News Moms Need

You recently had a baby and life is very busy. You’re focus is on caring for this little one, but you may also be juggling other children, work, mountains of laundry, home chaos, relationships and, for many of us, exhaustion. While you might like a sibling for Junior in the future, now may not be the right time. Many parents look to contraception for help, but how do you know what to choose?

When choosing birth control, there are many things for you and your partner to think about, such as:
   - Your overall health
   - How often you have sex
   - If and when you want to have children
   - How well each method works in preventing pregnancy  
   - If the method prevents sexually transmitted infections (STIs) as well as pregnancy  
   - Any potential side effects
   - How easy the method is to use for you or your partner
   - Cost
   - If it’s a good choice for breastfeeding moms
   - How comfortable you and your partner feel about the method

Learning how to use some birth control methods can take time and practice. Don’t be afraid to talk to your doctor or midwife and ask questions. The most important thing is to find and use the birth control that works best for you. You can always try one method, and if you don’t like it, try another one.

If you’ve been using birth control and are ready to have a baby, you’re going to stop using birth control one of these days. There are no hard-and-fast rules about how long you should wait to start trying to get pregnant after stopping birth control, but talk with your health care provider about what’s best for you.

You can begin trying right away. But if you don’t have regular periods, it may be more difficult to determine the right time for conception.
• If you’ve been on birth control pills, you may not have regular periods for a month or two after stopping the pills.
• If you take Depo-Provera, it can take from three months to one year to ovulate regularly after your last injection.
• If you have an IUD (intrauterine device) or implants, you can start trying to get pregnant as soon as you have the device removed.
• The barrier methods - such as condoms, diaphragms and spermicides - stop working as soon as you stop using them.

If you’re currently pregnant, be sure to discuss the best time to start birth control after you deliver. (It’s important to wait a few weeks after delivery before taking some pills.) You’ll want to be sure to give your body enough time to recover before having another baby. If you’ve recently had a new baby, ask your provider how long you should wait to get pregnant again. For most women, it’s best to wait at least 18 months. But some women can’t wait this long because of their age or other reasons. Talk to your provider about what’s right for you.

Sandoz is recalling 10 lots of Introvale® birth control pills due to a packaging error. The mistake has to do with how each pill is assigned to each day and week of the month. If you use Introvale® as your birth control pill, the recalled pills don’t put your health at risk. However, it can leave you without enough contraception and put you at risk for an unplanned pregnancy.

Each 3 month pack of Introvale® has 12 rows of peach colored pills and 1 last row of white (placebo) pills. The recalled lots mistakenly have the white placebo row in another row, not the final 13th row as it should be in.

If you find the white placebo row in any position other than the 13th row, start using another kind of non-hormonal contraception as a backup, such as condoms. Also, talk to your health provider and contact Sandoz to report the finding at 800-525-2492 or qa.druginfo@sandoz.com. To learn more about the recall, visit the FDA website.

The birth control  Lo/Ovral®-28 as well as its generic version, Norgestrel and Ethinyl Estradiol, are being recalled  because of a packaging error.

Birth control pills are taken each day in the order they appear in the package. However, the recalled birth control pills may not be in the right order. While the packaging mistake doesn’t harm women’s health, it can leave women without enough contraception and put them at risk for an unplanned pregnancy.

If you’re taking any of the recalled birth control pills, the Food and Drug Administration (FDA) recommends that you start using a barrier method, such as condoms, for birth control as a backup. FDA also says to talk to your health provider and return the recalled birth control to your pharmacy.

For more information about the recall, visit the FDA website. Learn more about birth control.

Qualitest pharmaceuticals is recalling several of its oral contraceptive products (birth control pills) because of a packaging error. The mistake has to do with how each pill is assigned to each day of the month. While the error doesn’t put women’s health at risk, it can leave women without enough contraception and put them at risk for an unintended pregnancy.

The birth control pill recall includes:
• Cyclafem™ 7/7/7
• Cyclafem™ 1/35
• Emoquette™
• Gildess® FE 1.5/30
• Gildess® FE 1/20
• Orsythia™
• Previfem ®
• Tri-Previfem®

If you have any of the recalled birth control pills, the Food and Drug Administration (FDA) recommends that you start using another form of non-hormonal birth control as a backup, such as condoms, and talk to your health provider or pharmacist.

For more information about the recall, visit the FDA website. Learn more about contraceptives.

It’s best for a woman’s health to wait 18 months before getting pregnant again. It gives your body time to heal, rebuild its energy stores, and it lets you get used to being a mom. And short birth intervals can have negative outcomes for both mom and baby. Since ovulation can take place as soon as 25 days after delivery, it’s important to establish a contraceptive plan to ensure you’ve got the time you need.

