Contraception in the puerperium.

Choice of contraception in the puerperium is complicated by the normal factors of lactation, involuting uterus and emotional lability. The individual's previous contraceptive experience is important, and new agents and techniques change current practices. In the puerperium, failure for IUDs is increased, and tubal ligation has more hazards. During lactation the standard combined oral contraceptives are not advised, but the microdose progestagen-only pill may be a most satisfactory agent-changing to more routine methods when menstruation starts. In a population of normal women, progestagen-only therapy may show about a 25 per cent dropout because of an unacceptable bleeding pattern, but there is a small group of women who appear to be well suited by this form of oral contraception.