North American Registry of Midwives (NARM) Practice Exam

What is a possible risk if a woman starts taking oral contraceptives too soon after delivery?

1. Increased risk of clotting

2. Decreased milk production

3. Improper healing of the cervix

4. Heightened risk of uterine infection

The correct answer is: Increased risk of clotting

Starting oral contraceptives too soon after delivery can lead to an increased risk of clotting. This is largely due to the physiological changes that occur during the postpartum period. After childbirth, a woman’s body is already at a higher risk for thromboembolic events due to factors such as increased levels of clotting factors, changes in blood flow, and potentially prolonged immobility during recovery. When oral contraceptives that contain estrogen are introduced prematurely, they can exacerbate this risk, as estrogen is known to further increase the likelihood of blood clot formation. This highlights the importance of timing in postpartum contraceptive counseling, where healthcare providers need to consider the individual’s health, the mode of delivery, and any other risk factors for thromboembolic disease before recommending the initiation of hormonal contraceptives.