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Discussing: Nursing and Contraception

Nursing and Contraception

Tossing this one out before I get to the point in my story where I'll need it. It is "general knowledge" that breastfeeding an infant prevents the mother from becoming pregnant again right away - is that so? 1. Is this true for all/the majority of women? 2. Why does this happen? I'm assuming some kind of hormonalswitch does/does not get flipped. 3. How long does this protection last? Does it only last for a few months? For as long as the child nurses? 4. How reliable is it? Slightly further afield, *besides abstinence*, what would/could be used for contraception in a pre-pill society? Intestines as condoms might be used at certain times, but they would be limited by, ahem, freshness concerns, I would think. Most fanfic stories have the female in question drinking a magical "tea" that keeps her from becoming pregnant. What herbs/plants/substances might actually be ingested? With what effect? So, given the amount of general nookie to be found in fanfic, what can our heor s and heroines do for some Middle-earth family planning? Toodles - Ang



Re: Nursing and Contraception

I think breastfeeding prevents ovulation in some women. There's a good study here that says it's as safe as mechanical contraception as long as it's the first six months and periods haven't recommenced. More information here.

The obvious problem would be the fact it doesn't work for every woman, and some women experience a lack of sexdrive after giving birth - so they might not be interested in sex at all, not to mention it might actually be painful for the first few months after birth. And the six-month rule means that babies may be born 15 months apart - I think that'd be very taxing on a woman's body.

This book review notes some medieval contraception methods, including which plants were used for the purpose - interesting stuff.

From my own research about medieval Japan, courtesans had tried-and-true herbal concoctions for abortion; it helped that according to their religious beliefs a baby didn't receive its soul until after birth. ISTR to recall that a possible side-effect would be for the woman to become permanently barren - a problem to them, since most dreamed of becoming a powerful lord's consort and bearing him children, who would then belong to their father's higher social class.



Re: Nursing and Contraception

1. Is this true for all/the majority of women?

2. Why does this happen? I'm assuming some kind of hormonalswitch does/does not get flipped.
3. How long does this protection last? Does it only last for a few months? For as long as the child nurses?
4. How reliable is it?

Expanding a little on what Beth wrote, breastfeeding is considered 98% effective in the first 6 months if these conditions are met:
Minimal or no supplemental feedings (Intervals between feedings should not exceed 4 hours during the day or 6 hours at night)
The child is less than six months old
The mother's periods have not returned

It is hormonal, production of certain hormones is affected by the infant's suckling, specifically the stimulation of the nipple.

After six months the pregnancy rate rises, in one study 7% after 12 months and 13% after 24 months.

Other methods:
Intestines were used, one interesting quote I saw - "As recently as the 1940s and 50s, animal membrane condoms were washed, covered in petroleum jelly, and kept in little wooden boxes next to the marital bed, ready for re-use."
My knowledge of herbs is limited, but I believe the historically used herbs most likely to be available in that climate would be pennyroyal, rue, and queen anne's lace.




Re: Nursing and Contraception

It is "general knowledge" that breastfeeding an infant prevents the mother from becoming pregnant again right away - is that so?

And just remember that breastfeeding has its side effects. If you are going to have your couples use it as a contraception method, don't forget that stimulation is the key to the milk 'let down' response. There *will* be milk during the nookie bits. Depending on how recently the baby has nursed, and what the mother's production rate is up to, it will seep, drip or spurt. Also, according to my husband, tastes good.

Been there, done that.

Just to show how unreliable and unpredictable bodies can be, I went 15 glorious months 'unfertile' with my first baby who was a determined nurser, but only 9 months with the second who was a lot more lackadaisical about the whole process. So if I had been counting on breastfeeding to protect me as long with my second as with my first, it would not have worked.



