North American Registry of Midwives (NARM) Practice Exam

What advice is typically given regarding postpartum hormone-based contraception?

1. It should be initiated immediately for effectiveness

2. Delaying initiation is safer to prevent complications

3. It can interfere with breastfeeding

4. It needs prior medical clearance to start

The correct answer is: Delaying initiation is safer to prevent complications

The advice given regarding postpartum hormone-based contraception typically emphasizes that delaying initiation is safer to prevent complications. In the postpartum period, a woman's body is undergoing significant physiological changes as it adjusts to not being pregnant. Introducing hormonal contraception too soon can lead to potential risks, such as the possibility of thromboembolism, especially in women who have had cesarean deliveries or other risk factors. Moreover, early initiation without assessing the woman's individual health status and potential complications may not be ideal for every postpartum woman. Therefore, the recommendation is often to encourage waiting for a specified period, usually around six weeks, before starting hormonal birth control. This allows time for the woman's body to heal and also provides an opportunity to discuss options with healthcare providers to ensure the chosen method is appropriate. While there are considerations regarding breastfeeding and medical clearance, the primary caution centers on the timing of when to start hormone-based contraceptives to ensure both safety and effectiveness.