Postpartum contraceptive methods are those used by breast feeding women before twenty six days after they have given birth. Basing on the NICE guidelines, the advice on how to use these methods should be explained to the patients before their second postpartum week. The breast feeding women are allowed to use the lactational amenorrhoea method but they are not recommended to use the COCP (combined oral contraceptive pills) method by the World Health Organization before the first 42 days postpartum because it’s illegal (outside the license) (WHO, 2006).
Below are some of the postpartum contraceptive methods. The contraceptive methods; The combined contraceptive pills (to the breast feeding women) This contraceptive method to breast women brings about some hormonal out comes on the quantity of milk and its quality too. If these pills are taken before 24 weeks postpartum, they affect the baby’s growth. In a previous review of randomized controlled trials held to clarify this case, the review reassured women that hormonal contraceptive method has no strong effects on the baby’s growth.
On the other hand, the World Health Organization recommended that, breast feeding mothers before 24 weeks of postpartum should not use the combined contraceptive pills because its use is outside the license (WHO, 2006). Sterilization Basing on the guideline of Royal College of Obstetricians and Gynecologists, it shows that women should be alert about the consequences and the increasing rates at which sterilization fails before the postpartum period (Johnson, Edelman and Jensen, 2003).
Lactational Amenorrhoe This method is scientifically proved to be effective in preventing unwanted pregnancies, given to a woman, in less than 24 weeks postpartum. As Johnson, Edelman and Jensen (2003) states, she does not experience virginal bleeding after the first seven weeks postpartum, and if she can fully breast feed the baby day and night. Progestogen injectables If this method is used before 42 days of postpartum, it means, that it has been used illegally by the applicant (outside their license).
According to Johnson, Edelman and Jensen, (2003), if injectables are used in the early periods of postpartum, it may result into excessive bleeding. It is therefore, recommended that it should be used after 42 days of breast feeding. This may prolong bleeding if applied when not breast feeding in five days of delivery. Emergency contraceptive method This method is not required before twenty one days postpartum and it can be used even if the woman is breast feeding. The IUD may be used after one month postpartum.
Implants and the progestogen only pills It is recommended by World Health Organization that this method should not be applied in the first 42 days postpartum (WHO, 2006). On the other hand, in the United Kingdom, this method is commonly used by women before 42 days postpartum since it is proved that it has no effect on the quantity of breast milk and the fact that it does not affect the growth of the baby during this specified period. The following have to be noted for application of POP
As noted by (Guillebaud (1993) if its application is started after the first two weeks, there is need for some additional contraception and need to clarify that the woman is not pregnant. If the woman starts to experience constant menstrual cycles again, she has to begin the applying POP including the period of five days without the necessity for additional barrier methods. For Etonogestrel implants Guillebaud (1993) explains that, this can be applied between the first 21 to 28 days of delivery. If it exceeds from 28 days, there is need to apply additional contraception methods for a week.
Barrier methods (condoms, cervical caps and diaphragms); Condoms It has been proved by scientists that condoms are eighty seven percent effective when used without any other protective measure. And said to be ninety eight percent effective if used with another measure of protection (spermicide). Every time you have sex, it is recommended that you use condoms (Guillebaud, 1993). Diaphragm As Guillebaud (1993) explains, scientifically, this method is said to be ninety eight percent effective that is if used correctly. It has to fitted by the doctor and used when having sex. Conclusion
From what has been discussed above, there are many postpartum contraceptive choices a breast feeding woman can use like POP, COCP, barrier methods such as condoms, cervical caps and condoms, progestogen only pills, and others. Some women are using the COCP method, for example, women in UK, before the first 42 days postpartum and yet it is not recommended by WHO. We there by strongly conclude that women should be keen when taking postpartum contraceptives for the seek of their healthy and the child they have, it is important that they should follow the recommendations of the World Health regarding postpartum contraceptives.
Reference Guillebaud, J (1993): Postpartum Contraception: Unnecessary before three weeks: BMJ, Vol. 307, 6918; p 1558-61 Johnson L, Edelman A, and Jensen J (2003): Patient satisfaction and the impact of written material about postpartum contraceptive decisions: AMJ Obstet Gynecology; Vol. 188, 5, p, 1201-5 WHO (2006): Medical eligibility criteria for contraception: Available online at: www. who. int/reproductive-health/public/mec/mec. pdf