My experience with depo is now 5 years old, but clearly (and sadly) still current. In the hospital where I worked (I have no reason to believe this has changed), depo was not only routinely given to moms in hospital, but mothers told me that they were told they could not leave without getting the shot! Once, when one of my staff gave a mom a package insert to read (the inserts were rearely given to the moms), I was told by a very high-level physician that to do this was practicing medicine w/o a license! He was serious and when I asked him if mothers had the right to informed consent, he replied that birth control was not a mother's decision, but the decision of her doctor. I will  never forget him saying that to me. I was truly stunned, and I knew he believed it. I almost never (maybe even really never) saw a private insurance mom get depo in hospital, but among the clinic population, it was pushed very hard. 

Once we had an "in-service" from the drug rep about depo (we could never get all of the nurses to a bf in-service, but the room was filled for this). She told us that a study had been done showing that depo actually increases milk production. I asked her if the mothers who had "increased" supply were monitored for number of times baby went to breast vs the other group--that perhaps the depo lowered supply and the babies compensated by nursing more often, thus possibly increasing supply (I have seen mothers who smoke have this happen). She told me she did not know, but promised to find out and to give me a hard copy of the study (of course she had no copy with her and didn't have the author's name). I never heard from her. 

Many of the clinic staff did not want us to tell mothers about LAM, as they wanted the clinic moms on depo. They did not even like them to use the mini-pill b/c they said the moms would forget to take it. They did not want the moms to come back at 6 weeks for the depo b/c they said the moms would be pregnant or would not come in. Issues around personal freedom and informed decision-making were a huge problem for us and often got us in hot water with staff. Among ourselves we said that "informed decision-making means that we (the HCP) will inform you of what we want you to know and you will make the decision we want you to make". It was very sad and painful to observe and sounds very much like the environment described in the first post. What was so shocking was how many people colluded in this completely classist behaviour and how little respect there was for women, for breastfeeding, for personal freedom (unless it meant freedom belonging to the priveleged) or for mothering. (Of course there were docs and nurses who were very truly pro-bf, but that was not the institutional attitude among the clinic--maybe this part has changed; maybe it all has--I do believe there are miracles). At the time, though, poor women breastfeeding was only acceptable if it didn't interfere with the goals that were valued--keeping poor women and young women from having babies, keeping teens in school and getting poor women back to work. And, of course, we were not to make anyone at all feel guilty!! Breastfeeding wasn't valued as a tool to accomplishing valued goals, even though it clearly could. In my experience, maintaining the status quo is a powerful motivator of those in power in the medical model.
Jennifer Tow, IBCLC, CT, USA