Family Planning

Woman’s situationFully or nearly fullybreastfeeding(continued)More than 6 monthsafter giving birthWhen to startóóIf her monthly bleeding has not returned, she canstart injectables any time it is reasonably certainshe is not pregnant. She will need a backupmethod for the first 7 days after the injection.If her monthly bleeding has returned, she canstart injectables as advised for women havingmenstrual cycles (see p. 89).Partially breastfeedingLess than 6 weeksafter giving birthMore than 6 weeksafter giving birthóóóDelay her first injection until at least 6 weeksafter giving birth.If her monthly bleeding has not returned, she canstart injectables any time it is reasonably certainshe is not pregnant. † She will need a backupmethod for the first 7 days after the injection.If her monthly bleeding has returned, she canstart injectables as advised for women havingmenstrual cycles (see p. 89).Not breastfeedingLess than 4 weeksafter giving birthMore than 4 weeksafter giving birthóóóShe can start injectables at any time on days21–28 after giving birth. No need for a backupmethod.If her monthly bleeding has not returned, she canstart injectables any time it is reasonably certainshe is not pregnant. † She will need a backupmethod for the first 7 days after the injection.If her monthly bleeding has returned, she canstart injectables as advised for women havingmenstrual cycles (see p. 89).†Where a visit 6 weeks after childbirth is routinely recommended and other opportunities toobtain contraception limited, some providers and programs may give the first injection at the6-week visit, without further evidence that the woman is not pregnant, if her monthly bleedinghas not yet returned.90 Family Planning: A Global Handbook for Providers