Post-Partum contraception

Question 1

When do women require contraception after giving birth?

Answer 1

After day 21 after giving birth → contraception is required

Question 2

Progesterone-only pill post-partum

• when can we start?
• is it safe for a baby?
• extra advice

Answer 2

• can be started at any time
• a small amount of progesterone will enter breast milk →not harmful for a baby
• after day 21 extra contraception should be used for first 2 days

Question 3

Can we use combined-oral contraception pill in a mum breastfeeding a baby <6 weeks?

Answer 3

Absolutely contraindicated

• the COC may reduce breast milk production in lactating mothers

Question 4

When can we insert intrauterine device post-partum?

Answer 4

• within 48 hours of childbirth
• after 4 weeks

Question 5

When Lactational Ammenorhoea Method is effective?

Answer 5

Lactational amenorrhoea method (LAM)

98% effective providing the woman:

• is fully breast-feeding (no supplementary feeds)
• amenorrhoeic
• < 6 months post-partum

Question 6

Is it OK for a woman to conceive again after <12 months of childbirth?

Answer 6

An inter-pregnancy interval of less than 12 months between childbirth and conceiving again is associated with an increased risk of preterm birth, low birthweight and small for gestational age babies