Return of Menstruation and Perceived Risk of Pregnancy among Exclusive Breastfeeding Women in South West Nigeria: Implications for Timely Introduction of Active Contraception

Download Article

DOI: 10.21522/TIJMD.2013.SE.19.02.Art001

Authors : Ernest Orji, Kolade Afolabi, K. A., Oluwabukunmi Afolabi, A. O. Ayotunde Titilayo, Omotade Ijarotimi


This study was conducted among 500 exclusively breast-feeding women in Ife Central Local Government Area, Osun State, Nigeria. The objectives of the study are to assess the pattern of resumption of menstruation, identify the determinants of variations in the resumption of menstruation and determine the proportion of women at risk of pregnancy. Quantitative data was collected using semi- structured interviewer administered questionnaire. Data entry and analysis was done using SPSS (version 20). Univariate, bivariate and multivariate analyses done. Chi-Square were used where appropriate. P value was set at < 0.05 Four sessions of Focus Group Discussion were held. Results showed that 50 % were sexually active 125 (25%) were using Modern Contraceptive which included Condom (75); IUCD (25); Injectables (25); Implanon (10). Majority relied on Lactational amenorrhea method 375 (75%). Unplanned Pregnancy occurred among those 4 women not on contraception. Three-quarter of the primiparous women breastfed their babies every 2-3 hours day and night. Majority of multiparous women breast feed mostly on demand. Only increasing age and parity is positively associated with early resumption of menses. In conclusion increasing age and increasing parity increases risks of early menstrual resumption.

Keywords: menstrual resumption, pregnancy risk.


[1].   Adeyemi, A.B., Ijadunola, K.T., Orji, E.O., Kuti, O., Alabi, M.M. (2005). The unmet need for Contraception among Nigerian Women in the first-year post-partum. European Journal of Contraception and Reproductive Health Care, 10(4): 229-234.

[2].   Guido, P. A, (2003). Working Paper on the Determinants of Postpartum Amenorrhea: A Multi-State Hazard Approach. Center for Demography and Ecology, University of Wisconsin-Madison. Working Paper No. 96-03.

[3].   Ijadunola K.T., Orji E.O., Ajibade F.O. (2005). Contraceptive Awareness and Use among sexually active breastfeeding mothers in Ile-Ife, Nigeria. East African Medical Journal, 85(5): 250-255.

[4].   Kuti O., Adeyemi, A.B., and Owolabi, A.T. (2007.) Breast-feeding pattern and onset of menstruation among Yoruba mothers of South-west Nigeria. The European Journal of Contraception and Reproductive Health Care, 12 (4): 335 -339.

[5].   Kinga A.S., Donna J. M., and Marc B. R., (2009). Breastfeeding Knowledge, Attitudes, and Practices among Providers in a Medical Home. Breastfeeding Medicine, 4(1): 31-42.

[6].   Orji, E.O.,Shittu, A.S., Makinde, O.N., Sule, S.S. (2004).Effect of prolonged birth spacing on maternal and perinatal outcome. East African Medical Journal, 81(8):388-391.

[7].   Foster, M.S. (2006) Women’s decision about breastfeeding and maternal employment. Journal of Marriage and the family 58, 239-251.

[8].   Sedgh, G., Bankole A., Boniface, O., Oyeniran, B., Adewole, I. F., Singh, S., Hussain, R. 2006). Unwanted Pregnancy and Associated Factors among Nigerian Women International Family Planning Perspectives, volume 32, Number 4.

[9].   Orji, E.O., Ojofeitimi, E.O., Olarenwaju, B.A., (2007). The role of men in family planning decision making in urban and rural Nigeria. European Journal of Contraception and Reproductive Health Care, 12(1):70-75.

[10].  Orji1, E.O., Adegbenro, C.A., Akinniranye, B. I., Ogunbayo, G. O., Oyebadejo, A.E. (2007). Spousal Communication on Family Planning as a Safe Motherhood Option in Sub-Saharan African Communities. Journal of Chinese Clinical Medicine, 21(61):328-335.

[11].  Chudasama R., Patel P., Kavishwar A. (2008). Breastfeeding initiation practice and factors affecting breastfeeding in South Gujarat region of India. The Internet Journal of Family Practice, 7 (2):1-7.

[12].  Shaaban, O.M., Glasier, A.F. (2008.). Pregnancy during breastfeeding in rural Egypt. Updated LAM Bibliography, 77: 350-354.

[13].  Uchendu U. O. (2009). Factors associated with exclusive breastfeeding among mothers seen at the University of Nigeria Teaching Hospital. South African Journal of Child Health, volume 3 (1).

[14].  Allagoa, D. O., Nyengidiki, T. K. (2011). Knowledge, Attitude and Practice of Contraception among antenatal patients at the University of Port Harcourt Teaching Hospital, Port Harcourt. The Nigerian Health Journal, Vol. 11, No 3.

[15].  Odu, B. K., Ogunlade, J. O. (2011). Breastfeeding and Child Spacing among Women in South West Nigeria. International Journal for Cross-Disciplinary Subjects in Education, 2, Issue 2:234-237.

[16].  Kulie, T, Slattengren, A., Redmer, J., Counts, H., Eglash, A. and Schrager, S., (2011). Obesity and Women’s Health: an evidence-based review. Journal America Board of Family Medicine, 84: 34-38.

[17].  Okolie U. (2012). Problems encountered by breastfeeding mothers in their practice of exclusive breast feeding in tertiary hospitals in Enugu State, South-east Nigeria International Journal of Nutrition and Metabolism, 4(8): 107 – 113.

[18].  Labbok, M.H. (2013). The Lactational menorrhea method (LAM) for postpartum contraception. Australian Breastfeeding Association. Retrieved October 5, 2016 from

[19].  Liu, Y., Gold, E. B., Lasley, B. L. and Johnson, W. O. (2004). Factors affecting Menstrual Cycle

[20].  Characteristics. American Journal of Epidemiology, 160, (2) 2004, 131–140.