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>In your practices, have you noted LAM to be more effectively practiced by certain groups of women?  What are the prevailing practices on teaching any woman LAM, regardless of sociocultural factors?  If women are hypothetically not suited for LAM, do they also experience problems with other birth spacing methods (e.g. OCPs, barriers, etc.)?  Thank you very much for your insights and responses!
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Thank you for an interesting post. I am very interested in LAM, although
with my large family people don't seem to believe that I am interested
in / capable of using any family planning methods :-)

Though tongue-in-cheek, my point is that people assume that certain
behaviours are associated with socio-cultural and socio-economic
factors. While there often *is* a correlation, there is, IMHO, no
causative relationship. It is just as possible for a single mother to be
in control of her fertility as it is for me to have a PhD *and* have
birthed seven babies (not a frequent correlation, but a real one).

Some of the problem has to do with assumptions that may begin as a
statistical correlation but become a deep-rooted mental association that
is perpetuated systemically. For instance, one teen mother I talked to
said that everyone assumed she wasn't going to breastfeed, so nobody
took the time to tell her how or to dispel the misconceptions she had
picked up from everyone else assuming that. If we tell our young mothers
that they are irresponsible, that men can't control their lust, that
they won't be able to say "no" to sex and "yes" to breastfeeding, they
may well perpetuate the behaviour we are expecting from them. They also
lose their sense of self-esteem, choice, safety etc. This attitude is
pervasive -- we begin by telling our children not to talk to strangers,
continue by telling our teen-age girls not to be alone with boys,
encouraging our daughters to take the pill rather than use other
methods, etc.
All of this makes sexuality and maternity related and, in fact,
demonizes both of them.

The other part of the problem is that we are less gifted in the soft
stuff -- qualitative, less "measurable" factors. And we are so aware of
our inabilities that we often prefer to ignore them. We don't bother
asking how a young or poor or unmarried woman feels about her body,
pregnancy, mothering, etc. To me, attitude is a *huge* component of the
way LAM works. If you are "the kind of mother" (whatever kind that is;
it has no colour or marital status AFAIK) who will nurse at the first
flickering eyelid and won't be able to sleep without a warm wee body
beside you, your chances of LAM working are excellent.

You have probably guessed that I feel that evidence has its limits.
Reflection goes much farther than apparent facts.

Jo-Anne Elder-Gomes, PhD, IBCLC, mother of 7 live ones, step-mother of
four live and two lost little ones (all bf, all lambs (LAM Baby Successes))

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