Help!  I am being challenged by a physician on giving Depo Provera in the
early days postpartum (Like day 2 before discharge).  This physician has an
article from the American Journal of Obstetrics and Gynecology, Volume 186,
Number 6, June 2002: "Impact of early postpartum administration of
progestin-only hormonal contraceptives compared with nonhormonal
contraceptives on short-term breastfeeding patterns."  The article finds no
adverse impact on breastfeeding when depoprovera is given within the first 3
days postpartum.  He and I have discussed this a number of times in the
past, and he continues to want to give the Depo in the hospital before
discharge.

Now, I think there is only anectdotal evidence that DepoProvera can decrease
the milk supply, and I also think that the company recommends waiting 6
weeks for administration.  If anyone has any suggestions for me, I would
sincerely appreciate it.  This issue is going before our perinatal board
next week, and I would love to have something in my hand besides anecdotal
evidence.  Thanks much!  Linda

Linda J. Tandy, MSN, RN, CCM, IBCLC
Clinical Nurse Specialist
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