Karen, Marie,

My curiosity is getting the best of me, and I'd like to share something I
observed a while back.  I'll try to be brief.

Year: 1987.  Subject: Spanish only-speaking, illiterate mother from rural
Mexico, pregnant with 6th baby.  "Juana" attended the very first NFP (Natural
Family Planning) class I taught here in Longview (TX).  Because she was
pregnant, she did not chart her cervical mucus and temperature signs during
the training.  However, she was *SO* eager to begin charting and use what she
had learned, she began charting her basal temperatures (oral) 3 days after her
daughter was born (at home, attended by midwife).

Two weeks after the birth, when I stopped by to see her, she asked me to take
a look at her "weird looking" chart.  I could not believe my eyes.  A newly
delivered mother would normaly have "basement-level" LOW basal temperatures
(approximately somewhere between 96.5 - 97.2 F), indicating zip ovarian
activity and profound infertility.  The odds of fertility returning at such an
early time are just astronomical.

This lady's basal temps were in the 98.4 - 98.8 F range!!  She wanted to know
why her chart didn't look at all like the after-childbirth & return of
fertility charts we had studied in class.  This looked more like a pregnancy
chart!  Of course, she was not pregnant (any more).  Her milk had come in
normally and just in the right volume -- assured me she felt just fine too
(not sick at all).  We discussed the only two causes I could think of: a) A
possible infection somewhere in her body (a sore throat would show elevated
temps too).  b) Something is wrong with the thermometer - checked & it was ok.
Since I had never heard of placental fragments back then, I didn't consider
that.  I convinced my friend to make a visit to her regular family doctor, and
he quickly and easily diagnosed a vaginal infection on her *and* an angry-red
and blistered rash in her baby daughter's diaper area.  By the time she
finished the treatment, her basal temperatures had already dropped down and
off the bottom of the chart!!

Lactnetters, I'm curious about this:  In general, would it be correct to
assume that elevated *early early* post-partum basal temperatures could
indicate:  a) A possible retained placental fragment because the body still
thinks it's "pregnant" (there would be milk supply problems here) and/or  b)
Infection somewhere in body,  or c) Fertility has resumed (trying  to allow
for everything here, ok).  Other than a defective thermometer,  are there any
*other* possible explanations that should also be explored?

If a) is a possible correct assumption, would using a relatively low tech
method such as basal temps be a useful diagnostic tool in cases of milk not
coming in?  Anyone can learn to take basal temps and basal thermometers are
easy to find, any brand will do, and run less than $10.  I wonder how a doctor
skeptical about retained fragments and no milk supply would explain away such
documented evidence of something being wrong to Marie.

My friend "Juana" did not have a retained placental fragment and she nursed
her child for 3 years.  But the experience with her weird chart has intrigued
me for years.  I think about her every time I see a  post about this topic on
Lactnet.  It would be so interesting to find out what kind of basal temps
mothers who do have a problem with fragments have.  I suspect they would be
high too, but have no proof.  Does anyone know?  Would anyone be interested in
doing a clinical study to document any possible relationship between elevated
early post-partum basal temps, retained placental fragment and the "milk not
coming in"?

Sorry I was not as brief as I promised, but just had to ask all these
questions.  Back to lurking.

Deya Stavinoha
NFP Instructor - Couple to Couple League
LLL Leader
Longview, TX
PS: I've never had another NFP student as eager to chart so early as "Juana"
:-(


In a message dated 4/8/98 10:25:31 AM Central Daylight Time,
[log in to unmask] writes:

<< If prolactin levels are nil when they are supposed to be high, we
 need protocols or something to see what is going on--if only to have a
 reason, and not leave a mom high and dry as to why she wasn't "normal" in
 her breastfeeding.>>
<<Several frustrations lately have led me to post this to the list.
 Many of our "Classic texts" describe what the problem could be but never how
 to deal with them.  I have been faced with this question several times in the
 past few weeks: "OK what do we do now?"
 For example
 CASE 1--Suspected retained placental fragments: What tests should be run?
 What should the results be? >>