Postpartum contraception

Abstract 

Why is so little time given to considering contraception during pregnancy and in the immediate postpartum period? Pregnancy may be the result of careful planning and previous knowledgeable use of contraception, but too often it is simply the unintended consequence of a lack of biological understanding or ignorance and fear of contraceptive methods. An extremely small percentage of women discuss postpartum contraception antenatally. Although most do discuss it with a midwife on the postnatal ward, this is mainly a brief, limited encounter as the new mother is about to leave hospital. For most women the definitive postpartum contraceptive advice is given at the 6-week postnatal visit to the GP.

We should not underestimate the importance of the immediate postnatal period as an opportunity to influence ongoing contraceptive use and reduce the risk of further unintended pregnancy. These issues may be particularly important in adolescent mothers whose prior use of contraception will usually have been extremely poor. This advice aims to give an overview of the range of contraceptive choice available to postpartum mothers, either breastfeeding or bottle-feeding. Each method is reviewed in terms of its positive and negative effects and its particular suitability or special precautions during use in this particular life-stage.

Keywords:  contraception , breastfeeding , lactation , oestrogen , oestrogenic methods , postnatal , postpartum , progestogen , progestogenic methods

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