UCSF

INTRODUCTION:: Lactational amenorrhea method (LAM) is a temporary postpartum contraceptive method that is typically more effective than use of condoms or birth control pills. However, this method may be underutilized due to incomplete knowledge. METHODS:: To assess perceptions of the effectiveness of LAM compared to other postpartum contraceptives in 2021, we used social media to recruit US-born nulliparous pregnant women carrying a singleton pregnancy of 28+ weeks’ gestation. Participants were compensated a $20 gift card for completing an online survey. Institutional review board (IRB) approval was obtained. RESULTS:: Of 152 respondents, 76% were college-educated, 90% wanted to breastfeed, and 7% indicated they planned to rely on LAM as their sole method of contraception in the first 6 months postpartum. However, less than half (48%) were aware that breastfeeding would delay the return of menses after the baby is born, and only 47% believed exclusive breastfeeding reduces the chance of pregnancy within 6 months of delivery. Only 9% (95% CI 5%-14%) knew breastfeeding prevents pregnancy when their infant is exclusively breastfed, while 27% (95% CI 20%-35%) knew breastfeeding only protects mothers from pregnancy until menstrual periods have returned. No respondents indicated that exclusive breastfeeding is typically more effective than condoms and only 2% (0%-6%) indicated that exclusive breastfeeding is typically more effective than birth control pills. CONCLUSION:: Few US pregnant women are aware of LAM criteria or the effectiveness of LAM compared with other postpartum contraceptive options, suggesting that patients may be receiving incomplete counseling from their health care providers regarding their options for postpartum contraception.