Post pregnancy contraception

Ovulation resumes as quickly as 21 days after birth in a non-fully breastfeeding woman. Traditionally, contraceptive services have been offered 6 weeks post-partum. This is far from ideal and results in unnecessary abortions or inadequate birth spacing which both carry an increased risk of morbidity to mother and potential newborn as well as costs to the health care service. It is now clear that contraception should be discussed during the pregnancy so that the method of choice can be offered immediately post pregnancy prior to discharge from hospital. Long acting reversible contraceptive methods such as implants and IUDs are highly effective as they are user-independent. Large studies have demonstrated that they can be safely inserted during the immediate post-partum period with no increase in complication rates. Policy makers should strive to overcome barriers to offering quality post pregnancy contraceptive services. (C) 2020 Published by Elsevier Ltd.