UKMEC postpartum breastfeeding CHC — DFSRH MCQ

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HardUKMECUKMEC postpartum breastfeeding CHCDFSRH

A 34-year-old is 32 days postpartum, breastfeeding, BMI 32 kg/m2 and had an emergency caesarean section. She wants the combined pill today and has not had sex since birth. What is the UKMEC category for CHC?

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Correct answer: B — UKMEC 4

CHC is contraindicated. She is breastfeeding and 32 days postpartum, which is less than 6 weeks after birth. Current UK guidance classifies combined hormonal contraception in breastfeeding women from 0 to <6 weeks postpartum as UKMEC 4, meaning an unacceptable health risk if the method is used. Her emergency caesarean section and BMI 32 kg/m² are additional postpartum VTE risk factors, but they do not change the answer because breastfeeding at <6 weeks postpartum already makes CHC UKMEC 4. Absence of intercourse or a negative pregnancy test does not alter the UKMEC safety category.

Reference: Faculty of Sexual & Reproductive Healthcare (FSRH). FSRH Guideline: Combined Hormonal Contraception, October 2023. https://www.fsrh.org/Common/Uploaded%20files/documents/fsrh-guideline-combined-hormonal-contraception-october-2023.pdf