![]() ![]() ![]() Postpartum blues typically resolve within 2 weeks. Women may notice feeling down, anxious, mood swings, crying spells, irritability, and difficulty sleeping. Postpartum blues: Transient depression (baby blues) is very common during the first week after delivery. ACOG recommends combination hormonal contraceptive use should not start until 3 weeks postpartum because of the increased risk of thromboembolism. Women should wait at least 6-18 months before trying to become pregnant again. WHO recommends breastfeeding women wait six weeks postpartum before starting progestin-only contraceptives. ![]() Both breastfeeding and non-breast-feeding women can use barrier contraceptives, intrauterine devices (IUDs copper-releasing and hormone-releasing), and progestin-only contraception. This becomes less reliable as the infant starts to eat solid foods. ![]() The woman must have to be breastfeeding exclusively on demand, be amenorrheic) i.e., no vaginal bleeding after 8 weeks postpartum), and have an infant younger than 6 months. Lactational amenorrhea method alone or other forms of contraception has a failure rate of 2%, but a specific criterion has to be fulfilled. Breastfeeding is not an effective contraceptive choice. Intrauterine devices are typically best placed after 4 to 6 weeks after delivery. Hormonal methods such as progestin-only oral contraceptives, depot medroxyprogesterone acetate injections, and progestin implants are preferred, as they do not affect milk production. A vaginal diaphragm and cervical cap should be fitted only after complete involution of the uterus, at 6 to 8 weeks after delivery. Among hormonal methods, combined estrogen-progestin vaginal rings can be used after 4 weeks postpartum. The American College of Obstetrics and Gynecologists (ACOG) recommend progestin-only contraceptives are the best hormonal contraceptive modality for breastfeeding women. Breastfeeding mothers should not use combination estrogen-progestin contraceptives as it can interfere with breast milk production. For breastfeeding women, nonhormonal modalities are usually preferred. Contraception: The prenatal period is the best time to discuss postpartum contraception. In adolescents begin motivational interviewing, discussion of long-acting reversible contraception during pregnancy. ![]()
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