Take-aways:
-We call the time from baby’s birth to your first menses “cycle zero”
-There is a HUGE range from how long cycle zero may last: from ~6 weeks to >1 year
-Ovulation returns before your first menses (you can get pregnant before your first period!)
-Due to risks for blood clots with estrogen-containing options, it’s recommended postpartum women who want to use hormonal contraception use an option that contains a form of progesterone only for at least the first 3 weeks postpartum and
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WHO recommends for the first 6 months postpartum
-Ovulation is not consistently suppressed with norethindrone progestin-only-pills, so its effectiveness relies on its ability to thicken cervical mucus (block sperm) and to thin the uterine lining (prevent implantation of a fertilized egg)
-It’s important to take progestin-only-pills at the exact same time everyday for them to be effective for contraception
-World Health Organization LAM protocol - a woman can use LAM if: her menstrual period has not returned since delivery AND she is breastfeeding her baby on demand, both day and night AND her baby is