Options for Postpartum Contraception

Options for Postpartum Contraception

MethodPregnancy rate in 1 yearSpecial Considerations
Sterilization (male & female)0.5%,
0.15%
- Permanent
Etonogestrel (ENG) Implant0.05%- Must be placed and removed by trained clinician
- Clinicians must attend manufacturer training prior to placement
IUD: Copper0.8%- Must be placed and removed by trained clinician
IUD: Levonorgestrel (LNG)0.2%- Must be placed and removed by trained clinician
Injectable (Medroxyprogesterone acetate)6%- Must obtain injection every 3 months
Lactational amenorrhea method (LAM)2-8%- May be impractical for many people
- Must breastfeed infant frequently & exclusively; be amenorrheic and <6 months postpartum
Progestin-only pill (norethindrone)9%- Must take pill at same time every day with 3-hour late window
Estrogen/progestin combined pill, patch or ring9%- Must take pill at same time every day, change patch every week, or ring every month
- Estrogen-containing methods are contraindicated with some medical conditions and immediately postpartum
Barrier Methods12-21%- Must be used with every act of intercourse
- Condoms are the only method that prevent STI transmission
Withdrawl22%- Continuation rates are low (46% at 1 year)
- Requires active participation by a willing partner
- Requires user involvement at every act of intercourse
Fertility awareness-based methods22%- Continuation rates are low (47% at 1 year)
- Requires active participation by a willing partner
- Requires daily action(s)
- Requires lead time to increase effectiveness

CDC Recommendations on Contraceptive Methods

The Centers for Disease Control and Prevention (CDC) has published guidance regarding who can use various contraceptive methods, and clinical guidance for the initiation and use of specific contraceptive methods. Both the U.S. Medical Eligibility Criteria (MEC) and Selected Practice Recommendations (SPR) address the use of LARC methods immediately postpartum.

The CDC, in collaboration with the Office of Population Affairs at the U.S. Department of Health and Human Services, developed recommendations on how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose not to have children. These recommendations are outlined in Providing Quality Family Planning Services (QFP).

United States Medical Eligibility Criteria for Contraceptive Use

U.S. Medical Eligibility Criteria (MEC), 2016

The 2016 U.S. MEC includes recommendations for using specific contraceptive methods by women and men who have certain characteristics or medical conditions.

United States Selected Practice Recommendations for Contraceptive Use

U.S. Selected Practice Recommendations (SPR), 2016

The 2016 U.S. SPR addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods.

Providing Quality Family Planning Services badge.

Providing Quality Family Planning Services (QFP)

The QFP recommends how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose to not have children.