The efficacy, acceptability and continuation of postpartum, post-abortive progestin-only pill: a pioneering prospective multicentric study from Turkey.

Abstract

The aim of this study was to evaluate the efficacy, side-effects and continuation rate of the desogestrel-progestin-only-pill (POP) in postpartum and post-abortive Turkish women its relation with breast-feeding. In this prospective multicentric study women who delivered (or had surgical abortion) and wanted to receive POP for contraception were recruited to the study. The follow-up visits were scheduled at 3rd, 6th and 9th months. Overall 7468 women (66.5% postpartum, 33.5% post-abortive) participated in the study. According to the previous visit, the percentage of women who came for a follow-up visit at 3rd, 6th and 9th month was 944(12.6%), 406(43%) and 121(29.8%) respectively. Out of the 7468 women recruited only 6% continued with the method at the end of the 9th month. There was a statistically significant increase in Hb level at the 3rd month when compared to the initial values. The incidence of breastfeeding at all visits was between 54.8% and 68.4%. Oligomenorrhea, spotting and headache were the three leading side-effects. There was no pregnancy among the patients who were followed up. This study demonstrates that POP is an effective postpartum and post-abortive contraceptive method that has no negative impact on breast-feeding and the change in bleeding patterns is the most common side-effect. However, the possible causes of low contraceptive maintenance rates need to be investigated.