Health Care Provider Attitudes Toward Safety of Selected Hormonal Contraceptives in Breastfeeding Women.
Matern Child Health J
; 23(8): 1079-1086, 2019 Aug.
Article
in En
| MEDLINE
| ID: mdl-31069600
ABSTRACT
OBJECTIVES:
Little is known about provider attitudes regarding safety of selected hormonal contraceptives among breastfeeding women.METHODS:
Using a nationwide survey, associations were analyzed between provider characteristics and perception of safety of combined oral contraceptives (COCs) in breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors and depot medroxyprogesterone acetate (DMPA) in breastfeeding women < 1 month postpartum and ≥ 1 month postpartum.RESULTS:
Approximately 68% of public-sector providers considered COCs safe for breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors, with lower odds among non-physicians versus physicians (adjusted odds ratios [aOR] range 0.34-0.51) and those with a focus on adolescent health/pediatrics versus reproductive health (aOR 0.68, 95% confidence interval [CI] 0.47-0.99). Most public-sector providers considered DMPA safe for breastfeeding women during any time postpartum, with lower odds among non-physicians versus physicians (aOR range 0.20-0.54) and those with primary clinical focus other than reproductive health (aOR range 0.26-0.65). The majority of office-based physicians considered COCs safe for breastfeeding women ≥ 1 month postpartum without other venous thrombosis risk factors, with lower odds among those who did not use, versus those who used, CDC's contraceptive guidance (aOR 0.40, 95% CI 0.21-0.77). Most office-based physicians also considered DMPA safe for breastfeeding women during any time postpartum. CONCLUSIONS FOR PRACTICE A high proportion of providers considered use of selected hormonal contraceptives safe for breastfeeding women, consistent with evidence-based guidelines. However, certain provider groups might benefit from education regarding the safety of these methods for breastfeeding women.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Breast Feeding
/
Health Personnel
/
Contraceptives, Oral, Hormonal
Type of study:
Guideline
/
Qualitative_research
/
Risk_factors_studies
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Matern Child Health J
Journal subject:
PERINATOLOGIA
Year:
2019
Type:
Article
Affiliation country:
United States