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Depo provera postpartumFrom: Cbcnm@aol.comTue Mar 26 07:45:50 1996
In our MD/CNM collaborative practice we provided care for a 14 year old who had a huge (8 cm) Gartners duct cyst on the anterior aspect of her vagina. This was very bothersome to her, so we planned for removal postpartum. She had an NSD at term. At her six week check she denied any sexual activity, had a negative pregnancy test and got DMPA. After arranging transportation, child care and housing, off she went to the Univerisity (200 miles away) for her pre-op appointment which was uneventful. However the day of surgery it was discovered that she was pregnant. She continued the pregnancy and had a 34 week preemie. So at the ripe old age of 14, she has 2 kids 40 weeks apart. In retrospect, she got pregnant prior to her six week check and the DMPA. As a practice we decided to look into immediate postpartum use. Many of our clients are at least partially nursing and establishing lactation is of primary importance to us. We read a lot of information regarding Depo use postpartum, and actually the literature supports an increase in milk supply with it's use, not a decrease. We have since instituted immediate postpartum use. Anecdotelly, I have seen more prolonged bothersome spotting with immeditate postpartum use. We have had good results with Ibuprophen 800 mg TID x 7 days. Most women opt for the convienience of Depo and will live with the side effects. Chris Beard CNM Prosser, Washington
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