{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:31:04Z","timestamp":1790199064319,"version":"4.1.0"},"reference-count":55,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,5,13]],"date-time":"2019-05-13T00:00:00Z","timestamp":1557705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Whatever the outcome, pregnancy provides the opportunity to offer effective contraception to couples motivated to avoid another pregnancy. This narrative review summarizes the evidence for health providers, drawing attention to current guidelines on which contraceptive methods can be used, and when they should be started after pregnancy, whatever its outcome. Fertility returns within 1\u00a0month of the end of pregnancy unless breastfeeding occurs. Breastfeeding, which itself suppresses fertility after childbirth, influences both when contraception should start and what methods can be used. Without breastfeeding, effective contraception should be started as soon as possible if another pregnancy is to be avoided. Interpregnancy intervals of at least 6\u00a0months after miscarriage and 1\u20102\u00a0years after childbirth have long been recommended by the World Health Organization in order to reduce the chance of adverse pregnancy outcome. Recent research suggests that this may not be necessary, at least for healthy women &lt;35\u00a0years old. Most contraceptive methods can be used after pregnancy regardless of the outcome. Because of an increased risk of venous thromboembolism associated with estrogen\u2010containing contraceptives, initiation of these methods should be delayed until 6\u00a0weeks after childbirth. More research is required to settle the questions over the use of combined hormonal contraception during breastfeeding, the use of injectable progestin\u2010only contraceptives before 6\u00a0weeks after childbirth, and the use of both hormonal and intrauterine contraception after gestational trophoblastic disease. The potential impact on the risk of ectopic pregnancy of certain contraceptive methods often confuses healthcare providers. The challenges involved in providing effective, seamless service provision of contraception after pregnancy are numerous, even in industrialized countries. Nevertheless, the clear benefits demonstrate that it is worth the effort.<\/jats:p>","DOI":"10.1111\/aogs.13627","type":"journal-article","created":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T05:48:48Z","timestamp":1555652928000},"page":"1378-1385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Contraception after pregnancy"],"prefix":"10.1111","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5697-255X","authenticated-orcid":false,"given":"Anna","family":"Glasier","sequence":"first","affiliation":[{"name":"College of Medicine and Veterinary Medicine University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siladitya","family":"Bhattacharya","sequence":"additional","affiliation":[{"name":"Cardiff University Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Evers","sequence":"additional","affiliation":[{"name":"Maastricht University Maastricht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6516-1444","authenticated-orcid":false,"given":"Kristina","family":"Gemzell\u2010Danielsson","sequence":"additional","affiliation":[{"name":"Karolinska University Hospital Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hardman","sequence":"additional","affiliation":[{"name":"College of Medicine and Veterinary Medicine University of Edinburgh Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8671-130X","authenticated-orcid":false,"given":"Oskari","family":"Heikinheimo","sequence":"additional","affiliation":[{"name":"University of Helsinki Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"La Vecchia","sequence":"additional","affiliation":[{"name":"University degli Studi di Milano Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0223-0032","authenticated-orcid":false,"given":"Edgardo","family":"Somigliana","sequence":"additional","affiliation":[{"name":"University degli Studi di Milano Milan Italy"},{"name":"Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30380-4"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69737-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1728-4465.2015.00037.x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002136"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000841"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2014-101165"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2013.820824"},{"key":"e_1_2_8_9_1","unstructured":"National Collaborating Centre for Women's and Children's Health.Ectopic pregnancy and miscarriage: Diagnosis and initial management in early pregnancy of ectopic pregnancy and miscarriage.https:\/\/www.nice.org.uk\/guidance\/qs69Accessed February 4 2019;2014."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69480-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01338.x"},{"key":"e_1_2_8_12_1","unstructured":"RutsteinSO.Further evidence of the effects of preceding birth intervals on neonatal infant and under\u2010five\u2010years mortality and nutritional status in developing countries: evidence from the Demographic and Health Surveys. 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