Postpartum Contraception

by Veronica Gillispie, MD, FACOG

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    Now let's talk about postpartum contraception. So when we address postpartum contraception, the first thing we want to address is if our patient is breastfeeding or not. So this is a clinical pearl. For women that are breastfeeding, contraceptive options should be limited to progestin only or non-hormonal options. Options that contain estrogen can dry up the patient's breast milk. So let's look at those. And we're going these into reversible options and non reversible options. So for our reversible options, we'll start with natural family planning. Now prolactin increases during breastfeeding and this causes ovulation to cease. It's reliable about 98% if used correctly. Again this is also called rhythm method. Next is the barrier method. This is the use of condoms and/or spermicides. It used together and correctly, the effective rate is about 82%. Next is the progestin only birth control pill. So the progestin only or the mini-pill has to be taken at the same time everyday. It's most reliable when done that way. Long acting reversible contraceptives. LARC as they're often called provide contraception for an extended period of time. And there are several options. Let's go through those. So for our long acting reversible contraceptives or LARC as they are often called, let's start with the Copper IUC or intrauterine contraception. The Copper IUC is non-hormonal and it is the only non-hormonal IUC. It actually provides contraception, by providing a sterile environment that kills the sperm. And it's effective for 10 years. The progestin IUC's prevent pregnancy by also creating a sterile environment that kills the sperm. But because of the progestin, they increase cervical mucus to make it difficult for the sperm to enter the cervix. They also the make the endometrium thin and they can inhibit mortality of the fallopian tube. So there...

    About the Lecture

    The lecture Postpartum Contraception by Veronica Gillispie, MD, FACOG is from the course Postpartum Care. It contains the following chapters:

    • Postpartum Contraception
    • Non Reversible Contraceptives

    Included Quiz Questions

    1. 98% effective
    2. 82% effective
    3. 99% effective
    4. 60% effective
    5. 75% effective
    1. Copper intrauterine device
    2. Mirena intrauterine device
    3. An upper arm implantable device
    4. E-Sure (Hysteroscopic tubal ligation)
    5. Condom and spermicide combined
    1. A hysterosalpingogram should be done 12 weeks after the procedure to assure it has worked.
    2. It is a long acting reversible type of contraception.
    3. It should be performed within six weeks of delivery.
    4. It involves removing a portion of the fallopian tubes.
    5. Side effects include irregular menstrual cycles.
    1. Prolactin levels are increased, diminishing ovulation
    2. Prolactin levels are increased, increasing ovulation
    3. Prolactin levels do not have any effect on ovulation
    4. Prolactin levels are decreased, diminishing ovulation
    5. Prolactin levels are decreased, increasing ovulation
    1. Blocks the fallopian tubes with scared coils
    2. Creates a sterile environment that kills sperm
    3. Increases thickness of cervical mucous
    4. Thins the endometrial lining
    5. Decreases fallopian tube mobility
    1. 82%
    2. 65%
    3. 99%
    4. 95%
    5. 50%

    Author of lecture Postpartum Contraception

     Veronica Gillispie, MD, FACOG

    Veronica Gillispie, MD, FACOG

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