DOCTOR: Assalaam alaykum Ummu Fulaan, how are you today? Awww! Fulaan is such a chubby boy now!

UMM FULAAN: I’m not fine doc. I think I’m pregnant. My baby is just 5 months old, I’m not ready for another pregnancy now. Please help me get rid of it…

DOCTOR: Calm down Ummu. Have you done pregnancy test?

UMM FULAAN: No. I haven’t. But I just know…

DOCTOR: When was your last period?

UMM FULAAN: I haven’t had any menses since the birth of my baby. The nifaas ended about 40 days after delivery. Since then, we have been using withdrawal method, but I doubt that it was effective. I’m very sure I’m pregnant…

DOCTOR: OK. Before we continue, let me ask, are you breastfeeding?

UMM FULAAN: Yes doctor. Exclusively as we were taught by the midwives.

DOCTOR: That’s good to hear. So, most likely, it is lactational amenorrhea (LAM)

UMM FULAAN: What’s LAM? The midwives didn’t mention that.

DOCTOR: LAM means that as long as you are exclusively breastfeeding your baby, you will not menstruate, nor conceive in the first 6 months. This is a form of natural contraception and it more than 90% effective.

UMM FULAAN: Wait I don’t understand…

DOCTOR: See, Allaah (سبحانه وتعالى ) has made it easy for women to rest naturally after giving birth to a baby. The same hormone (called prolactin) that is responsible for milk production, is also responsible for blocking the menstrual cycle. So, if you breastfeed exclusively, you will not ovulate, let alone get pregnant in the first 6 months. This contraceptive effect is sometimes extended for up to 1 year, even after your baby starts eating adult food. Are you getting my point?

UMM FULAAN – Na’am. SubhaanaLlaah! That’s interesting.

DOCTOR – In fact, some women do not even get any menses until they wean their babies off breastfeeding completely. It’s just that women are so obsessed with their menses, they start to freak out when it’s missing for so long!

UMM FULAAN – Hahaha… exactly doc. I want to see my menses jare. It’s a reassuring sign that I am still a “normal woman”. Lol

DOCTOR – Smiles… don’t worry Ummu. Your menses will come when the hormonal environment is right.

UMM FULAAN – But how will I know if truly I’m not pregnant?

DOCTOR – Na’am. That’s simple. We will carry out a pregnancy test on your urine or blood samples….. (a moment later)…. You see?! It’s negative!

UMM FULAAN – Phew! AlhamduliLlaah. Thanks doc. You’re the best.

DOCTOR – You’re welcome Ummu. Like I said, the effectiveness of LAM is about 90% in the first half year. This begins to fall after your baby starts taking supplementary foods. You may wish to consider other more reliable family planning methods if you’re not mentally ready for another baby. Unfortunately, withdrawal method isn’t that reliable either.

UMM FULAAN – Hmmm.. I’ll discuss with my husband and get back to you. We once discussed the options with a midwife but we couldn’t decide. Thanks so much. JazaakiLlaahu khairan.

DOCTOR – Alright, let me know when you decide, then I can book your appointment with the family planning clinic…



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