One of my concerns with giving Depo right after birth is the definition
of "right after birth". It seems to me that there is a big difference
between giving it at discharge (2-4 days after birth) and giving it on
the day of birth, especially within the first 12 hours. I saw both being
done when I was working in a hospital; there was some discussion at
around that time of the effects of very early progestin administration
on the prolactin receptors (sorry, I don't have any references on this.)
When I had built a base of understanding I was able to discuss this with
the OB physician assistant who wrote many of the postpartum orders for
the largest OB practice there. After she read up on it she began
recommending that bfing moms wait six weeks (if they insisted on having
it before discharge - and some did! - she would write it for JUST before
discharge.)  I always kept in my mind that there is no way to neutralize
Depo. I also have encountered some women who had obvious milk supply
issues within a week or so of starting the mini-pill; these can at least
be stopped and with support supply usually recovers well.
Flossie Rollhauser

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