Which is why my little brother is just 17 month younger. Mom was nursing me and didn’t even realize she was pregnant for 3 or 4 months!

Cheated, probably. You need to know this stuff to get INTO med school, let alone graduate. Any docs reading this care to comment?

Amen! It needs to be part of HS health classes.

Supply issues are horrible – I’m so sorry you had to deal with them. I know some women try everything and nothing helps, but I’ll share what has been helping me in case it’s new and might be relevant to you or another reader. Fenugreek alone didn’t work, but in conjunction with a Calcium/Magnesium/Zinc supplement I have been able to limit and ride out the supply dips. I also switch out the fenugreek for More Milk Plus when I start to feel PMS-y but I’m not sure it actually does much more. I, too, am pretty jealous of the folks who get to skip their periods for a while!

While you did do a very impressive job of attempting to defend your fellow OB by saying a whole bunch of nothing in a lot of words, what this doctor SAID was, “Nursing causes you to ovulate every month without having a period – ie. without bleeding”.
That is not true. Ever. Once an egg is released, hormones cause the uterus builds up a lining, and then shed that lining out of somewhere if the egg is not fertilized. That shedding is what we call a period.
Yes, many women will ovulate before they bleed for the first time after birth. That is still ovulation WITH a period. And yes, a woman’s fertility signs may alter somewhat during breastfeeding. That still doesn’t make “ovulation every month but without bleeding” a fact. This doc make a patently false and clearly uneducated statement. And in the post, it seems that the woman DID tell the doc that she was trying to conceive, which is why she was concerned that her period had not yet returned.
So, yes, that does make me lose faith in a profession that claims it knows everything about childbearing issues.

“the doctor just didn’t articulate or make him/herself clear in explaining to the patient clearly what lactational amenorrhoea means. ”

Okie dokie. Let’s see if you can do any better, shall we?

“While breastfeeding does not equal anovulation (although a cycle of anovulation does occur immediately after the delivery) or infertility (the word infertility implies no possibilty of conception)”

True – It is possible for a woman to start ovulating again even while bfing, and certainly bfing does not cause “infertility” (duh, did anyone say it did?). Also true – many women will experience a length of time (varying from just a couple months to over a year) where she is not ovulating due to the fact that bfing alters her hormones. This second statement is what doctor dipstick fails to understand.

“Different females will respond differently with different hormone changes during lactation. Thus it’s a spectrum.”

True. This is why some women start ovulating (and see a positive pregnancy test OR a return of menses) within a couple of months of delivery (lochia is NOT menses and should not be confused with that) while other women don’t resume ovulation (and therefore don’t get a positive pregnancy test OR a return of menses) for a year or more, some for the entire time they are bfing. The person who submitted this was nursing a toddler and reported that she still had not had her first post-partum period. That suggests that while she could resume ovulation at any time, she had not done so as of yet.

“Additionally, the mucus changes with ovulation do occur but depending on what stage of bleeding or Lochia a female is at after her pregnancy, might make it harder for her to interpret mucus changes.”

Here’s where you lose me. She’s nursing a TODDLER. If she’s still having lochia, she’d be dead by now. She’s reporting that her periods had not yet returned so she’s not in ANY “stage of bleeding”. She hasn’t bled since her lochia stopped (around 4-6 weeks post partum). She’s not pregnant and hasn’t had a return in her period yet, so she hasn’t ovulated since before her toddler was concieved. This is what doctor dipstick fails to understand, and what you apparently fail to understand as well. If you release an egg there are two possible results: conception or menses. She has not experienced either, therefore she has not yet ovulated. It isn’t as difficult as you are making it out to be.

“I think that rather than critisize the doctor’s medical knowledge, or the american medical schools and their admission policies, it is clear that this doctor was poor in communicating and taking the time to explain to his/her patient this process.”

