Resumption of menstruation among urban post-partum women in Bangladesh

Abstract

To investigate the return of menstruation among postpartum women in Dacca, a random sample of 360 women (1-12 months postpartum) was selected from 4 Dacca hospitals for a cross-sectional study; another random sample of 200 women ( 1 month postpartum at time of interview) was selected from the same hospitals for prospective follow up. Many of the women were from rural areas who left the city after delivering their babies; most were under 25 years old at the time of interview. Results of the cross sectional study showed that 63% started menstruating by the 6th postpartum month; 10% were still amenorrhoeic by the 12th postpartum month; 46% were breastfeeding their infants by the 4th month; 90% resumed sexual relations, and 48% were using contraceptives, by the 6th month. Results of the prospective study showed that slightly more than half of the women started menstruating by the end of the 5th postpartum month; almost half stopped breastfeeding by the 5th month, 88.8% were having sexual relations with their husbands, and about 50.5% were on some form of birth control. The findings suggest a much shorter duration of lactational amenorrhea than has been claimed for a rural area of Bangladesh; they also suggest that urban women start menstruating earlier because of their primary reliance on supplementary feeding. The contraceptive effectiveness, as well as health benefits to infants, of prolonged and intensive lactation should be promoted to urban mothers.