Options for Postpartum Contraception

Postpartum Contraceptive Options

MethodEffectivenessSpecial Considerations
Sterilization (male & female)99%+- Permanent
Etonogestrel (ENG) Implant99%+- Must be placed and removed by trained clinician
- Clinicians must attend manufacturer training prior to placement
IUD: Copper99%+- Must be placed and removed by trained clinician
IUD: Levonorgestrel (LNG)99%+- Must be placed and removed by trained clinician
Injectable (Medroxyprogesterone acetate)94%- Must obtain injection every 3 months
Lactational amenorrhea method (LAM)92-98%May be impractical for many women; this effectiveness is reached when:
- Infant frequently & exclusively breastfed (no pumping or bottles; time between feeding during day <4 hours & <6 hours at night)
- <6 months postpartum
- Amenorrheic
Progestin-only pill91%- Must take pill at same time every day with 3 hour late window
Estrogen/progestin combined pill, patch or ring91%- Cannot be used within 3 weeks of delivery due to increased risk of blood clots
- Women with risk factors must wait until 6 weeks after delivery to use these methods safely

CDC Recommendations on Contraceptive Methods

The Centers for Disease Control and Prevention (CDC) has published guidance regarding who can use various contraceptive methods, and clinical guidance for the initiation and use of specific contraceptive methods. Both the U.S. Medical Eligibility Criteria (MEC) and Selected Practice Recommendations (SPR) address the use of LARC methods immediately postpartum.

The CDC, in collaboration with the Office of Population Affairs at the U.S. Department of Health and Human Services, developed recommendations how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose not to have children. These recommendations are outlined in Providing Quality Family Planning Services (QFP).

United States Medical Eligibility Criteria for Contraceptive Use

U.S. Medical Eligibility Criteria (MEC), 2016

The 2016 U.S. MEC includes recommendations for using specific contraceptive methods by women and men who have certain characteristics or medical conditions.

United States Selected Practice Recommendations for Contraceptive Use

U.S. Selected Practice Recommendations (SPR), 2016

The 2016 U.S. SPR addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods.

Providing Quality Family Planning Services badge.

Providing Quality Family Planning Services (QFP)

The QFP recommends how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose to not have children.