Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Postpartum Initiation of Contraception Implants

Contraception; ePub 2018 Nov 5; Averbach, et al

Immediate postpartum initiation of contraceptive implants does not have a harmful effect on infant growth or initiation or continuation of breastfeeding, a recent study found. Researchers conducted a randomized controlled trial of women who desired contraceptive implants postpartum. They randomly assigned participants to receive either immediate (within 5 days of delivery) or delayed (6‒8 weeks postpartum) insertion of a 2-rod levonorgestrel contraceptive implant system. The primary outcome of this secondary analysis (breastfeeding outcomes) was change in infant weight; infants were weighed and measured at birth and 6 months. Among the findings:

  • The change in infant weight from birth to 6 months was similar between groups (96 women randomized to the immediate group and 87 women to the delayed group).
  • Among the 97 women who had not experienced lactogenesis prior to randomization, the median time to onset of lactogenesis did not different significantly between groups.
  • Similar proportions of women in the 2 groups reported exclusive breastfeeding at 3 and 6 months.


Averbach S, Kakaire O, McDiehl R, Dehlendorf C, Lester F, Steinauer J. The effect of immediate postpartum levonorgestrel contraceptive implant use on breastfeeding and infant growth: A randomized controlled trial. [Published online ahead of print November 5, 2018]. Contraception. doi:10.1016/j.contraception.2018.10.008.

This Week's Must Reads

ACOG Guidelines: Pregestational Diabetes Mellitus, Obstet Gynecol; ePub 2018 Dec; ACOG, et al

Infertility, Metabolic Dysfunction & CV Events, Fertil Steril; ePub 2018 Nov 17; Gleason, et al

Barriers to Contraception After Vaginal Delivery, Contraception; ePub 2018 Nov 19; Flink-Bochacki, et al

Sleep Disturbance After Surgical Menopause, Menopause; ePub 2018 Nov 12; Cho, Kim, et al

NSAID Administration & Postpartum Blood Pressure, Obstet Gynecol; ePub 2018 Nov 5; Anastasio, et al

Must Reads in Contraception

Barriers to Contraception After Vaginal Delivery, Contraception; ePub 2018 Nov 19; Flink-Bochacki, et al

Postpartum Initiation of Contraception Implants, Contraception; ePub 2018 Nov 5; Averbach, et al

Women’s Preferences for Permanent Contraception, Contraception; ePub 2018 Oct 6; Piazza, et al

Intended Pregnancy After Being Denied an Abortion, Contraception; ePub 2018 Sep 20; Upadhyay, et al

VTE risk for continuous cycle oral contraceptives, Li J et al. JAMA Intern Med. 2018 Oct 1. doi:10.1001/jamainternmed.2018.4251