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Postpartum VTE risk and CHC — DFSRH MCQ

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HardSpecial CircumstancesPostpartum VTE risk and CHCDFSRH

A formula-feeding patient 24 days after caesarean birth has BMI 39 kg/m² and requests her previous combined pill. What is the best response?

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Correct answer: D — Do not start CHC now; offer a suitable non-oestrogen method

The best answer is “Do not start CHC now; offer a suitable non-oestrogen method”. From 21 to 42 days postpartum, CHC is UKMEC 3 when additional VTE risk factors are present. Caesarean delivery and BMI at least 30 kg/m² are both relevant, irrespective of formula feeding. Progestogen-only and intrauterine methods have different postpartum eligibility and can usually be offered without deferring effective contraception.

Reference: CoSRH/FSRH, Contraception After Pregnancy (amended October 2020): https://www.cosrh.org/Common/Uploaded%20files/documents/contraception-after-pregnancy-guideline-oct2020.pdf