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Health Care Provider Attitudes Toward Safety of Selected Hormonal Contraceptives in Breastfeeding Women
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8 2019
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Source: Matern Child Health J. 23(8):1079-1086
[PDF-344.10 KB]
Details:
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Alternative Title:Matern Child Health J
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Description:Objectives
Little is known about provider attitudes regarding safety of selected hormonal contraceptives among breastfeeding women.
Methods
Using a nationwide survey, associations were analyzed between provider characteristics and perception of safety of combined oral contraceptives (COCs) in breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors and depot medroxyprogesterone acetate (DMPA) in breastfeeding women < 1 month postpartum and ≥ 1 month postpartum.
Results
Approximately 68% of public-sector providers considered COCs safe for breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors, with lower odds among non-physicians versus physicians (adjusted odds ratios [aOR] range 0.34–0.51) and those with a focus on adolescent health/pediatrics versus reproductive health (aOR 0.68, 95% confidence interval [CI] 0.47–0.99). Most public-sector providers considered DMPA safe for breastfeeding women during any time postpartum, with lower odds among non-physicians versus physicians (aOR range 0.20–0.54) and those with primary clinical focus other than reproductive health (aOR range 0.26–0.65). The majority of office-based physicians considered COCs safe for breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors, with lower odds among those who did not use, versus those who used, CDC’s contraceptive guidance (aOR 0.40, 95% CI 0.21–0.77). Most office-based physicians also considered DMPA safe for breastfeeding women during any time postpartum.
Conclusions for Practice
A high proportion of providers considered use of selected hormonal contraceptives safe for breastfeeding women, consistent with evidence-based guidelines. However, certain provider groups might benefit from education regarding the safety of these methods for breastfeeding women.
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Pubmed ID:31069600
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Pubmed Central ID:PMC10983027
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