Return of Menstruation among Exclusive Breastfeeding Women in Southwest Nigeria

Background: Women experience variations in postpartum amenorrhea, the length of which depends on the type of breastfeeding and women’s physiology. We conducted the present Study to assess the perception and pattern of resumption of menstruation, and identify the determinants of resumption of menstruation and proportion at risk of unplanned pregnancy among exclusive breastfeeding women. Methods: Study employed sequential explanatory mixed method research design and was conducted between September and November, 2019. We collected the quantitative data using a semi-structured questionnaire from 497 exclusive breastfeeding women selected through a two-stage sampling technique in Southwest Nigeria. In addition, Focus Group Discussion guide was utilized to conduct qualitative study. The quantitative data were analyzed with SPSS version 22 using appropriate statistic, and the level of significance was P<0.05. We analyzed the qualitative responses thematically. Results: Our result revealed that 43.4% of women whose postpartum period begins in less than eight weeks were amenorrheic, 65.6% of women whose postpartum period occurs between the 8th and 16th week were also amenorrheic, 85.8% of women whose postpartum period begins between 17th and 24th week remained amenorrheic. 76% of the women studied relied on Lactational Amenorrhea for contraception. Age (P=0.001, OR=0.24, CI=0.10-0.50), parity (P=0.04, OR=0.55, CI=0.31-0.79), and postpartum length (P=0.002, OR=0.23, CI=0.18-0.75) remained significant determinants of the return of menstruation. Conclusion: A significant proportion of women studied perceived themselves to be at no risk of unplanned pregnancy which may ultimately influence timely postpartum contraceptive uptake. Advocacy should therefore focus on addressing effective contraception among this group of women.