| a) New user? Postpartum women who plan to use the lactational amenorrhea method
(LAM) can be given their pill cycles immediately postpartum, with instructions to begin
taking them (see Question 1) when any of the LAM criteria no
longer apply. Women who plan to rely on LAM for six months can be given at least a six
month supply (to begin when the LAM criteria no longer apply), so they will have
contraceptive protection for at least one year.
Up to 13 cycles (a full year's supply) can be given,
although only three or four may be programmatically feasible. The greatest need is to
guarantee continuous, ready access. |
a) The woman's convenience is
important. To avoid running out of pills, the woman should have ready access to more POP
cycles. Ideally, she should be able to obtain plenty of POP cycles at her visit. While some providers suspect that clients who receive multiple pill
cycles may "share" these with friends, such "sharing" is likely to be
as safe and effective as over-the-counter distribution systems. |
| b) Subsequent visits? There is no compelling medical reason for a routine return visit
concerning POP use, but clients should be encouraged to return at any time with concerns,
problems or questions.
For first-time users of POPs, programs may encourage a
three-month follow-up visit for counseling to assess whether the client is satisfied with
the method and is correctly using the method, to reinforce instructions, and to help
clients with the management of side effects. |
b) The extremely low dose of
progestins in POPs make them a very safe method of contraception. The greatest health risk
from POPs is pregnancy due to method failure, which is preventable by assuring adequate
POP supply and correct, consistent method use.
- McCann MF, Potter LS. Progestin-only
oral contraception: a comprehensive review. Contraception 1994;50(6).
- Harlap S, Kost K, Forrest JD.
Preventing pregnancy, protecting health: a new look at birth control choices in the United
States. Washington, D.C.: The Alan Guttmacher Institute, 1991.
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