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Abstract
This study evaluated the performance of progesterone vaginal rings (n = 187), progestin-only
pills (n = 117), Norplant® implants (n = 120), and Copper T 380-A intrauterine devices (n = 122) in lactating
women. Contraceptive efficacy, bleeding pattern, and influence of the method upon
breastfeeding duration and infant growth were compared with those of untreated women
(n = 236) who relied on lactational infertility. Participants were healthy, 18 to
38 years, had had a normal delivery, and were intending to breastfeed for as long
as possible. Contraceptives were initiated at day 57 ± 3 postpartum. Results are reported
for the first year of use. All methods were highly effective, with pregnancy rates
below 1%. None affected breastfeeding performance or the rate of infant growth. Users
of the progestin-only methods experienced a period of lactational amenorrhea 4 to
5 months longer than did users of Copper T or untreated women. More than half of the
women in each contraceptive group reported a bleeding in the first month after treatment
initiation, which was not considered in the calculation of the duration of amenorrhea.
Prolonged or frequent bleedings were infrequent. The proportion of bleedings lasting
more than 10 days ranged from 0 in the progestin-only pills group to 7% in the Norplant
implants group. The four methods, initiated around the eighth postpartum week, provided
effective contraception with no negative effects upon lactation or infant growth and
without the bleeding problems associated with their use in nonlactating women.
Keywords
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Article info
Publication history
Accepted:
July 28,
1997
Received in revised form:
July 25,
1997
Received:
June 17,
1997
Identification
Copyright
© 1997 Published by Elsevier Inc.
