Natural Family Planning International

Within the current NFP Movement, more attention needs to be paid to the value of menstruation (or menses) as a marker of fertility and infertility among mothers who are breastfeeding. While this is very important among mothers doing Ecological Breastfeeding, it is also significant for all breastfeeding mothers.

There are two studies at our website that looked at the relative infertility of the time before a breastfeeding mother’s first postpartum period.  In 1895, Dr. Leonard Remfry found that only five percent of breastfeeding mothers became pregnant before their first period. In 1971, Dr. Konald A. Prem, working with La Leche League breastfeeding mothers, found that six percent of these mothers became pregnant before their first period. (Since today’s fertility awareness was unknown in Dr. Remfry’s time and not widely practiced in Dr. Prem’s time, I assume that the women in these studies did not practice fertility-based periodic abstinence from the marriage act.) To put that in terms of current “effectiveness” terminology, that means that breastfeeding-in-general has a typical-use delayed fertility effectiveness of 94% prior to the first postpartum menstruation. That compares favorably with the typical-use rate of today’s common forms of fertility awareness.

What are recognized fertility awareness methods? Two Day Method, Standards Days Method, rhythm, monitoring devices, mucus, temperature, and cervix. Sometimes the Lactational Amenorrhea Method is included. But ecological breastfeeding is ignored and so is menstruation.

With contemporary Western cultural breastfeeding, the first menstruation will occur very early, sometimes within a few weeks postpartum. The situation is significantly different among mothers following the Seven Standards of Ecological Breastfeeding.  Our research found that these mothers will experience an average of 14.5 months of breastfeeding amenorrhea with a range of both shorter and longer durations.  Two recent breastfeeding surveys illustrate this well. An Italian mother experienced 37 months of postpartum breastfeeding amenorrhea, and a French mother went 16 months with breastfeeding amenorrhea. The Italian experience is at the far end of the spectrum of duration; the French experience is just a month more than the average. In both cases, the mothers regarded this first period as a sign that fertility was returning

In a regular cycle, menstruation is usually a sign of infertility and fertility. At the end of a cycle a woman can be infertile up until the heavy flow ends. Once menstruation lightens, we know fertility will return sometime in the near future of that cycle..

The bottom line is this: Relying solely on the first postpartum menstruation as a sign of returning fertility is a Fertility Awareness Based Method of Natural Family Planning. By “solely” I mean that the couple is not practicing fertility-awareness-based abstinence or any form of contraception. This has almost no significance for mothers doing Western cultural breastfeeding because fertility returns so soon. However, for couples doing Ecological Breastfeeding, this abstinence-free type of Natural Family Planning can be significant.

All couples have a right to learn these things. It is a basic principle of psychology that a person is not free to make a choice for something good unless he knows what it is. That’s why I think the Church should make sure that all engaged and married couples learn the Seven Standards of Ecological Breastfeeding. That choice should be theirs, not that of a bureaucracy.

For the eco-breastfeeding mother, the long absence of menstruation is a sign of infertility and the return of menstruation can be a sign of returning fertility. In this sense, menstruation is a fertility awareness-based method.
Sheila Kippley
The Seven Standards of Ecological Breastfeeding: The Frequency Factor
All studies mentioned in this blog can be found at the NFPI website.