Contraception, Postpartum Depression, Lactation
Conditions
Keywords
Postpartum contraception, Contraceptive continuation, Breastfeeding, Postpartum depression, Progestins
Brief summary
The investigators plan to enroll 184 women who are planning to breastfeed and use DMPA after delivery to find out whether the timing of postpartum administration of DMPA (prior to hospital discharge or 4-6 weeks after delivery) affects the duration or exclusivity of breastfeeding among women who plan to breastfeed their infants.
Detailed description
In the United States, depot medroxyprogesterone acetate (DMPA) is given to women after delivery and before hospital discharge with the belief that women who delay starting DMPA may be more likely to become pregnant when they are not yet ready to be pregnant and that giving DMPA before discharge has little to no negative effect on breastfeeding. Administering DMPA to breastfeeding women has not been widely questioned because the limited existing studies do not show any adverse impact of DMPA on breastfeeding. However, these studies used inappropriate control groups and did not control for prior lactation experience. The investigators plan to enroll 184 women who are planning to breastfeed and use DMPA after delivery to find out whether the timing of postpartum administration of DMPA (prior to hospital discharge or 4-6 weeks after delivery) affects the duration or exclusivity of breastfeeding among women who plan to breastfeed their infants. The investigators will also look at rates of use of highly effective contraception (defined as DMPA, intrauterine device, implant, sterilization, or lactational amenorrhea) and postpartum depression.
Interventions
Postpartum administration of DMPA (prior to hospital discharge)
Sponsors
Society of Family Planning
Beatrice Chen
Study design
Allocation
RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Age \> 18 years old and \> 24 0/7 weeks pregnant at time of enrollment * Planning to deliver at Magee-Womens Hospital and to breastfeed * Plans to use DMPA for postpartum contraception for at least 6 months * Willing and able to provide informed consent in English and to comply with study protocol
Exclusion criteria
* Intolerance of irregular vaginal bleeding * Severe coagulation disorder * Severe liver disease (LFTs \>2x upper limits of normal at time of randomization) * Contraindications to breastfeeding: maternal HIV infection; active herpes simplex with breast lesions; active varicella; active, untreated tuberculosis; antineoplastic, thyrotoxic, or immunosuppressive medications; concern that the infant may have galactosemia * History of breast cancer, reduction or augmentation surgery * History of severe clinical depression * Multiple gestation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2, 4, 6, 8 12, 16, 20, 24, and 28 weeks postpartum | Any breastfeeding at specific time intervals postpartum |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | 6 months | Use of DMPA, IUD, implant, or sterilization |
| Rates of Postpartum Depression After Postpartum or Delayed Initiation of DMPA | 8 weeks postpartum | Edinburgh Postnatal Depression Scale (EPDS) score after postpartum or delayed initiation of DMPA: minimum possible score 0, maximum possible score 30; score of 12 or greater is a positive screen for postpartum depression |
| Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2, 4, 6, 8, 12, 16, 20,24 and 28 weeks postpartum | Exclusive breastfeeding at specific time intervals postpartum |
Countries
United States
Participant flow
Pre-assignment details
Since participants could be recruited antepartum but may have changed their mind about breastfeeding or DMPA use post-partum, eligibility criteria were re-assessed postpartum, prior to randomization, thus the number of women enrolled in the study (184) does not equal the number of women randomized (157).
Participants by arm
| Arm | Count |
|---|---|
| DMPA Postpartum Depot medroxyprogesterone acetate postpartum
Depot medroxyprogesterone acetate: Postpartum administration of DMPA (prior to hospital discharge) | 79 |
| DMPA at 4-6 Weeks After Delivery Depot medroxyprogesterone acetate at 4-6 weeks after delivery
Depot medroxyprogesterone acetate: Delayed administration of DMPA (4-6 weeks postpartum) | 78 |
| Total | 157 |
Baseline characteristics
| Characteristic | DMPA at 4-6 Weeks After Delivery | Total | DMPA Postpartum |
|---|---|---|---|
| Age, Continuous | 24.4 years STANDARD_DEVIATION 4.7 | 24.1 years STANDARD_DEVIATION 4.8 | 23.9 years STANDARD_DEVIATION 4.9 |
| Race/Ethnicity, Customized Black | 61 Participants | 122 Participants | 61 Participants |
| Race/Ethnicity, Customized Hispanic | 6 Participants | 9 Participants | 3 Participants |
| Race/Ethnicity, Customized Other | 8 Participants | 15 Participants | 7 Participants |
| Race/Ethnicity, Customized White | 9 Participants | 20 Participants | 11 Participants |
| Sex: Female, Male Female | 78 Participants | 157 Participants | 79 Participants |
| Sex: Female, Male Male | 0 Participants | 0 Participants | 0 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 79 | 0 / 78 |
| other Total, other adverse events | 0 / 79 | 0 / 78 |
| serious Total, serious adverse events | 0 / 79 | 0 / 78 |
Outcome results
Primary
Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA
Any breastfeeding at specific time intervals postpartum
Time frame: 2, 4, 6, 8 12, 16, 20, 24, and 28 weeks postpartum
Population: 1 ppt withdrawn postrandomization due to enrollment violation (did not meet eligibility criteria)
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Formula only | 9 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Missed call | 6 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Formula only | 4 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Any breastfeeding | 40 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Missed call | 9 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Formula only | 30 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Formula only | 4 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Missed call | 8 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Any breastfeeding | 59 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Any breastfeeding | 39 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Missed call | 6 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Formula only | 29 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Formula only | 14 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Missed call | 10 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Any breastfeeding | 69 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Any breastfeeding | 34 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Missed call | 6 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Formula only | 32 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Any breastfeeding | 61 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Missed call | 12 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Any breastfeeding | 51 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Any breastfeeding | 39 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Missed call | 4 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Formula only | 28 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Formula only | 22 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Missed call | 11 Participants |
