North American Registry of Midwives (NARM) Practice Exam

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How soon after a full-term delivery can a non-breastfeeding woman safely start taking combination oral contraceptives?

1 week
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3 weeks
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The correct answer is: 3 weeks

The correct timing for a non-breastfeeding woman to begin taking combination oral contraceptives after a full-term delivery is at least three weeks postpartum. This recommendation is based on the understanding that the postpartum period presents specific risks and health considerations. Starting combination oral contraceptives too soon after delivery, particularly within the first three weeks, is associated with a higher risk of thromboembolic events, such as deep vein thrombosis or pulmonary embolism. The body undergoes significant changes during the postpartum period, including increased coagulability, which can elevate the risk of blood clots. By waiting until at least three weeks have passed, the slight increase in risk diminishes. Additionally, it's important to note that the hormonal changes associated with a woman's body returning to its pre-pregnancy state typically take several weeks. This time allows for better stability in hormonal levels, which can reduce side effects and improve the overall efficacy of the contraceptive method. While there are other contraceptive options that may be suitable sooner, especially for breastfeeding women, combination oral contraceptives specifically require this waiting period to ensure safety and optimal health outcomes.