Dear Friends:
    There is a study used to support the use of depo early on. It is by
Shabaan in 1993. Found no problem with milk supply when depo given in the
early postpartum. Before you all gasp (I can hear you :-), keep reading...
    "Early on" in this study meant at 8 weeks after delivery! The population
in the study were poor Muslim women in a rural area, who had a cultural
mandate to breastfeed for at least 2 years and had no access to any other
feeding method.
    Which is quite a bit different to giving depo before hospital discharge
and sending women out into a world with little or no breastfeeding support
and gallons of breastmilk substitutes visible everywhere.
    It is outrageous and clearly malpractice to give depo before the
manufacturer's recommendation. It is paternalistic for the health care system
to feel responsible for "those women" getting pregnant again. It also
reflects a societal belief that women are sexually active all the time, no
matter what else is going on. The assumption is that women will not take care
of themselves either. Women are subtly encouraged to go home and jump in the
sack right away; why else give a powerful contraceptive on day 2 or 3
postpartum?
    How long will women tolerate such attitudes?
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner; childbirth educator
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative

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