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.