Re: Nursing and Contraception

It is "general knowledge" that breastfeeding an infant prevents the mother from becoming pregnant again right away - is that so?
I can only tell you my own experience. I was still nursing my first son when I got pregnant with the second. I had had a dificult time conceiving and maintaining that earlier pregnancy, so I didn't think it would happen again so quickly - or easily. Of course he was amost fifteen months old and not nursing as frequently when this happened, so changes in the hormone levels could have something to do with it.
It seems likely that women in M-e would continue nursing well into the second year if they follow the general pattern of pre-industrial societies. But as my experience shows, that's no guarantee that conception won't occur.
~Nessime *still quite happy with the surprise second son*



Re: Nursing and Contraception

And breastfeeding can be extremely unreliable as a contraceptive - I had a friend at school who had just an eleven month gap to her younger brother because her mother assumed breastfeeding would be an effective contraceptive (ie she got pregnant within two months of the first birth). As an aside, I believe pennyroyal was used to induce abortions at a later stage (ie it works like a "morning after pill" rather that makes the uterus unreceptive rather than a hormonally based contraceptive pill that prevents ovulation). Cheers, Liz



Re: Nursing and Contraception

Llylyn's information is the same as I have. The most important factor is how frequently the baby nurses. The hormone responsible for surpressing ovulation is prolactin, which is produced when the breasts are stimulated by the baby nursing, but the high levels only last an hour or two. Frequent nursing day and night is the most likely to produce the high prolactin levels that surpress ovulation.

Another effect breastfeeding has that can prevent pregnancy, is that for the first few cycles after menses return, the luteal phase, the time between ovulation and period, tends to be shortened, often to less than the ten days or so needed to give the fertilized egg a chance to implant.

Women's bodies are highly, highly variable in this, however. I belong to a group of moms who practice this kind of nursing, and we have had periods/fertility return as early a a couple months and as late as two plus years. If relying on breastfeeding for contraception, it is important to watch other fertility signs, like the production of cervical fluid, to know when your fertility is returning.

LAM (lactational amenorhea method) is considered about 98% effective (comparable to birth control pills) in the first six months IF periods have not yet returned. In that time frame it is most likely that you will have a period before you ovulate. After that time, the likelyhood of ovulation preceeding the first period increases, though for the baby's second six months, if periods still haven't returned, the protection is still pretty good, comparable to condoms.

I only was aware of this with my third child. He was concieved while I was still nursing my second. We started trying when she was about two years, three months (before that I had been taking the progesterone-only pill). I was having regular cycles but short luteal phases, and it took us about six months of trying to get pregnant. With my third, even though I was tandem nursing both of them and sleeping with the baby, both of them were night sleepers and there was regularly a six hour period at night when neither of them would nurse - not every night, but often enough that I didn't feel secure relying on LAM, so we used condoms as a back up (successfully) for more than two years until my husband had a vasectomy. But my periods didn't come back until he was 23 months old.

And it is very typical for women to have low to no libido during at least the early stages of breastfeeding. And as for the leaking milk, that's also very typical though not universal - I never had that happen, though I expected it.

For more information, the books "Breastfeeding and Natural Child Spacing," and "Taking Control of Your Fertility" are very good.

As for birth control methods, I'm not aware of herbs that will supress ovulation. I believe progesterone is found in wild yam, although I think it has to go through some sort of processing to be available to the body, and I don't know if that is something that could be done pre-industrially. But if it could, theoretically that could supress ovulation, the same way the progesterone-only pill does.

Barrier methods - I think I've read of sea sponges being used in ancient Egypt.

Fertility awareness involves monitoring both cervical fluid, which could be done in any time, and temperature, which requires very sensitive thermometers not available pre-industirally. Just using cervical fluid can be quite reliable in many women. It's called the Billingsly Method. Basically, cervical fluid is neccessary for the sperm to live in the vagina and travel into the uterus. Right after a woman's period, she tends to have no or very small amounts of cervical fluid. As she approaches ovulation, the amount increases and the consistency changes from sticky to creamy to the texture of egg-whites, which is the most fertile. Sperm can live up to five days in egg-white cervical fluid, so you can get pregnant from sex up to five days before you ovulate. Cervical fluid is at a maximum at ovulation. The egg lives for about 24 hours after ovulation, then leaves the body. The cervical fluid goes away, and the woman is infertile until her next ovulation. About two weeks after ovulation, she has her period, and the cycle starts over. By watching the cervical fluid and abstaining on days when fertile-type fluid is present, pregnancy can be avoided. I think the effectivess of looking at cervical fluid alone is in the 80-90% range.

