without breastfeeding, which can signal the body to no longer suppress ovulation.
- Breastfeed your baby at least every 4 hours during the day.
- Breastfeed your baby at least every 6 hours at night.
http://kellymom.com/ages/older-infant/fertility/
NOTE: Exclusive or “cultural” breastfeeding IS NOT THE SAME as Ecological Breastfeeding.
Ecological Breastfeeding (EBF)
(average of 14.5 months of amenorrhea)
“Further, there should be no debate that ecological breastfeeding is a form of natural child spacing. To be sure, it seems that almost everyone has heard of breastfeeding mothers who became pregnant only three or four months postpartum, but that simply highlights the difference between cultural breastfeeding and ecological breastfeeding. Cultural breastfeeding, which is the term I use when women breastfeed but on a schedule or while using pacifiers or while having separation from their babies, [cultural breastfeeding] has almost no effect on postpartum fertility. I acknowledge that even with ecological breastfeeding, there can be an occasional very early return of fertility, but the demonstrated reality is that the early return is very far from the average and it cannot be regarded as the norm.”
www.nfpandmore.org/The%20Seven%20Standards%20Summary.pdf
POSTPARTUM RESOURCES
Fertility Friday Q&A Podcast
This episode of Fertility Friday is a Q&A that answers a lot of questions. Several of the questions are focused on the postpartum woman about charting, cervical fluid, weaning, LAM, etc. It’s full of great info that would be helpful for the postpartum FAMer:
“The Seven Standards of Ecological Breastfeeding”
By Sheila Kippley
1. Exclusively Breastfeed you baby/ies for the first 6 months (at least)
2. Pacify Your Baby at the Breast
Pacification at the breast is important for breastfeeding infertility. The extra non-nutritive or comfort suckling at the breast is nature’s way of providing those extra hormonal surges in the woman’s body that help to maintain natural infertility. Pacification at the breast is nature’s way of comforting the baby and is an essential practice for natural child spacing. Regular use of the pacifier interferes with this natural plan.
3. Don’t Use Bottles and Pacifiers
Avoid the use of bottles and pacifiers. This rule is implied with the First Standard of exclusive breastfeeding and the Second Standard of pacification at the breast and this happens naturally with breastfeeding.
4. Sleep with Your Baby for Night Feedings
Nighttime nursings are important for maintaining a steady milk supply and for natural child spacing, and co-sleeping greatly assists both effects. Night feedings are normal for a breastfed baby. Many infants need one or several feedings nightly during the first few years of life. These form a normal part of the baby’s nutrition.
*Disclaimer: Sleeping with your baby is not universally recognized as a good idea, please do your own research on safe sleeping conditions.
5. Sleep with Your Baby for a Daily-Nap Feeding
Sleep with your baby for a daily-nap feeding. A daily nap refreshes a mother. She avoids fatigue which may affect or reduce her milk supply. The lack of a nap may also negatively affect the natural child spacing mechanism. The hormonal suppression of fertility is dependent upon lactation, especially good lactation involving frequent and unrestricted nursing. For those reasons, I believe that a daily nap with the nursing baby is extremely important for most mothers in maintaining amenorrhea.
6. Breastfeed Frequently Day and Night and Avoid Schedules
Frequent nursing is common among eco-breastfeeding mothers. Doctor William Sears, author of many breastfeeding-related books, was once asked, “How can a mother breastfeed successfully?” His answer was,” frequently, frequently, and frequently.” This same answer holds true for those mothers interested in the natural-child-spacing effect of breastfeeding: “Frequently, frequently, and frequently.” It is the frequency of suckling that prolongs natural infertility after childbirth as well as helping a mother to nurse successfully.
7. Avoid Any Practice that Restricts Nursing or Separates You from Your Baby
Nature intends for mother and baby to be one, a biological unit. Mothers who remain with their babies will find it easy to follow the eco-breastfeeding program.
The World Health Organization described this oneness well: “Mothers and babies form an inseparable biological and social unit; the health and nutrition of one group cannot be divorced from the health and nutrition of the other.” Other researchers have described mother and infant as one biological system. Mother-baby togetherness is the key to natural child spacing.”
FAM in Postpartum
MUST read!
www.indiebirth.com/fertility-awareness-in-the-postpartum/
http://www.starryliving.com/postpartum-birth-control-options-without-artificial-hormones-or-iuds/
When To Begin Charting
Some women will begin charting all or a few signs right away. Others will wait until after 6 months if using LAM, others will wait until they see a change in Cervical fluid.
Temping
Many women are under the impression that temping while breastfeeding and or co-sleeping is not possible. But many women, with time and good habits that work for them, find they can get a consistent enough routine to learn a rough baseline during their cycle zero and eventually catch their first temp shift. Many women don’t bother with temps until their first bleed or cervical mucus build-up (which is fine!) but if you are willing or have an interest to experiment during cycle zero you can learn some important factors to YOUR temp routine. Like what time frame your temps seem steadiest, what sort of things tend to disturb your temps, whether you prefer oral or vaginal temping etc. Learning some of these things in cycle zero may help for an easier transition to the eventual first few cycles and understanding your charts if you are new to FAM.
Popular Wearable Thermometer – TempDrop:
A relatively new device that you wear overnight on your arm while you sleep that temps for you. It will filter out restless periods/night feedings and give you one BBT reading from each night. Many PP women have had great results using this new tech!
www.tempdrop.xyz
For those unable or not confident in deciphering cervical mucus/fluid or BBT while breastfeeding:
Marquette Method NFP (This is a catholic NFP method, the efficiency numbers are based on abstinence during the fertile window.)
Marquette Method uses the Clearblue fertility monitor to test daily levels of estrogen and LH – highly effective for PP use with instruction.
“The Marquette Model (MM) system of NFP brings 21st-century technology to NFP by using the ClearBlue Easy Fertility Monitor, a device used at home which measures hormone levels in urine to estimate the beginning and end of the time of fertility in a women’s menstrual cycle. The information from the monitor can be used in conjunction with observations of cervical mucus, basal body temperature, or other biological indicators of fertility. The MM was developed by professional nurses and physicians at Marquette University in the late 1990s. A recent (2007) study published in the Journal of Obstetric, Gynecologic, and Neonatal Nursing demonstrated a 97-98% efficacy of the MM in avoiding pregnancy when taught by a qualified teacher and correctly applied. “
*If you are interested in using this method you must either join the Marquette method’s site forum for a fee -OR- join the facebook group “Clear Blue Fertility Monitor NFP” to view the current protocols! A new Marquette website for charting is supposed to launch in 2020.
* ETA: Marquette is a method that appears very simple to self teach but there are small yet crucial details often missed by new users. It is also a relatively new method that is still adjusting protocols for the best efficiency and ease of use. For this reason, an instructor to cover the basics and appropriate protocols are HIGHLY recommended (a must!)