Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Progesterone pills postpartum

20 October, 2004

Question:

I gave birth to a baby boy 4 weeks ago. My bleeding has almost stopped so I went to discuss birth control with my doctor. Since I am breastfeeding, she gave me micronor and told me that I must take it two weeks before it will be effective and that while I am on it I will not get a period at all. I have done research on it and have not found anywhere that I must take it for two weeks before it will be effective. Also, I found that it will cause irregular bleeding between periods, not that it will stop periods. She is very abrupt and hard to talk to so I hope you can help me.

Before I begin anything I will speak to my rabbi about if and for how long I can go on birth control I would just like to know what I am getting myself into.

Thanking you in advance for all your help.


Answer:

Micronor is a form of progesterone only contraception. It is often used for breastfeeding women, as progesterone is less likely to affect the milk supply than are contraceptive pills that include estrogen.

Many physicians do recommend a backup method (such as a spermicide) when beginning oral contraceptives as the effect does not start with the first pill.

The effect of progesterone only pills varies from woman to woman. Some get no period, particularly if also breastfeeding, some get an almost regular period and some have irregular bleeding – which can be difficult for women keeping hilchot niddah. Unfortunately, there is no way to predict in advance what will happen with a particular woman. It is important to note that some women have irregular bleeding at the beginning but then switch to a more regular pattern. Therefore, when starting this method you need to be prepared to give it about 2 months – during which it may be difficult to get to the mikveh – before abandoning it.

You can also ask your rabbi whether he permits the diaphragm.

This should give you some background information for your she'elah. Please feel free to get back to us with any further questions.


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