Who gets pregnant shortly after returning from maternity leave?

If you came across a heavily-pregnant woman with her fifth child when the fourth is barely a year old, you would probably not think much of it. However, if it is an educated woman, you would probably think, “she should have known better.” 

 

When Molly started spending a lot of time eating diced raw mangoes with salt, suspicion was rife that she was expecting. This was shortly after she had returned from maternity leave. When she could no longer handle the whispers in the corridors, she blurted out to whoever asked her or stared at her bulging tummy that; “it just happened!” 

 

Can a pregnancy just happen? Why are young educated women having poorly-spaced pregnancies? Is it a race against time, ignorance or the unavailability of contraceptives? 

 

Other women Her Vision spoke to who had a second child on the heels of the first said when they conceived, they were not planning to neither were they doing anything to stop it from happening. They were aware of the consequences of unprotected sex, but laxity settled in. 

 

In retrospect, Molly says her pregnancy was a spur of the moment. “I use the natural family planning method. My husband works up-country. On the day he returned home, we were both too excited to see each other. We did not check the calendar to make sure it was okay to have unprotected sex without running the risk of having a baby.” 

 

However, other women get surprised when they conceive soon while breastfeeding. 

If a woman had a healthy pregnancy and normal birth, she is usually ready to resume sexual activity six weeks after birth. 

“When she is breastfeeding, she is less fertile, but not infertile,” says Dr. Charles Kiggundu, a consultant gynaecologist at Mulago Hospital. 

 

Although you might not menstruate for weeks after giving birth, your body usually releases its first postpartum egg before you get your first period. So, you are not likely to know you have ovulated until two weeks later when you menstruate. 

 

However, any vaginal bleeding before four to six weeks elapse after childbirth is always without ovulation. It is a residual of the uterine lining that supported the baby in the womb. But bleeding six weeks after birth should be taken as a sign of resumption of ovulation, Dr. Kiggundu explains. 

 

When fertility resumes after childbirth is one confusing time for some women, especially those who do not have their periods for the first six months after birth, or, have irregular ones. So while breastfeeding, they believe that they cannot get pregnant. 

 

The assumption that you cannot conceive while breastfeeding is wrong, Dr. Kiggundu adds. He explains that breastfeeding can be used as a birth control method only under certain circumstances. That is, you exclusively breastfeed, you have not yet had your period after birth and your baby is not yet six months old. 

 

Since using breastfeeding as a contraceptive measure has many checks and balances, it is usually advisable to use it with another contraceptive method. 

 

 Sylvia Awor, an obstetrician attached to St. Catherine Clinic, suggests that at the six-week review visit after childbirth, you need to consider a family planning method that will not interrupt the supply of breast milk. A thorough review by a medical expert is advised before settling for a contraceptive method.

 

This is important when changing from one method to another. 

The success of a contraceptive method depends on the effectiveness of the method and a woman’s ability to use it properly. 

 

The World Health Organisation recommends a gap of 18 to 24 months before a woman can have another child. By then, a woman’s body should be able to support another pregnancy. 

 

Dr. Kiggundu says there are health benefits to spacing your children. Childbirth is a rigorous activity a woman goes through, she loses blood and needs to recuperate. On the other hand are also risks of limited spacing between the children.

 

Essential nutrients such as iron and folate can be depleted from a woman’s stores. If you become pregnant before replacing these stores, it could affect your or your baby’s health, doctors caution. 

 

State of the World’s Mothers, a research by Save the Children, suggests that children born less than two years after their siblings are more likely to die within the first year than those that are born after two or more years. 

 

 

When I had my daughter two years ago, I was elated. After delivering her, family planning was not a priority. I was engrossed in taking care of her, lots of sleepless nights, an overflow of breast milk and the hard work that comes with new babies. 

 

But I was perhaps also naïve. It never crossed my mind that a woman can conceive while breastfeeding. I had always heard that breastfeeding was in itself a birth control method. 

 

My maternity leave ended and I was back to work. When my daughter was six months old, I noticed that I was getting tired so easily and my appetite was growing. At the time, I attributed it to breastfeeding. 

 

However, after missing three periods, I suspected I could be pregnant. The doctor wondered why I was surprised when he handed me the results. I had also been told that when exclusively breastfeeding, your period can take even a year to resume after having a baby. I took a pregnancy test and it was positive.  

 

Initially I was disappointed in myself. My baby was just six months and another was on the way. How was I going to manage? We would need a bigger house, two maids and I would have to go for maternity leave two years in a row. I cried. However, since it is a situation I could not change, I had to find ways of coping with it. I sought counselling and broke the news to my husband. 

 

My back hurt so bad, something the doctor attributed to the short birth intervals. 

When people see my two daughters, they always ask whether they are twins and I response with a sheepish grin. 

I have since adopted an appropriate birth control method to avoid such a reoccurrence.

You are pregnant soon after having your baby, you are at work and obviously there are some busybodies, who will make it their business. They provoke you with silly jokes and make life uncomfortable. You would think that the shock of having a baby on the heels of another is enough stress. The pressure to explain why you ‘let’ it happen can be overwhelming. 

When you feel harassed, speak to your human resource managers, advises Gloria Tugume, a human resource consultant. 

 

“This is a sensitive issue and they are supposed to protect you. The individuals harassing you can be approached about the issue. Your human resource management should be the bridge between you and your colleagues,” she notes. 

Telling your immediate boss about the pregnancy is a given, says Tugume. Some pregnancies can be difficult and will affect your performance at work. It could also be the psychological issues about having a small gap between the children that could affect the way you work. 

 

Secondly, telling your supervisor early helps plan for your replacement when you take leave. Whether you are obliged to get a replacement to do your work while you are away depends on the contract you signed with your employers, Tugume says. 

In some contracts it is clearly spelt out that you cannot go for maternity leave two years in a row.

 

Depending on the workplace, you could be fired. However, this is where the art of negotiation comes in. You can suggest someone cover for you when you are away, offer to take half of your salary so that the other person can be catered for without inflating your employers’ budget.

 

Tugume suggests that you come up with creative or pro-active ways of helping your employer handle this change. These could be offering to work extra hours where possible if the nature of your work allows it. It, however, remains your employers’ obligation to get a replacement during your absence. The proactive measures, however give, you an edge with your employer.