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    Safe contraception for women with medical conditions


    Case 1

    Shawna is a 33-year-old gravida 3 para 2+0+1+2 postoperative day 2 from a full-term repeat cesarean delivery. She wishes to wait at least 4 years before having her third and final child. Her body mass index (BMI) is 32 km/m2. She does not have hypertension or other medical problems. She is planning to breastfeed. She has used condoms, withdrawal, and combined oral contraceptives in the past but she is interested in learning about other methods because she previously conceived while taking the pill and had an induced abortion.

    Shawna has 3 main issues to consider when selecting a safe contraceptive: obesity, breastfeeding, and postpartum venous thromboembolism (VTE) risk (Table 1).

    Neena T Qasba, MD
    Dr Qasba is Family Planning Fellow, Department of Obstetrics, Gynecology, and Reproductive Sciences at Yale School of Medicine, New ...
    Nancy L. Stanwood, MD, MPH
    Dr. Stanwood is Section Chief, Family Planning, and Director, Fellowship in Family Planning, Department of Obstetrics, Gynecology & ...

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    • UBM User
      As an accredited Fertility Educator with Natural Fertility NZ and their Clinical Supervisor it is a real disappointment to see that LAM (lactational amenorrhoea method) was not mentioned or investigated as a valid option for client 1. It has no side effects to the mother or baby and actually promotes breastfeeding.


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