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授乳期間, 産後武月經 및 避姙實施와의 相關에 對한 硏究

A Study on the Relationships of Breastfeeding, Postpartum Amenorrhea and Contraceptive Practice in an Urban Area

공중보건잡지 1972년 9권 2호 p.425 ~ 440
조희숙,
소속 상세정보
조희숙 (  ) - 서울대학교 보건대학원

Abstract


This survey was conducted by the 20 interviewers for 2 months, from July 1 to August 31, 1972, aimed at grasping the relationships of breastfeeding and postpartum amenorrhea of women, who were residing in Hoigi and Limum Dong, Dongdaimun Gu, Seoul City.
The interviewers visited the 593 women, who have last live-births aged within 8 years, with the questionnair (about Lactation, Postpartum Amunorrhea, and Contraceptive Practice). Major findings from this study can be summarized as ofllows;
1. Basic Characteristics of Women:
1) Age; The 35.9 percent of the women were 30 to 34 of age as the most proportion. The average age at interview is 31.0 years.
2) Education; The women´s educational level was higher than Korea´s National averages for married females. The 36.1 percent of the women graduated the high school as the most proportion
3) Age at marriage; Women in the study area were found to be marrying at the average age of 23.0 years. The majority of women (62.7 percent) are 20 to 24 of age.
4) Duration of marital lives; The average duration of marital lives is 7.9 years. The 32.2 percent of the women is 5 to 9 years as the most proportion.
5) Frequency of Pregnancies; The average frequency of pregnancies is 2.5. The 30.7 percent of the women had two pregnancies as the most proportion.
2. Basic Characteristics of Last Live-Births in Relation to Breastfeeding, Weaning and Delivery Environments:
1) Age of last live-Birth at interview; The average age of months at interview is 22.4 months. As the most proportion, the 29.2 percent of last live-births are longer than 37 months of age.
2) Experience of breastfeeding; Those who has no experience of live births rated 8.3 percent and those who had experience rated 91.7 percent of all 544 women. About the reason of abscence of breastfeeding experience, the 38.6 percent of women as the most proportion, spoke "because insufficient milk."
3) Duration fo lactation; The women who had breastfed and weaned are the majority (63.1 percent) of all 544.
The women who have still lactation at interview are 28.6 percent. And the women who have nave never breastfed are 8.26 percent.
As the most proportion, the 31 percent of women who had breastfed and weaned had 10 to 12 months of lactation. The average duration of Lactation is 10.6 months.
4) Delivery place; The majority (57 percent) of the women delivered at Ob-Gyn´s clinic. And the 31.5 percent are home deliveries, the 7.6 percent are delivered by Ob-Gyn doctor. The midwife rated 3.9 percent.
5) Delivery attendant; In the case of Homedelivery, supervised home delivery (by Ob-Gyn. local doctor, midwife) rated 29 percent, and unsupervised home delivery (by mother, mother in-law, relatives, herself etc.) rated 71 percent of all 187 women.
3. Average Periods of Lactation and Postpartum Amenorrhea for Mothers Classified by Whether (a) Breastfed last child (b) Had weaned child by Interview Date:
1) The average period of lactation for mothers who had breastfed and weaned is 10.6 months, and for mothers who still breastfeeding is 9.3 months.
2) The average duration of amenorrhea for mothers who had breastfed and weaned is 9 months, and for mothers who still breastfeeding is 5.9 months.
4. Conditional Monthly Probabilities of Terminating Lactation, Resuming Menstruation, and Practicing Contraception by Months Since Last Live-Birth (By Life Talbe Method):
Conditional monthly probabilities of terminating lactation by sixth month since last live-birth is 5 percent. And that by 7-11th months is 7-8 percent. Conditional monthly probabilities of resuming menstruation by first month since last live-birth is 7 percent. And thereafter the probabilities are irregular. The majority (6-11th months) is 6-10 percent showing wide breadth probabilities of resuming menstruation. The breadth of the conditional monthly probabilities of practicing contraception is 3-7 percent.
5. Cumulative Rates of Terminating Lactation, Resuming Menstruation and Puacticing Contraception at the End of Successive Months:
The cumulative rates of terminating lactation of women(excludes the women who did not breastfeed their last child) at the end of sixth month is 85.3 percent, and 32.4 percent at the end of 12th month, and 4.2 percent at the end of 18th month. At the end of 12th month, the majority is terminated lactation within the 18th month. On the other hand, the cumulative rates of terminating lactation of the women (includes women who did not breastfeed from the beginning) at the end of 6th month is 60 percent, and 3 percent at the end of 12th month. Therefore, the majority of women is terminated within 12th month.