No. I think everyone so far has been correct in the assessment that this doctor doesn’t know what he/she is talking about. Just like it’s clear that you don’t know what you are talking about either. Let’s recap: she is nursing a toddler (child over the age of one year). she is bfing. she has not gotten pregnant (this is the problem, she wants to get pregnant) or experienced a return of menses. she goes to her doctor who tries to tell her that, although she has neither experienced the return of menses OR her next pregnancy, she is ovulating anyway (wtf?). And that only proves that the doc in question is dumber than a box of bricks. So where, pray tell, did her uterine lining go? If she IS ovulating (which is what you appear to be claiming) then why haven’t her periods returned (we know she isn’t pregnant)?

Sorry, you used a LOT of words to say nothing but “stop picking on doctors!” But you didn’t actually say anything to make the doctor under discussion right. If a woman experiences the hormonal upsurge that triggers ovulation (even for the first time after pregnancy, barring any serious medical problems which require the OBs intervention) that same hormonal cascade is going to continue through its whole process: the corpus luteum WILL start producing progesterone, the endometrium WILL start to build up within the uterus in response to that activity, the released egg either will or will not be fertilized by sperm, and if conception does not happen the egg will NOT produce HCG to stimulate the corpus luteum to continue producing progesterone, thus menstruation WILL occur. If conception did take place, then one would hope you (who claim to be a doctor) would understand the hormonal process that should halt menstruation and allow for the woman’s body to begin another pregnancy.

This is ALWAYS the result of ovulation (barring serious hormonal imbalances which require care provider attention). The timing of ovulation itself, following a pregnancy, is the only part of the process that is truly variable. Any care provider worthy of the title understands this. The care provider in question for this post clearly does not wish to listen to his/her patient and take time to provide appropriate care. In other words, s/he is a combination of arrogant and lazy.

I breastfed for the past fourteen years, and that includes four babies conceived during that time.

{Additionally, the mucus changes with ovulation do occur but depending on what stage of bleeding or Lochia a female is at after her pregnancy, might make it harder for her to interpret mucus changes.}

THis is not true. Whenever I was in a state of lactational amenorrhea, there was NO mucus pattern (or no change to the basic infertile pattern) because there was not enough estrogen production to trigger ovulation. The whole female reproductive system is a cycle. It doesn’t *begin* with menses even though that’s the most obvious part. Menses is the end of that process. That’s why it’s possible for a woman to ovulate before her first period. And she may have a few trial-runs of gearing up to ovulate. But in general while she’s in a state of lactational amenorrhea, she will not be producing cervical mucus because the cervical mucus is produced in response to rising estrogen levels.

Low estrogen = no production of cervical mucus
low estrogen = no ovulation

Eventually the mom’s estrogen levels do reach high enough levels to produce cervical mucus. At some point after that, they will reach high enough levels to produce ovulation. After that, she will either conceive or she will not, and if not, there will be a period to end that cycle. Then the next one begins.

Most OBs and most doctors seem to think the period is the only part of the cycle that matters because it’s the only one they trust the mother to reliably interpret. But for a doctor to say “you’re probably still ovulating EVERY MONTH” but that nursing causes her not to have a period is just bad medicine.

This is not a communication issue.

If you haven’t read the book Take Charge Of Your Fertility, I would suggest you do so, or maybe take a Creighton Method or Billings Ovulation Method class. Many doctors find it helpful to understand the totality of a woman’s cycle.

Well, you must’ve gotten lucky and hit one of the hundreds of released eggs floating around in your uterus!

But they don’t specialize until AFTER they graduate. that is the problem. They do a very limited rotation through OBGyn before graduation before they ever do their residency. They they keep them up 18-22 hours a day being trained by other doctors who may or may not know WTF they are talking about and probably have never seen a natural birth. This is partr of the problem. There is no effing reason to go to 4 years of undergrad so you can prove you can get a 4.0 but never have a social life. So you can go to 4 years of medical school where you get may 3 months of OB/Gyn.
The system is so broken it isn’t even funny!