Family Planning

Providing Monthly InjectablesWhen to StartIMPORTANT: A woman can start injectables any time she wants if it isreasonably certain she is not pregnant. To be reasonably certain she is notpregnant, use the Pregnancy Checklist (see p. 372).Woman’s situationHaving menstrualcycles orswitching froma nonhormonalmethodWhen to startAny time of the monthóóóIf she is starting within 7 days after the startof her monthly bleeding, no need for a backupmethod.If it is more than 7 days after the start of hermonthly bleeding, she can start injectables anytime it is reasonably certain she is not pregnant.She will need a backup method * for the first 7days after the injection.If she is switching from an IUD, she can startinjectables immediately (see Copper-BearingIUD, Switching From an IUD to AnotherMethod, p. 148).5Monthly InjectablesSwitching froma hormonalmethodóóImmediately, if she has been using the hormonalmethod consistently and correctly or if itis otherwise reasonably certain she is notpregnant. No need to wait for her next monthlybleeding. No need for a backup method.If she is switching from another injectable, shecan have the new injectable when the repeatinjection would have been given. No needfor a backup method.Fully or nearly fullybreastfeedingLess than 6 monthsafter giving birthóDelay her first injection until 6 months aftergiving birth or when breast milk is no longer thebaby’s main food—whichever comes first.*Backup methods include abstinence, male and female condoms, spermicides, andwithdrawal. Tell her that spermicides and withdrawal are the least effective contraceptivemethods. If possible, give her condoms.Providing Monthly Injectables89