If you plan to go back on the pill, when should you start taking it again? New recommendations from the CDC say it’s very important to wait at least three weeks after giving birth before starting estrogen-progestin combined oral contraceptives. Why? Studies have shown that there is a significant increase in the risk of serious, potentially fatal blood clots, called venous thromboembolism or VTE, in women who use the combined contraceptive during the first 21 days postpartum.

The recommendations go on to say that 21-42 days postpartum, women without risk factors for VTE generally can begin combined hormonal contraceptives, but women with risk factors for VTE (e.g., previous VTE or recent cesarean delivery) generally should not use these methods. After 42 days postpartum, no restrictions apply to the use of combined hormonal contraceptives based on postpartum status.  Any other medical conditions, however, need to be taken into account.  Women who are breastfeeding also should steer clear of the combined pill because of the side effect it has of reducing milk production.

What about the other forms of contraception?  It’s still safe to immediately start using other birth control methods like progestin-only contraceptives (pills, injections, and implants), intrauterine devices (IUDs), and contraceptive methods other than combined hormonal contraceptives. It’s a good idea to plan ahead with your health care provider before you deliver so that you can start your preferred method of contraception at the best time for you once you deliver.

According to a publication by the American College of Obstetricians and Gynecologists (ACOG) in the Jan. issue of Obstetrics & Gynecology, “the benefits of hormonal contraceptives may extend beyond pregnancy prevention.” Benefits of hormonal contraceptives (pills, patches, injections, implants, vaginal rings, etc.) include the effective treatment of difficult and painful, heavy or very long periods. They may reduce symptoms of premenstrual discomfort, and may offer a “lower risk for the development of endometrial cancer…ovarian cancer,” and “colorectal cancers.” 

The bulletin also states that “combined contraceptives block androgen production and may therefore reduce hirsutism (excessive bodily and facial hair) and acne,” and may even help prevent “menstrual migraines,” treat “pelvic pain caused by endometriosis,” and treat “uterine bleeding from fibroids.” A note of caution about migraines: “combined [oral contraceptives] have been associated with possible increased stroke risk in women with migraine who are 35 years or older, who smoke, or who have focal neurologic signs. Combined OCs should therefore be avoided in these women.”

If you face some of these issues and are not trying to get pregnant at this time, you may want to have a talk with your health care provider about possible treatment benefits of hormonal contraceptives.  If you are hoping to become pregnant but have excessively long or heavy periods, your provider may suggest trying to regulate your periods first with hormonal contraceptives.  It’s worth a conversation.

Today the U.S. Food and Drug Administration issued a statement about the increased risk of birth defects when a fetus is exposed to valproate sodium and related products (valproic acid and divalproex sodium).

The birth defects are neural tube defects, craniofacial defects, and cardiovascular problems. A neural tube defect is a defect of the brain and spinal cord. A craniofacial defect affects the face and the skull.

Valproate sodium and its related products may be used to treat migraine headaches, certain seizures and other conditions. If a woman is taking any of these products, she should talk to her health care provider, preferably before she gets pregnant. It’s also wise for her to use effective contraception. The risk of birth defects is especially high during the first trimester.

There are no rules about how long you should wait to start trying to get pregnant after stopping birth control. However, some health care providers may have different opinions about this.  During your preconception visit, talk to your provider about when you should discontinue your method and start trying.

• If you’ve been on birth control pills, you may not have regular periods for a month or two after stopping the pills.
• If you take Depo-Provera, it can take from three months to one year to ovulate regularly after your last injection.
• If you have an IUD (intrauterine device), you can start trying to get pregnant as soon as you have the device removed.
• Barrier methods - such as condoms, diaphragms and spermicides - stop working as soon as you stop using them.

If you have irregular periods, it may be more difficult to determine the right time to conceive. Click here for more info: http://www.marchofdimes.com/pnhec/28699_1904.asp

Breastfeeding has a host of great benefits for moms, but don’t rely on breastfeeding or the absence of your period for birth control, or… surprise!  Breastfeeding may decrease the odds of becoming pregnant by delaying the return of a woman’s menstrual period.  Contrary to popular myth, however, it does not prevent pregnancy, even if the mother is not menstruating.  Many women ovulate before they see their period return.

If you want to be certain not to conceive again until you and your partner are ready for another child, speak with your health care provider about when to return to using contraception.  By the way, oral contraceptives containing estrogen may decrease milk production for some women.  If you think that might be a problem for your milk supply, discuss different birth control options with your provider.