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OBG · Contraception: initiation after childbirth
Sample itemA woman who delivered 3 weeks ago, who is not breastfeeding, requests a progestogen-only implant. What is the advice?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. It can be inserted at any time after childbirth
Progestogen-only methods can be started immediately postpartum, and in non-breastfeeding women ovulation may return as early as 3 to 4 weeks, so earlier contraception is needed. Implants are suitable and do not affect lactation. Combined methods are delayed until at least 6 weeks.
Option by option
A. It is contraindicated in the puerperium
There is no contraindication in the puerperium.
B. It can be inserted at any time after childbirth (correct)
Correct. Progestogen-only implants can be placed at any time postpartum.
C. Only after a negative pregnancy test at 4 weeks
A pregnancy test at 4 weeks is not required if she is not at risk.
D. It must be delayed until 6 months
A six-month delay leaves her at risk of pregnancy.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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