Can postpartum contraception do more to support breastfeeding? [Full text of letter to Journal of Family Planning and Reproductive Healthcare]
As mentioned in the above post, I wrote this letter with Emma Pickett after reading this research about how to improve postnatal contraception. The full text is here, in case the other link doesn't work:
Reading this book made me realise how lucky I was with my breastfeeding experience. Thanks to absorbing information from friends and ante-natal classes, I expected breastfeeding to be a doddle and it was. Time-consuming but a doddle. There's worse things than having to sit around for hours at a time with a baby attached to your boob.
Unfortunately, not everyone has it so easy. We might be designed to breastfeed but we are also from the generation that was most likely to be fed formula ourselves. What was once routine can now seem mysterious and intimidating.
We hear the glib message “breast is best” but that doesn’t always help. "Best" is all very well but who achieves that? Women need support not just slogans. That's what this book is all about.
BPAS kindly nominated me a Champion of Choice for my fertility awareness work so I wrote this:
Fertility awareness (natural family planning) is not a contraceptive choice for the faint-hearted.
This isn’t because the method is difficult or ineffective. You need to know what you’re doing, and you need to be able to handle your fertile time, but it’s not rocket science.
The hardest part is probably telling your doctor (and your friends) that you’re relying on it to avoid pregnancy.
I’ve heard reports of eye-rolling and angry sighs from some doctors, or more dramatically “Well, don’t come back to me if you need an abortion”. [Not all doctors are like this, mine was lovely]
Funny, clear and wonderfully well made, this film has a freshness and honesty that makes it compelling viewing whether you’re new to fertility awareness as contraception or you've been using it for years.
The tone is steady, measured and not overly evangelical, which I found a relief. I love fertility awareness but I don't want anyone to feel like they don't have options.
Those interviewed talk briefly about how profit affects healthcare but this doesn’t overwhelm the main messages, and the film is sympathetic to healthcare providers wanting to do the right thing by their patients.
That said, there’s a few things it's worth knowing:
One of the first things you’ll be asked if you're choosing contraception is whether you’d like to have periods.
Many methods of contraception have "no periods"* as a selling point - even the pill can be taken more or less continuously, with just a few pill free days every so often to stop irregular bleeding.
If you’re using fertility awareness as contraception there isn't a "no periods"
It was the 1995 pill scare that got me thinking about my contraception. The "scare" meant that women had died.
I’d automatically chosen the pill, like millions of women, and I was fortunate enough to get on with it perfectly well.
I would have continued with it, despite the slightly increased risk, but then a friend suggested fertility awareness as contraception.
I thought it sounded a bit fringe, not like a serious method at all.
It also felt irresponsible. We were both working in the NHS, in public health, we knew how risk worked. Shouldn't we "walk the talk"?
If you want to get pregnant, the NICE Fertility guidance recommends that you have vaginal sexual intercourse every 2 to 3 days.
For many this is great news. At last – freedom from contraception! Woo Hoo!
Others will find that their hearts sink.
Maybe you don’t have sex that often (which is fine - you're not alone*), or your patience is limited, or you have a slightly more varied approach to sex (which is fine as well - just so long as everyone is happy).
If that any of that sounds like you, then you might benefit from having some
Fertility awareness (natural family planning) practitioner and advocate working in London. Wants to see fertility awareness become a routine contraceptive option, not the only option. read more...
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