| DMPA Postpartum | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Any breastfeeding | 71 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Missed call | 13 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Any breastfeeding | 70 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Formula only | 4 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Missed call | 3 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Any breastfeeding | 66 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Formula only | 7 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Missed call | 4 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Any breastfeeding | 63 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Formula only | 9 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Missed call | 5 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Any breastfeeding | 53 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Formula only | 16 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Missed call | 8 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Any breastfeeding | 47 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Formula only | 21 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Missed call | 8 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Any breastfeeding | 40 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Formula only | 28 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Missed call | 8 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Any breastfeeding | 31 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Formula only | 34 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Missed call | 11 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Any breastfeeding | 32 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Formula only | 34 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Missed call | 10 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Any breastfeeding | 38 Participants |
| DMPA at 4-6 Weeks After Delivery | Duration of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Formula only | 25 Participants |
Secondary
Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA
Exclusive breastfeeding at specific time intervals postpartum
Time frame: 2, 4, 6, 8, 12, 16, 20,24 and 28 weeks postpartum
Population: Two participants withdrew during follow-up
| Arm | Measure | Group | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|---|
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Exclusive breastfeeding | 25 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Any formula | 37 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Missed call | 4 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Exclusive breastfeeding | 29 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Any formula | 44 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Missed call | 6 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Exclusive breastfeeding | 38 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Any formula | 45 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Missed call | 9 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Exclusive breastfeeding | 23 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Any formula | 50 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Missed call | 6 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Exclusive breastfeeding | 17 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Any formula | 56 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Missed call | 6 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Exclusive breastfeeding | 13 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Any formula | 57 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Missed call | 8 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Exclusive breastfeeding | 11 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Any formula | 57 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Exclusive breastfeeding | 9 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Any formula | 57 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Missed call | 12 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Exclusive breastfeeding | 7 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Any formula | 60 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Missed call | 11 Participants |
| DMPA Postpartum | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Missed call | 10 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Any formula | 46 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Exclusive breastfeeding | 37 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Any formula | 57 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Any formula | 37 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Missed call | 8 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 2 weeks postpartum | Missed call | 3 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Exclusive breastfeeding | 10 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Exclusive breastfeeding | 28 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Exclusive breastfeeding | 15 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Any formula | 45 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Exclusive breastfeeding | 6 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 4 weeks postpartum | Missed call | 4 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Any formula | 53 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Exclusive breastfeeding | 25 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Any formula | 56 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Any formula | 47 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 16 weeks postpartum | Missed call | 8 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 6 weeks postpartum | Missed call | 5 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 28 weeks postpartum | Missed call | 13 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Exclusive breastfeeding | 19 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Exclusive breastfeeding | 10 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Any formula | 50 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 24 weeks postpartum | Missed call | 10 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 8 weeks postpartum | Missed call | 8 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Any formula | 55 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 12 weeks postpartum | Exclusive breastfeeding | 22 Participants |
| DMPA at 4-6 Weeks After Delivery | Exclusivity of Breastfeeding Among Women Who Plan to Breastfeed Their Infants After Postpartum or Delayed (4-6 Weeks Postpartum) Initiation of DMPA | 20 weeks postpartum | Missed call | 11 Participants |
Secondary
Rates of Postpartum Depression After Postpartum or Delayed Initiation of DMPA
Edinburgh Postnatal Depression Scale (EPDS) score after postpartum or delayed initiation of DMPA: minimum possible score 0, maximum possible score 30; score of 12 or greater is a positive screen for postpartum depression
Time frame: 8 weeks postpartum
Population: Excludes 14 participants with a missed call at 8 weeks postpartum
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| DMPA Postpartum | Rates of Postpartum Depression After Postpartum or Delayed Initiation of DMPA | 1.0 scores on a scale |
| DMPA at 4-6 Weeks After Delivery | Rates of Postpartum Depression After Postpartum or Delayed Initiation of DMPA | 0 scores on a scale |
Secondary
Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA
Use of DMPA, IUD, implant, or sterilization
Time frame: 6 months
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| DMPA Postpartum | Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | DMPA, IUD, implant, or sterilization | 43 Participants |
| DMPA Postpartum | Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | Less effective than DMPA | 25 Participants |
| DMPA Postpartum | Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | Lost to followup | 11 Participants |
| DMPA at 4-6 Weeks After Delivery | Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | DMPA, IUD, implant, or sterilization | 44 Participants |
| DMPA at 4-6 Weeks After Delivery | Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | Less effective than DMPA | 21 Participants |
| DMPA at 4-6 Weeks After Delivery | Rates of Use of Highly Effective Contraception (Defined as DMPA, IUD, Implant, Sterilization, or Lactational Amenorrhea) After Postpartum or Delayed Initiation of DMPA | Lost to followup | 13 Participants |