It would be entirely possible to use this method in ME, but it takes a fairly sophisticated knowledge of exactly how fertility works to come up with it in the first place. So it wouldn't be very believable in the context of the culture.

Herbs for abortion would probably be used. In addition to the ones above, I've heard of ginger in large quantities being used. I think "A Wise Woman's Herbal for the Childbearing Year" has more information on those.

Here's a great link to a woman who's done lots of research in cross-cultural breastfeeding and parenting practices, Kathy Dettwyler:
She's got an article on "Breastfeeing and Fertility."

Hope this helps, and if you've got any more questions, I love to talk about this stuff.




Re: Nursing and Contraception

Disclaimer: I've never been pregnant and am simply on The Pill, so I have no firsthand knowledge.
I also have read about Natural Family Planning and all that-- I don't think it would be unreasonable for wise women to know a great deal about a woman's cycle, and so it would be believable for a woman to have been taught to know when she's fertile or not. Pre-industrial medicine was far more sophisticated than we give credit for-- they believed strange, strange things, but they did get an awful lot right without having any of our modern conveniences.

Another method which I know was in wide usage during the pre-industrial period in the early United States was a method called coitus interruptus-- nowadays known as the withdrawal method. No, it is not 100% safe and effective and I know people who've gotten pregnant using it (c'mon, a condom is like a buck, people, sheesh), but it's a lot better than nothing, Simply put, the man withdraws from the woman before his climax. Semen is often discharged before climax in small amounts, and so the method is not foolproof. But if it is practiced habitually, the frequency of pregnancies goes way down.
Believe it or not, I first saw that mentioned in my high school social studies textbook. Don't ask me why.

And in pre-industrial societies, a woman will nurse a baby up to 4 years in some cases. This is at-will nursing-- i.e. the baby doesn't have regular feedings, but is kept close to the mother and given the breast whenever it wants it. So the baby will naturally feed frequently and in smallish amounts, ensuring that the mother's body darn well knows she's still nursing.

But, that's been covered better by others, and better!

Longer nursing times are customary because food quality for infants is low-- there isn't formula, and animal milk may not be available.



Re: Nursing and Contraception

Yowza! What a *great* collection of information, one that would definitely be useful to any number of writers. Thank you all! Hmm, am I smelling a research article in this? Toodles - Ang



Re: Nursing and Contraception

Hmm, am I smelling a research article in this?
There's certainly a couple of worthy candidates for the job.



Re: Nursing and Contraception

Another herb used to induce miscarriage (if I remember correctly) is tansy. And there was a practice in rural England of women inserting small plugs of green elm into their vaginas, which would swell up & form a barrier.




Re: Nursing and Contraception

Ang, I know this isn't exactly what you were asking, but since it relates to breastfeeding (specifically nursing and nutrition), I thought I'd toss it into the general pool of information. And this way I'll know where to look for this link when I need it myself. ~Nessime



Re: Nursing and Contraception

I don't know a great deal about contraceptive herbs off the top of my head, but I can suggest a couple of books on historical contraception and abortion that might be helpful. Both are by John M. Riddle; one is Contraception and abortion from the ancient world to the Renaissance (1992), and the other is Eve's herbs : a history of contraception and abortion in the West (1997). Depending on the social class of the characters in question, there is also the possibility of reduced fertility due to poor nutrition - but if you're talking nobility of Gondor, that wouldn't be likely to apply! Cel



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