Laurie Barrett writes, re: depo-provera & milk supply:
"...if EBF, the mother should not need this form of birth control anyway?...

"Should" is a kind of loaded word to use here - while I understand what
Laurie is saying, I have seen SO MANY women come back pregnant while still
breastfeeding their very young babies. For the most part, these are women
who don't want to be pregnant again so soon; they tend to be very young
(teens, usually),with lives that are very often chaotic at worst and
difficult at best. They do breastfeed, but they don't necessarily do so in
the way that we know helps to prevent the return of ovulation. There is such
social & family pressure on these young women to "get" the baby to sleep
through the night, to limit feedings to every 3-4 hrs. (or more), to "let"
grandma or dad or girlfriends feed the baby "just once in a while", to "get
the baby used to a bottle so he'll be able to take it when you have to leave
him to go back to work/school",etc. (And these are the ones who are getting
"good" BF support from their families!) Or they may be women with lots of
children already. Some of the women who choose depo know they aren't good at
taking a pill consistently, or their partners refuse to use (or allow them
to use) other means of birth control - may seem far-fetched to you or me,
but it happens a lot!

These very same women are the ones least likely to be able to support and
raise another child so soon; they are frequently trying to finish high
school (or even middle school, sadly), or working at very low-paying menial
jobs (often with irregular hours, which further makes their BFing less than
ideal for suppressing ovulation). They may not have a consistent partner, or
the father of the current baby may be incarcerated or away in the military.
For an awful lot of reasons, these are not women who can afford (in all the
dimensions of the word) to have another child right now; managing the one
(or more!) they already have is a feat almost beyond my imagination.

"We see the aftermath when the mother comes into the clinic
for formula because her supply will no longer meet the baby's needs."

Hate to admit it, but I'd rather deal with the aftermath of giving out
formula than watch these moms take on the struggle of an unwanted baby!

For anyone who just can't imagine that there are that many women whose lives
look like this, I'd recommend spending some time at a WIC clinic, or Planned
Parenthood, or the local Teen Pregnancy center. I stand in absolute awe of
the many women I've known through WIC, who do a good job with their kids in
spite of obstacles that I can't even describe!

Sorry, I didn't mean to get up on my high horse, just wanted to share an
alternate view. Cathy Bargar, RN, IBCLC