Oral contraception during lactation: A global survey of physician practice

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Abstract
The use of combined estrogen-progestogen oral contraceptives (EP-OC) by lactating women has been associated with suppression of lactation. To determine the extent to which physicians prescribe combined EP-OC for lactating women, the International Planned Parenthood Federation (IPPF) and the United States Centers for Disease Control (CDC) collaborated in a global mail survey of 3697 physicians affiliated with Family Planning Associations (FPA) in 72 countries. Usable responses were received from 831 physicians (22%) in 65 countries. The percent of clinicians who provide EP-OC to lactating women was higher in developing regions (63% or more) than in developed regions (40% or less). Patient preference was rated important more often than any other factor in the decision to prescribe EP-OC for lactating women. The percentage of clinicians who reported complaints of decreased milk production from women using EP-OC was higher (32% or more) in developing regions where breast milk is often essential to infant nutrition.

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