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  1. 1
    046435

    Nature's contraceptive.

    Shah I; Khanna J

    WORLD HEALTH. 1987 Nov; 10-2.

    Breastfeeding is at times referred to as "nature's contraceptive." Intensive breastfeeding naturally stops the discharge of eggs from the ovaries, which commonly is experienced as a delay in the return of menses after the birth of a baby. An obvious limitation is that for breastfeeding to produce a contraceptive effect, a successful pregnancy and suckling are essential, and it is not possible to predict when the contraceptive protection might cease. Consequently, in terms of fertility regulation, breastfeeding is regarded as a birth spacing rather than as a contraceptive method per se. The sooner a woman starts to menstruate after a birth, the shorter the birth interval is likely to be, assuming the woman is sexually active, there are no miscarriages, and no contraceptives are used. In women who do not breastfeed, the menses usually returns within 2-3 months after delivery. For those who breastfeed intensively for 1 or 2 years, the menses generally return within 6-10 months or 15-18 months, respectively. The ideal way of prolonging the birth interval seems to be by combining prolonged breastfeeding with the commencement of contraceptive use at the appropriate time, provided this time were known. Without breastfeeding and contraceptive use, the birth interval averages 16 months, but with prolonged and intensive breastfeeding it potentially could be extended by another 18 months, giving an average interval of 34 months. This suggests that the fertility of women who do not breastfeed could be halved by breastfeeding alone. The tendency for fertility to increase during the early stages of modernization is observed in countries where the trend away from a traditional of prolonged breastfeeding is not accompanied by increased use of modern contraceptive methods. It is known widely that breastfeeding helps to postpone the next pregnancy, practices and beliefs vary by region and ethnic group. For a long time, the World Health Organization Special Program of Research, Development and Research Training in Human Reproduction has been involved in the study of natural methods of fertility regulation, and it is important that WHO continues to study breastfeeding in different ethnic and social group if it intends to give sound advice on this issue to family planning programs.
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  2. 2
    027019

    World Health Day 1984. Children's health--tomorrow's wealth.

    Mahler H

    Who Chronicle. 1984; 38(3):109-15.

    The theme of the 1984 World Health Day--children's health, tomorrow's wealth--provides an occasion to convey to a worldwide audience the message that children are a priceless resource, and that any nation which neglects them does so at its peril. World Health Day 1984 spotlights the basic truth that the healthy minds and bodies of the world's children must be safeguard, not only as a key factor in attaining health for all by 2000, but also as a major part of each nation's health in the 21st century. An investment in child health is a direct entry point to improved social development, productivity, and quality of life. Care of child health starts before conception, through postponement of the 1st pregnancy until the mother herself has reached full physical maturity, and through spacing of births. It continues from conception on, through suitable care during pregnancy, childbirth, and childhood. In the developing countries the child must be protected by all available means, particularly from the killer diseases. What happens in the immediate family and community around the mother and child, and even far away in the world, can have a direct impact on the health and security of both of them. The mother and child need to be placed in an environment that will ensure their health by protecting the overall setting in which they live. This means providing clean water, disposing of waste, and helping to improve shelter. Nothing can diminish the importance of good food, enough food, and proper nutrition for children and their mothers. Beyond the immediate physical needs are the equally important needs for love and understanding which stimulate the healthy development of the child. The emergence of new health problems of mothers and children in developing and developed countries should be kept in mind. Better health services must be made available to all who need them. The World Health Organization (WHO) provided resource material on World Health Day issues for dissemination throughout the world. Extracts from 4 articles on this year's theme are reproduced. The articles report on the success of the Rural Health Center in Ballabhgarh (India) in reducing maternal and infant mortality, the value of breastfeeding as 1 of the simplest and safest ways of ensuring adequate spacing of births, Tunisia's integration of a program of immunization into the routine activities of the health care system, and the needs of the healthy child.
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  3. 3
    020489

    Breast feeding: fertility and contraception.

    Kleinman RL; Senanayake P

    London, International Planned Parenthood Federation, 1984. 43 p. (IPPF Medical Publications)

    This booklet, for health care workers in developing countries, reviews the fertility-controlling effects of breastfeeding, its strengths and limitations as an element in family planning, and how to provide modern methods of contraception to lactating women. Breastfeeding currently provides about 30% more protection against pregnancy in developing countries than all of the organized family planning programs. The recent trend toward a falling off in the practice of breastfeeding poses a threat to infant welfare and a danger of increased fertility. Health workers are urged to reach pregnant women in the community with knowledge about the value of breastfeeding versus bottle feeding. Each country must set its own policies concerning contraception for lactating women. It is preferable for lactating women to use nonhormonal methods, but if selected, they should not be used too early. Lowest-dose preparations, especially progestogen-only pills, are preferable. Determination of when to start contraception during lactation should be based on breastfeeding patterns in the community, the age at which supplementary foods are introduced, usual birth spacing intervals, and the mean duration of lactation amenorrhea. If the usual time of resumption of menstruation in a given community is known, a rough guide to the optimal time for starting contraception is returning menstruation minus 2 months.
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  4. 4
    798483

    IPPF perspectives.

    Sai FT

    In: Jelliffe DB, Jelliffe EF, Sai FT, Senanayake P, eds. Lactation, fertility and the working woman. London, International Planned Parenthood Federation, 1979. 7-9.

    The principal objective of the International Planned Parenthood Federation (IPPF) -- an international federation of 95 voluntary national family planning associations with operations in 110 countries -- is to enable people to practice responsible parenthood as a matter of human right, family welfare, and the well-being of the community. A second IPPF objective is to increase understanding on the part of people and governments of the demographic problems existing in their communities and the world. In the area of lactation the IPPF has had several activities in the past few years. 1 activity was a Biological Sciences Workshop on Lactation and Contraception in November 1976. A 2nd activity is a study on breastfeeding being conducted in collaboration with the World Health Organization (WHO). The Central Medical Committee of the IPPF passed a resolution early in 1976 which states that lactation is a good thing in itself, that breastfeeding is the best way of feeding an infant in the early months, if not the early years of its life, and that breastfeeding is a good contraceptive in its own right. A definite advantage of breastfeeding is that there is more avoidance of pregnancy and more protection of women from unwanted pregnancy by breastfeeding than by all combined scientific technology in family planning based programs. Some of the problems of breastfeeding and outside work relate to sheer expense, both in a positive and negative sense. There is also the question of inconvenience of breastfeeding. 1 approach to the disadvantages has been prolonged maternity leave with pay. Another approach is causing the child to invert its feeding rhythm.
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