The cumulative rates of resuming menstruation at the end of 6th month es 45.9 percent, and 81.2 percent at the end of 12th month. That is, the majority was resumed menstruation within 1 year since last live-birth.
The cumulative rate of practicing contraception at the end of 6th month is 29.5 percent, and 53.7 percent at the end of 12th month. Therefore, the cumulative rates of practicing contraception are the half of the resuming menstruation.
6. Cumulatative Rates of Resuming Menstruation by Duration of Lactation;
The 86.5 percent of the women who did not breastfeed from the beginning is resumed menstruation at 3rd month since last live-birth, and 98 percent resumed at 12th month.
The rates of resuming menstruation of the women who were terminated lactation at interview (by duration of the lactation) are as follows. The rates of resuming menstruation of the women who were breastfeeding during 1-6 months is 53.1 percent at the 3rd month since last live-birth, 97.1 percent resumed at 12th months
In the women who were breastfeeding during 7-12 months, the 23.2 percent of women resumed menstruation at the 3rd month since last live-birth, and 89.3 percent resumed at 12th month. The rates of resuming menstruation of the women who were terminated lactation at interview are 79.6 percent at the 12th month since last live-birth, and 95.1 percent terminated at the 18th month respectively. The rates of resuming menstruation of all women are 45.9 percent at the 6th month since last live-birth, and 81.2 percent at 12th month, and 95,2 percent resumed at 18th month.
7. The Rates of Resuming Menstruation by Duration of Lactation:
In the women who did not breastfeed from the beginning, the 63 percent was resumed menstration within 3 months, and 87 percent was resumed within 12 months. On the other hand, in the women who were terminated breastfeeding, the longer the duration of lactation, the longer the duration of amenorrhea.
The average duration of amenorrhea by duration of lactation is as follows.
The average duration of the women who did not breastfeed is 3.5 months.
The womes who were breastfeeding during 6 months have 5.5 months of amenorrhea.
And women who were breastfeeding during 12 months have 9.3 months of amenorrhea.
The average duration of amenorrhea of women is 9 months.
Therefore, we can know following. If the women breastfeed 1 month increased, the average duration of amenorrhea is increased 2 weeks.
8. The Influences of Average Period in the Months of Lactation and Postpartum Amenorrhea by Age, Education and Parity of Women:
1) The duration of Lactation.
a) Age: The average duration of lactation of women under 24 years old is 9.8 months.
The duration of women above 35 years old is 11.2 months. The more age of women, the longer the duration of lactation.
b) Education; The duration of lactation of the women who graduated primary school is 12.7 months, and the duration of women who graduated college is 8.8 months. The higher the level of education, the shorter the period of lactation.
c) Birth order; The average duration of lactation of the women who have first birth order is 9.9 months. In the women above 5th birth order, the duration of lactation is 13.7 months.
The more the birth order, the longer duration of the lactation.
2) The Duration of Amenorrhea and Lactation;
a) Age; For those who had no experience of breastfeeding, the duration of amenorrhea is 3.5 months.
For those who had breastfed and weaned, the more age of women, the longer duration of amenorrhea.
b) Education; For those who had breastfed and weaned, the higher the level of education, the shorter the duration of amenorrhea.
c) Birth order; For those who breastfed and weaned, the more the birth order, the longer the period of amenorrhea.
9. Proprotion of Contraceptive Practice and Resuming Menstruation by Number of Months:
The 50 percent of women who resumed menstruation practiced contraception. The practice rate before resumed menstruation is 9 percent, at the same month which menstruation was resumed is 67 percent, and after resumed menstruateon is 24 percent.
Therefore, the majority of women practiced contraception at the same month which menstruation was resumed.
The contraception method of postpartum period is as follows. The 35.5 percent of contraceptive method is oral pill as the most proportion. The loop is 18.2 percent, condom is 18.6 percent, the rhythm is 24.0 percent, and the surgical operation is 2.9 percent.

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