The CDC today published recommendations on use of contraceptive methods for non-breast feeding women in the post-partum period (full text is here). The key recommendations are as follows:
Combined (estrogen+progestin contraceptives)
- During the first 3 weeks post-partum women should NOT use combined (estrogen + progestin) hormonal contraceptives, because of the high risk for venous thromboembolism (VTE).
- During 3-6 weeks postpartum, women without risk factors for VTE generally can initiate combined hormonal contraceptives, but women with risk factors for VTE (e.g., previous VTE or recent C-section) generally should not use these methods.
- After 6 weeks postpartum, there are no restrictions on the use of combined hormonal contraceptives because of postpartum state.
- Progestin-only contraceptives (minipill, Depot-Provera, Implanon rod, Mirena IUD) are safe and can be initiated immediately after delivery.
Of course, condoms and diaphragms can be used any time, as they do not increase the risk for blood clots.
The recommendations above are good for women at low or standard risk for venous thromboembolism. However, the woman with particularly strong risk factors for VTE (strong family history, presence of a strong thrombophilia, personal history of VTE) may want to avoid combined estrogen-progestin and progestin-only contraceptives at any time, not just in the postpartum period, to minimize her risk of VTE. A Clot Connect discussion on progestin-only contraceptives can be found here.
Disclosures: I have no financial disclosures relevant to this blog entry.
Last updated: July 8th, 2011
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