Lactation and post-partum amenorrhoea: a study based on data from three Norwegian cities 1860–1964

Abstract

SummaryMedical records from maternity clinics in three Norwegian cities, Oslo, Bergen and Trondheim, have been used to study the relationship between lactation and post-partum amenorrhoea during the period 1860–1964. Resumption of menses after a period of post-partum amenorrhoea has been examined separately during lactation, after cessation of lactation, and in the absence of lactation, in 5250 cases. During ongoing lactation the median duration of post-partum amenorrhoea was found by survival analysis to be 12 months for women who had given birth before 1900 and 6 months for women who had given birth after 1900. In a Cox regression analysis, age of menarche and parity were found to influence the duration of post-partum amenorrhoea, in addition to the child's birth year. With a later age of menarche there was longer amenorrhoea, and primiparae resumed menses earlier than multiparae. After cessation of breast-feeding the median duration of amenorrhoea was 1 month, the only variable significantly influencing it being the age of menarche, a younger age showing a shorter duration. In the absence of lactation the survivor function started to decline after 3–4 weeks, and had a half-life of 2 months.None of the variables indicating the woman's social condition seemed to influence the duration of amenorrhoea. The decline in the duration of post-partum amenorrhoea during ongoing lactation from 1860 until today is therefore probably caused by a changed breast-feeding pattern rather than by improved nutrition for women giving birth.