[Postpartum contraception: medical guidelines, women's point of view]

Postpartum contraception is subjected to specific medical guidelines related to the suckling mode. The practitioner must conciliate prescription rules with women's expectations. The purpose of this work was to estimate the medical practice in the maternity centre at a local hospital and the actual practice of women at home, in immediate postpartum and during the year that followed the childbirth.

One hundred and four new mothers from the maternity centre, in September 2004, took the survey. During their stay after birth, they filled a questionnaire on contraception. Various data have been collected from their obstetrical file. The analysis allowed the synthesis of medical guidelines on postpartum contraception. One year later, patients answered a telephone survey about their contraceptive practice.

In our survey, two-third of the new mothers (61.5%) chose breast-feeding. Seventy percent of them received progestins as contraceptives. Three out of four women (78%) followed this prescription after they left the hospital. Two-third (62.5%) of the women who had chosen artificial suckling received a prescription of estroprogestin. The majority of them (96%) used it after their return home. A high number of women (87.5%) estimated that these contraceptions were efficient, but more than a third of them thought they were uneasy to use (38.9%). Half of the women (52.8%) forgot their contraception during postpartum and the majority of them (86%) changed it within a year. A quarter (23.1%) of the contraception follow-up during this time was made by a general practitioner.

The practice in the maternity centre generally follows medical guidelines. However, it seems important to adapt postpartum contraception to the real practice of women. The general practitioner plays a major role in this management, especially during well-baby visits.