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29 September 2012

UK: Call for improved post-natal contraceptive advice

Almost two-thirds of mothers-to-be do not get contraception advice after the birth of their babies, a Mumsnet/BPAS survey has suggested.

Research found that 61% of women who have given birth in the last three years did not get such advice from healthcare professionals while pregnant.

The survey of 1,000 women also found that more than half did not discuss it until their postnatal check at around six weeks or later, PA reports.

BPAS said that it conducted the research after noticing a rise in the number of women experiencing unplanned pregnancy shortly after giving birth. It also noted an increase in the number of women who became pregnant whilst breastfeeding, believing it provided full contraceptive cover.

Breastfeeding can be used as a natural contraceptive which can be effective for up to six months after giving birth but only if strict criteria are met about frequency of feeds. The research found that 32% of women who were breastfeeding or planning to breastfeed said that safe contraception when breastfeeding was not discussed with a healthcare worker. More than half (55%) of women who chose to use breastfeeding as a method of contraception said that no healthcare professional discussed with them what form of contraception they would use if they stopped or reduced feeds.

Only 1% of all women discussed newer forms of contraception such as the contraceptive ring and patch. And more than a quarter of women would have liked more support and advice about contraception.

Ann Furedi, BPAS chief executive, said: “There’s never going to be a one-size-fits-all answer to postnatal contraception advice - and many women understandably find it laughable that they would want to discuss methods hours after giving birth or indeed find it patronising that it’s raised at all. Some women may want to fall pregnant again very rapidly - so healthcare professionals always have to tailor their care to the needs of the individual.

“But it’s vital that women who do want contraception can make their choice from the full range of options, particularly as their lifestyle and needs may have changed dramatically with the arrival of a new baby.

“Given the emphasis on breastfeeding, it is important that information is given about the limitations of this as a form of effective contraception, and what other methods can safely be used at the same time.”

Justine Roberts, Mumsnet co-founder, added: “Unreliable and unclear advice about contraception is the last thing a new mother needs.

“The number of discussions asking for advice about postnatal contraception on our forums indicates a worrying level of confusion amongst some parents, as confirmed by this survey. It would be helpful if mothers - whether breastfeeding or not - were offered access to clear, consistent advice from the medical profession before and after the birth.”

Comments from Mumsnet users on how contraception advice and information could be improved after a baby included:

“I would have preferred to have it discussed towards the end of pregnancy. I had to ring my GP when my daughter was 4 weeks, when I stopped breastfeeding and wanted to begin taking contraception again as I had no idea what to do about starting. I’d not discussed it with anyone up until this point.”

“I have found the information on what hormonal contraception is suitable whilst breastfeeding very muddled. For example, various guidance I have seen online say that I could go on the combined pill (youngest is 14 months and still breastfeeding) but the GP said categorically not.”

“I received contradictory advice from the midwife and GP- the GP believed that breastfeeding was a safe form of contraception, whereas the midwife warned me that it wasn’t (but didn’t offer any alternatives.)”

“I specifically asked for contraception as I didn’t want to rely on breast feeding alone as it’s not fail safe. I was then told that I didn’t need it as I was breastfeeding and we just went round in circles.”

“[There should be] more discussion whilst pregnant as I felt a bit overwhelmed with a new baby to even think about contraception.”

“I think the discussion should start ante-natally. Day one postpartum I laughed when the midwife mentioned contraception. Antenatal advice could include discussion on what is and isn’t suitable if breastfeeding.”

Contraception help plea for mothers. PA, 28 September 2012

Mumsnet/bpas survey shows gaps in contraception care for new mums – unclear advice to breastfeeding women raises risk of unplanned pregnancy. BPAS, 28 September 2012