title: Effectiveness of the lactational amenorrhea method in Pakistan.
abstract: OBJECTIVE
  To determine the efficacy of the lactational amenorrhea method of family planning (amenorrhea during full or nearly full breastfeeding for 6 months postpartum).
  
  
  METHODS
  Prospective noncomparative study.
  
  
  METHODS
  Normal breastfeeding women in Karachi and Multan, Pakistan, most delivered at home by a midwife.
  
  
  METHODS
  Three hundred ninety-nine newly delivered mothers who successfully had breastfed a previous child and chose the lactational amenorrhea method to prevent a subsequent pregnancy, 391 of whom were followed for a full year.
  
  
  METHODS
  Mothers were taught, before or shortly after delivery, to use the method and were interviewed in their homes each month by a Lady Health Visitor.
  
  
  METHODS
  Life-table pregnancy rates. Periods of postpartum or lactational abstinence were excluded in the calculation of the pregnancy rates.
  
  
  RESULTS
  During full or nearly full breastfeeding, while the women were amenorrheic and not otherwise contracepting, the rate of pregnancy was 0.6%. The pregnancy rate during lactational amenorrhea alone was 1.1% at 1 year postpartum.
  
  
  CONCLUSIONS
  The lactational amenorrhea method was found to be highly effective for 6 months. A high degree of contraceptive protection endures for a full year during lactational amenorrhea, but not after the return of menses during breastfeeding.
authors.affiliation: National Research Institute for Fertility Control, Karachi, Pakistan.
authors.forename: A
authors.initials: A
authors.lastname: Kazi
authors.forename: K I
authors.initials: KI
authors.lastname: Kennedy
authors.forename: C M
authors.initials: CM
authors.lastname: Visness
authors.forename: T
authors.initials: T
authors.lastname: Khan
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D003075:Coitus; D005069:Evaluation Studies as Topic; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006801:Humans; D007774:Lactation / Q000502:physiology*; D010154:Pakistan; D011247:Pregnancy; D013997:Time Factors