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Abstract
From approximately one week before normal ovulation resumes, lactating women require
protection against pregnancy by a contraceptive that is safe for both infant and mother.
In a multicenter one-year study, the natural hormone, progesterone, delivered vaginally
by a sequence of four contraceptive rings designed for continuous use, was evaluated
as a contraceptive for nursing mothers in comparison with the Copper T 380A IUD. Individual
rings release an effective average dose of 10 mg/day for a 3-month period. Evaluation
included measures of lactational performance as well as of contraceptive efficacy
and safety to mother and child. Nine participating clinics enrolled 802 ring users
and 734 IUD acceptors between postpartum days 29 and 63. Life table analyses were
performed with parallel decrements for ring and IUD subjects. Continuation in the
study and analysis required that subjects not stop breastfeeding. The ring, with a
one-year pregnancy rate of 1.5 per 100, did not differ significantly from the IUD
with respect to contraceptive effectiveness (p > 0.05). More than half of the ring
subjects were continuing at 6 months post admission and a quarter (23.5 per hundred)
were still using the ring and breastfeeding one year after admission. Women with the
IUD, however, had higher continuation rates (p < 0.001) at both time points. The largest
single decrement for each method was that for weaning. Ring users had more complaints
of vaginal problems but had fewer vaginal disorders on examination. At 12 months postpartum,
46 per 100 continuing ring users remained in amenorrhea. Lactation performance and
the health and weight gain of the infants were similar among users of either regimen.
Keywords
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Article info
Publication history
Accepted:
January 16,
1997
Received in revised form:
January 14,
1997
Received:
July 23,
1996
Identification
Copyright
© 1997 Published by Elsevier Inc.
