Informed choice--the timing of postpartum contraceptive initiation.
BACKGROUND
In South Africa injectable progestogen-only contraceptives (IPC) are typically administered to women immediately after delivery. Several guidelines advise that breast-feeding women should not commence IPC until 6 weeks postpartum on the basis of theoretical risks to the infant.


OBJECTIVE
We examined women's preferences regarding timing of postpartum IPC initiation, as well as women's contraceptive and breast-feeding behaviours and pregnancy risk in the early postpartum period. DESIGN AND DATA COLLECTION: A cross-sectional study was conducted among 200 antenatal clinic (ANC) attendees and 180 mothers attending a child health clinic (CHC). At the ANC, women were given information on the theoretical risks of IPC and re-interviewed about their postpartum contraceptive intentions.


RESULTS
Most ANC women planned to use IPCs (92%) and to breast-feed (98%) after delivery. Most CHC mothers had used IPCs (91%) and had breast-fed (83%) after delivery. When women at the ANC were provided with appropriate information they made decisions about when to initiate IPC by balancing the theoretical risks of IPC to their infant against their personal risk of pregnancy and ability to return to a clinic in the early postpartum period.


CONCLUSIONS
It is important to include informed choice in postpartum IPC initiation guidelines.
Hani
A
A
Women's Health Research Unit, School of Public Health and Primary Health Care, University of Cape Town.
Moss
M
M
Cooper
D
D
Morroni
C
C
Hoffman
M
M
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D002755:Choice Behavior; D003268:Contraception Behavior / Q000706:statistics & numerical data; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006266:Health Education; D006801:Humans; D019359:Knowledge; D049590:Postpartum Period; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D016387:Women's Health
D003271:Contraceptive Agents, Female