Progestin-Only Pill Use and Breastfeeding Study

Progestin-Only Pill Use and Breastfeeding Study

This study will assess the impact of early initiation (less than one week postpartum) and delayed initiation (4 weeks postpartum) of two types of progestin-only contraceptive pills (POPs) on maternal, breastmilk, and infant outcomes.

This is a placebo-controlled randomized controlled trial enrolling dyads of birthing people and their newborn infants. We will explore if the type and timing of initiation of pills is acceptable to the user with minimal side effects, impacts the supply or composition of breastmilk, and/or affects infant growth.

Birthing people will be randomly assigned to 1 of 3 groups and will be blinded to group assignment:

1. immediate initiation of drospirenone-containing progestin-only pills (d-POPs),
2. immediate initiation of norethindrone-containing progestin-only pills (n-POPs)
3. immediate initiation of a placebo pill for one month followed by d-POPs.

Inclusion Criteria:

• 18 years of age and older
• Desires to use POPs for 3 months
• Speak English or Spanish
• Had a vaginal or cesarean delivery of a singleton full term (≥37 weeks) infant less than 168 hours prior
• Intends to breastfeed exclusively for 6 months

Exclusion Criteria:

• Desire another pregnancy in less than 6 months
• Do not intend to exclusively breastfeed
• Do not have access to a telephone
• Have any medical contraindication to POPs
• Have any contraindication to breastfeeding, including maternal illegal drug use, history of augmentation or reduction, infant with major congenital anomaly
• Cognitively impaired
• Currently incarcerated