Depoprovera is a wonderful form of birth control which can be used in
specific "high risk" groups of women...........women who may not have
much control over when they "do it" after birth due to their crummy
abusive relationship at home. Or that woman who has had 3 babies in 3
years because she doesn't return for postpartum checkups and doesn't use
barrier methods.

The key to use of depoprovera is informed consent. I counsel all women
to their choices and they do the selecting of the method. I think it is
a travesty when women are not informed by their provider of possible
side effects.

In terms of the milk production and use of progestin hormomal birth
control, many of us who provide BC to women use the Contraceptive
Technology book which continues to state that there is no effect on milk
production with these products. I know of providers who prescribe
combination OCPs because there in no "sound" research to show there is a
decrease in BM supply with these products. They won't take years of
anecdotal evidence as enough to change their practice. "Too many
variables to believe it's the OCPs."

It will be a few more generations before we can "prove" that
breastfeeding is not to be treated in such a cavalier fashion, and that
we need to provide care to women with the whole woman in mind. Until
then, we need to continue to swim upstream in our travels in womens
health care.

Bari Creager,CNM/IBCLC
College Station,Tx