Family Planning

Woman’s situationPartially breastfeeding(continued)More than 6 weeksafter giving birthWhen to startóóIf her monthly bleeding has not returned,she can start POPs any time it is reasonablycertain she is not pregnant. † She will need abackup method for the first 2 days of takingpills. (If you cannot be reasonably certain, giveher POPs now and tell her to start takingthem during her next monthly bleeding.)If her monthly bleeding has returned, shecan start POPs as advised for women havingmenstrual cycles (see next page).Not breastfeedingLess than 4 weeks aftergiving birthMore than 4 weeksafter giving birthSwitching froma hormonalmethodóóóóóShe can start POPs at any time. No need for abackup method.If her monthly bleeding has not returned,she can start POPs any time it is reasonablycertain she is not pregnant. † She will need abackup method for the first 2 days of takingpills. (If you cannot be reasonably certain, giveher POPs now and tell her to start takingthem during her next monthly bleeding.)If her monthly bleeding has returned, shecan start POPs as advised for women havingmenstrual cycles (see next page).Immediately, if she has been using thehormonal method consistently and correctlyor if it is otherwise reasonably certain she isnot pregnant. No need to wait for her nextmonthly bleeding. No need for a backupmethod.If she is switching from injectables, she canbegin taking POPs when the repeat injectionwould have been given. No need for a backupmethod.†Where a visit 6 weeks after childbirth is routinely recommended and other opportunities toobtain contraception limited, some providers and programs may allow a woman to start POPsat the 6-week visit, without further evidence that the woman is not pregnant, if her monthlybleeding has not yet returned.32 Family Planning: A Global Handbook for Providers