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CHC postpartum non-breastfeeding — DFSRH MCQ

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HardCombined hormonal contraceptionCHC postpartum non-breastfeedingDFSRH

A mobile, bottle-feeding woman with BMI 24 requests a COC 16 days after an uncomplicated vaginal birth. She has no other VTE factors and has not resumed sex. What should be offered today?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Defer CHC to day 21 and offer a POP or implant today

The best answer is “Defer CHC to day 21 and offer a POP or implant today”. CHC is contraindicated during the first 21 days postpartum because baseline VTE risk is high even without additional factors and regardless of feeding method. A non-breastfeeding person without other VTE factors may become eligible from day 21, but contraception need not be deferred in the meantime. A POP, implant, injection or suitable non-hormonal method can be offered now; a patch is also CHC.

Reference: CoSRH/FSRH, Contraception After Pregnancy: https://www.cosrh.org/Public/Public/Documents/contraception-after-pregnancy-guideline-january-2017.aspx