Post-Partum Contraception

Question 1

How many days after giving birth do women require contraception?

Answer 1

21 days

Question 2

What does the FSRH advise regarding the POP for postpartum women?

Answer 2

• It can be started at any time whether breastfeeding or non-breastfeeding.
• If started after day 21 then additional contraception is needed for 2 days

Question 3

What should you tell the patient regarding the POP and breast milk?

Answer 3

A small amount of progestogen enters the breast milk but this is not harmful to the baby.

Question 4

Describe the contraindications of the COCP and breast feeding?

Answer 4

Absolutely contraindicated - UKMEC 4 - <6 weeks if breast feeding

Relatively contraindicated - UKMEC 3 - 6 weeks to 6 months if breast feeding

Question 5

If the COCP is started after day 21 then how long should additional contraception be used?

Answer 5

7 days

Question 6

What can the COCP do to lactation in breast feeding mothers?

Answer 6

It can reduce or stop milk production

Question 7

How effective and under what conditions is the lactational amenorrhoea method (LAM)?

Answer 7

98% effective provided:

1. Amenorrhoeic
2. <6 months post-partum
3. Fully breast-feeding