Box 3.6Recommendations for contraceptive methods for postpartum women, including lactating women (109)

Less than six weeks postpartum
Postpartum women who are < 48 hours postpartum can use Cu-IUDs (MEC Category 1).
Breastfeeding women who are < 48 hours postpartum can generally use LNG-IUDs (MEC Category 2).
Breastfeeding women who are < 6 weeks postpartum can generally use POPs and LNG and ETG implants (MEC Category 2).
Breastfeeding women who are ≥ 4 weeks postpartum can use the PVR without restrictions (MEC Category 1).
Postpartum women who are ≥ 4 weeks postpartum can use Cu-IUDs and LNG-IUDs without restriction (MEC Category 1).
Postpartum women who are ≥ 21 days to 42 days postpartum without other risk factors for venous thromboembolism (VTE) can generally use CHCs (MEC Category 3).
Six weeks to less than six months postpartum
Breastfeeding women who are ≥ 6 weeks to < 6 months postpartum can use POPs, POIs, and LNG and ETG implants without restriction (MEC Category 1).
Postpartum women who are > 42 days postpartum can use CHCs without restriction (MEC Category 1).
Recommendations against some contraceptive methods
Postpartum women who are ≥ 48 hours to < 4 weeks postpartum generally should not have an LNG-IUD inserted (MEC Category 3).
Breastfeeding women who are < 6 weeks postpartum generally should not use POIs (depot medroxyprogesterone acetate or norethisterone enanthate) (MEC Category 3).
Breastfeeding women < 6 weeks postpartum should not use CHCs (MEC Category 4).
Breastfeeding women ≥ 6 weeks to < 6 months postpartum generally should not use CHCs (MEC Category 3).
Postpartum women who are < 21 days postpartum and do not have other risk factors for VTE generally should not use CHCs (MEC Category 4).
Postpartum women who are < 21 days postpartum with other risk factors for VTE should not use CHCs (MEC Category 2).
Postpartum women who are ≥ 21 days to 42 days postpartum with other risk factors for VTE generally should not use (MEC Category 3).
Recommendations on emergency contraception
Breastfeeding women can use combined oral contraceptive pills or LNG for emergency contraceptive pills (ECPs) without restriction (MEC Category 1).
Women who are breastfeeding can generally use ulipristal acetate for ECPs (MEC Category 2).

From: 3, Evidence and recommendations

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