FSRH press release: Contraception should be offered to all women after giving birth, say leading medical organisations

The Faculty of Sexual and Reproductive Healthcare (FSRH), the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) have today launched recommendations for women to access contraception in maternity units.

• With the continuing pressures associated with the Covid-19 pandemic, access to contraception in GP practices and contraceptive clinics has been reduced
• Evidence suggests sexual activity and fertility may return quickly after childbirth, and pregnancies soon after giving birth may increase the risk of complications
• For most women, a six month-supply of the progestogen-only pill (POP) can be safely started immediately after childbirth

The healthcare organisations, representing thousands of doctors, nurses and midwives working in women’s health, recommend that women should be able to access effective contraception as soon as possible after childbirth.

Most contraceptive methods (except the combined pill, patch and vaginal ring) can be started safely immediately after giving birth, including women who are fully breastfeeding. A six month-supply of the progestogen-only pill (POP) can be offered to women after childbirth, unless they have a medical reason not to.

In some maternity units, women will also be able to choose to have highly effective intrauterine contraception - the copper intrauterine device or the hormone-releasing intrauterine system - fitted during a caesarean birth.

Dr Asha Kasliwal, President of the Faculty of Sexual and Reproductive Healthcare (FSRH), said:

“With GP practices and contraceptive clinics significantly reducing or shutting down services due to the Covid-19 pandemic, women are finding it harder to access contraception. Maternity services are well-placed to provide effective contraception after childbirth, reducing the need for women to seek further care once they have left the maternity unit.

“It is crucial that women are able to decide if and when they would like to conceive again. Short spacing between pregnancies - less than 12 months - increases the risk of complications including preterm birth, low birthweight, stillbirth and neonatal death.

“The choice of contraception will be more limited during the pandemic, and we advise women to discuss their options with their nurse, midwife or doctor. The progestogen-only pill can be a safe bridging method until women are able to access their preferred method.”

Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:

"A choice of safe and effective contraceptive methods should be offered to women right after birth, particularly during the coronavirus outbreak, when there are limited GP and contraceptive services available.

"Meeting the contraceptive needs of women in one go in a maternity unit will help to reduce the need for additional visits to health services, and reduce the risk of coronavirus transmission among women and healthcare professionals.

"It will also give women and their partners the choice of controlling their fertility and planning when they next become pregnant. Planning and spacing pregnancies lead to healthier outcomes for women and their families."

Mary Ross-Davie, a Director at the Royal College of Midwives, said:

"This is about ensuring you continue to have access to high-quality contraception care, and as much choice as possible during these difficult times.

"It is practical and sensible guidance that will use our hard-pressed NHS resources better and reduce the pressures on them as we work through this pandemic."

ENDS

For further information please contact Camila Azevedo, FSRH External Affairs Manager, at cazevedo@fsrh.org or 07379408587.

Notes to Editors

• The joint FSRH, RCOG and RCM recommendations can be found here
• The joint recommendations are accompanied by FSRH guidance on provision of contraception by maternity services after childbirth during the Covid-19 Pandemic April 2020
• FSRH has a dedicated webpage featuring COVID-19 resources and information for SRH professionals
• RCOG and RCM are regularly updating clinical guidance and advice for healthcare professionals and pregnant women during coronavirus

About FSRH
The Faculty of Sexual and Reproductive Healthcare (FSRH) is the largest UK professional membership organisation working at the heart of sexual and reproductive health (SRH), supporting healthcare professionals to deliver high quality care. It works with its 15,000 members, to shape sexual reproductive health for all. It produces evidence-based clinical guidance, standards, training, qualifications and research into SRH. It also delivers conferences and publishes the journal BMJ Sexual & Reproductive Health in partnership with the BMJ.

About the RCOG
The Royal College of Obstetricians and Gynaecologists (RCOG) is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.

About RCM
The RCM is the only trade union and professional association dedicated to serving midwifery and the whole midwifery team. We provide workplace advice and support, professional and clinical guidance and information, and learning opportunities with our broad range of events, conferences and online resources.