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Postpartum contraception

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In the postnatal period contraception needs to be considered if a woman is sexually active. Some women may be sexually active in the first six weeks postpartum.1 Contraception options can be discussed antenatally as well as in the immediate postnatal period. NICE guidance advocates discussing contraception with mothers in the first week following delivery.2 Discussing contraceptive options antenatally when the women has time to consider the options might be more effective than postnatally when the day-to-day care of a newborn is her top priority.

All contraceptive advice should be tailored to the individual by taking a thorough medical history and assessing any plans for future children. The UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) can be consulted. Having a further pregnancy within six months of giving birth is associated with an increased risk of adverse perinatal outcomes.1 Maternal health is also adversely affected. The risk of sexually transmitted infections and the need to use barrier contraception such as condoms might also usefully be discussed in some situations.

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