Postpartum Contraception — MRCGP AKT MCQ
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Correct answer: C — The progestogen-only pill can be started immediately after birth
The progestogen-only pill can be started immediately after childbirth and is compatible with breastfeeding. This woman can therefore start it now. As she is already more than 21 days postpartum, initial additional precautions are required: generally 2 days for a traditional or desogestrel pill and 7 days for drospirenone. Combined hormonal contraception should not be used immediately postpartum because of venous thromboembolism risk; breastfeeding women are usually advised to wait until at least 6 weeks after birth. A copper IUD is not contraindicated: it can be inserted within 48 hours of delivery or from 4 weeks postpartum. Breastfeeding alone is reliable contraception only when all lactational amenorrhoea method criteria are met, so it does not universally remove the need for contraception.
Reference: NHS. Sex and contraception after birth: Contraception after having a baby. Page last reviewed 7 February 2024. https://www.nhs.uk/baby/support-and-services/sex-and-contraception-after-birth/