In the USA, it can be an insurance coverage issue.

If the mother is on Federal Emergency Services (FES), perhaps because she's not a citizen, the Depo shot is covered when she gets it in the hospital before discharge. Because it's emergency health care, the coverage ends for mother at the moment of discharge. This same mother will have to pay for it out of pocket if she waits until her 6-week checkup, (also paid out of pocket?) it is too much $$ out of her very limited resources, so she doesn't get it. Or she gets the cheapest: oral contraceptive pills. Or relies on her husband's use of condoms.

If the mother is on state-funded health care or a private health care provider as part of an employment benefits package or self-paid, the Depo shot is covered when given at the 6 week checkup.

I meet mothers every day who state that they breastfed previous babies for a year or more, but it's very rare that they spent any time breastfeeding exclusively. The vast majority used supplemental formula on a daily basis. Is their selection of birth control the reason they believe they can never make enough milk and therefore they "need" formula and always choose "breast and bottle" when admitted to the hospital in labor?

Some lose their milk in 2-4 months, likely related to heavy use of supplemental feeds many times a day.

Some lose their milk within a week or two of beginning Depo, or the Pill. Others claim absolutely no effect on milk supply, which supports the ACOG protocol for beginning the Pill at 4-6 weeks postpartum. Would like to know why this is....

Phyllis

 
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Phyllis Adamson, BA, IBCLC
Glendale, AZ.
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