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Lactational Amenorrhea Method
Average Failure Rate: 6%

Even today, breastfeeding prevents more pregnancies in the world than all other methods of birth control combined. Utilizing what is known about the endocrine system and patterns of fertility in nursing women, a highly effective, temporary method of contraception has been developed called the Lactational Amenorrhea Method (LAM). It can be used as long as a women nurses her baby frequently and has no periods.

Among breastfeeding women, menstruation will usually not occur for several months after the birth of a child. In fact, most breastfeeding women do not ovulate for four to 24 months after delivery, whereas non-breastfeeding women can ovulate as early as one or two months after delivery. The hormone that stimulates milk production decreases the hormone necessary for maintaining the menstrual cycle.

For breastfeeding to act as an effective contraceptive, a woman must nurse ten or more times throughout the day and introduce no other foods into her baby's diet. Because babies need extra food at about six months, it is not recommended that this method be used beyond that time. Although nursing can act as a contraceptive for as long as three years, it will not postpone menstruation indefinitely. Many breastfeeding women will not ovulate until after the first period, but the longer LAM is used, the more likely it is that ovulation will precede the first menses. Cervical mucus changes will herald the first ovulation; a woman should start checking daily at six weeks postpartum. Pregnant women and new mothers should confer with a trained counselor before initiating LAM. Women with no periods who breastfeed without practicing LAM, have a pregnancy rate of 6% over a year. Perfect users can expect a failure rate of only 0.5%.

Electronic Fertility Computers

One new method of birth control is a small electronic fertility computer, marketed under the name Persona, which tells a woman which days she is fertile. Fertile days are indicated with a red light and infertile days with a green light. If the light is yellow, the woman takes a urine test which changes the light to green or red, based on the amount of hormone found in the urine. This method is now available in Europe and Canada, where manufacturers boast a failure rate as low as 6% among women who abstain on fertile days as indicated by the device. Clinical trials are now being conducted to obtain FDA approval, but such devices are currently not on the market in the United States. One advantage of this method is that charting body signs is not necessary. Disadvantages include the expense of the computer and the need to purchase urine test sticks for use eight days out of each cycle. Additionally, this method is currently only being recommended for women whose cycles are between 23 and 35 days.

Other models measure and store basal temperature readings, like the LadyComp and BioSelf models pictured on the right. The LadyComp device can be used by women with longer or irregular cycles, such as those experienced postpartum.

Persona Fertility Computer

LadyComp and BioSelf

Average Failure Rate: 19%

Withdrawal, also known as coitus interruptus, has long been used for contraception as a natural response to the discovery that ejaculation into the vagina causes pregnancy. It requires no devices, involves no chemicals, and is available in any situation at no cost. Withdrawal is accomplished when, during intercourse, the man pulls out his penis just before ejaculation. This requires much discipline. As orgasm is impending, a man may not withdraw in enough time to prevent semen from escaping into the vagina. Although withdrawal has no known side effects, interruption of the sexual response cycle can greatly diminish the pleasure of a couple. Some couples, however, have worked out these problems and use withdrawal successfully.

Withdrawal is most popular among teens, the age group for which this method is also least effective. Withdrawal requires self-control and practice, which teens are generally lacking, resulting in an increased failure rate. Furthermore this method offers little protection from STDs. Lubricating fluids escape long before ejaculation; usually they contain no sperm but can transmit diseases like the AIDS virus.

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