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Sex Planeam Fam. 1997 Jul-Dec;(15-16):25-7.
[Postpartum contraception]
[Article in Portuguese]
Sousa M, Sousa MP.
PIP: Postpartum depression often occurs with symptoms of dysphoria, emotional instability, anxiety, insomnia, headache, loss of appetite reaching its peak 3-6 days after childbirth, with an incidence of 26-85% of women giving birth being affected. Postpartum contraception requires medical consultation during the puerperal period when the time of return of ovulation is also discussed. Oral contraceptives pose some risk of thromboembolism, especially in the first 10 days postpartum and also have an effect on lactation, but help faster return of menstruation and the diminution of menstrual flow. OCs should be prescribed 10-15 days postpartum. For women who nurse OCs containing progestational hormones could be prescribed which have a 99% effectiveness in the first year of use. Injectables also containing progestational hormones are commenced 7 days postpartum and are effective for 8-12 weeks. Implants are implanted 4 weeks postpartum and are effective for 5 years. The IUD could be inserted after the return of menstruation to avoid any risk of uterine perforation. Tubal ligation is usually performed 24-48 postpartum by periumbilical minilaparotomy. Natural methods are not recommended because of their low efficacy and difficulty of interpretation during this period, while barrier methods (both the male and female condom) using spermicides are more effective.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12179261&dopt=Abstract
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