The primary excuse given where I worked was, "These moms will get pregnant before their 6 week checkup if we don't give it now"  What a paternalistic attitude!  If breastfeeding were truly supported, the likelihood of pregnancy before 6 weeks is all but nil.  Even with formula feeding it is rather unlikely.  The other excuse is ,"They might not show up for the 6 week checkup so we need to be sure they have it now."  Again, this is making the decision for the mom, not letting her make an informed decision.  This was especially prevanent in the clinic that catered mostly to low income clients qnd those who were not (or very litle) English speaking.  It was also the practice with most of the Family Practice residents.  When I mentioned the concern with milk supply to one of the residents, he was quite surprised.  Aren't they taught to know or at least read the info from the supplier?!  Giving Depo completely avoids the underlying issues and is, to me, a "band-aid" approach.  Some of the real issues are:
1-Getting the moms back for their follow-up appointments.
2-Getting past the male attitudes of:
      It's the woman's responsibility to practice birth control
      I don't like using condoms
      I can'tg wait 6 more weeks for sex.  If I don't get it from her I will get it somewhere
3-Empowering the moms by helping them make truly informedd choices

Winnie Mading

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