Smallpox vacine and NFP

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I wonder how many woman are given this tidbit of information before they are prescribed the shot?
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That is not the standard recommnedation. However, it may take that long or longer for a small percentage of women to return to fertility. Take it from me… I was one of those women.
 
Is NFP considered that unreliable by health care providers?
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Yes. Health care providers often refer to Contraceptive Technology which reports that sterilization, OCs, Depo, & IUD are more effective than NFP.

If I taught a couple NFP based on my notes from NP school, the stats medical professionals quote may be accurate. 🙂 My notes were very, very sad… a few pages. I was humbled when I received Taking Charge of You Fertility. 🙂 The majority of medical professionals are uninformed. My PCP was not familiar with Creighton, Billings, etc., but he has heard of them now.
 
I wonder how many woman are given this tidbit of information before they are prescribed the shot?
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Not enough women. The other poster was correct that this is not standard advice. However, the risk to the baby is great indeed.
 
Not enough women. The other poster was correct that this is not standard advice. However, the risk to the baby is great indeed.
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Do you have reference for this? The most conservative figure I have read is to wait 6 months after discontinuing hormonal contraception; however, this is not based on the scientific evidence that I’ve read. So I am always interested.

Thanks!
Autumn
 
astegallrnc said:
Do you have reference for this? The most conservative figure I have read is to wait 6 months after discontinuing hormonal contraception; however, this is not based on the scientific evidence that I’ve read. So I am always interested.

Thanks!
Autumn
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No, I don’t have a reference but I am sure if you give me some time I may be able to come up with something. I have heard about the 6 months though. If I remember correctly my friends dr had told them to wait a year because the depo vera shot is much worse and more potent then your regular birth control. I will see what I can come up with.
 
astegallrnc said:
Do you have reference for this? The most conservative figure I have read is to wait 6 months after discontinuing hormonal contraception; however, this is not based on the scientific evidence that I’ve read. So I am always interested.

Thanks!
Autumn
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Years and years ago, I got pregnant about 3 or 4 months after going off the pill (after I learned the truth about ABC), my pregnancy ended in a miscarriage. I will never get over the guilt that those pills that I chose to take may have been what killed my unborn child.
 
I appreciate that. Thank you! All women considering Depo should be told that if they want to become pregnant within a year to avoid Depo, which even the Depo pattient information now states. I find the advice to wait one year odd.
 
masondoggy said:
Years and years ago, I got pregnant about 3 or 4 months after going off the pill (after I learned the truth about ABC), my pregnancy ended in a miscarriage. I will never get over the guilt that those pills that I chose to take may have been what killed my unborn child.
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I am sorry for your loss!

Most health care providers are basing the information on the scientific evidence. There is no scientific evidence to support that women need to wait after discontinuing hormonal contraception. The rate of miscarriage is not greater post-pill than it is in other women.

Some health care providers are more cautious, which is not a bad thing.
 
astegallrnc said:
I appreciate that. Thank you! All women considering Depo should be told that if they want to become pregnant within a year to avoid Depo, which even the Depo pattient information now states. I find the advice to wait one year odd.
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No problem. I am confused though. Why do you find the advice to wait one year odd when you just said that the patient info now states this? Also, why do you say their is no scientific evidence to support that the pill causes miscarriages but you just stated that the patient info for depo says to wait? I think I am confused.
 
Why do you find the advice to wait one year odd when you just said that the patient info now states this? Also, why do you say their is no scientific evidence to support that the pill causes miscarriages but you just stated that the patient info for depo says to wait? I think I am confused.
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Sorry about the confusion. It may take a year for fertility to return in women who have had a Depo Prover injection, so it is not advisable for a woman seeking pregnancy within a year to use this (of course, ABC she never be used to avoid pregnancy:) ). It isn’t that Depo increases the risk of miscarriage or birth defects but the delay in return to fertility.
 
deb1 said:
Is NFP considered that unreliable by health care providers?
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Only by the ones who don’t understand it.

Rhythm method, of course, doesn’t work. But, when used properly, scientifically based NFP methods are just as reliable as ABC methods, when those are used proplerly, if not more effective.
 
astegallrnc said:
Sorry about the confusion. It may take a year for fertility to return in women who have had a Depo Prover injection, so it is not advisable for a woman seeking pregnancy within a year to use this (of course, ABC she never be used to avoid pregnancy:) ). It isn’t that Depo increases the risk of miscarriage or birth defects but the delay in return to fertility.
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Ok. Here is some interesting stuff I am finding from the actual package insert. Should I start a new thread on this? Have I hijacked this thread?

*6. Unexpected Pregnancies
To ensure that DEPO-PROVERA CI is not administered inadvertently to a pregnant woman, the first injection must be given **ONLY **during the first 5 days of a normal menstrual period; **ONLY **within the first 5-days postpartum if not breast-feeding, and if exclusively breast-feeding, **ONLY **at the sixth postpartum week (see DOSAGE AND ADMINISTRATION). Neonates from unexpected pregnancies that occur 1 to 2 months after injection of
DEPO-PROVERA CI may be at an increased risk of low birth weight, which, in turn, is associated with an increased risk of neonatal death. The attributable risk is low because
such pregnancies are uncommon.9,10 A significant increase in incidence of polysyndactyly and chromosomal anomalies
was observed among infants of users of DEPO-PROVERA CI, the former being most pronounced in women under 30 years of age. The unrelated nature of these defects, the lack of confirmation from other studies, the distant preconceptual exposure to DEPOPROVERA CI, and the chance effects due to multiple statistical comparisons, make a causal association unlikely.11 Neonates exposed to edroxyprogesterone acetate *in utero *and followed to adolescence, showed no evidence of any adverse effects on their health including their physical, intellectual, sexual, or social development. Several reports suggest an association between intrauterine exposure to progestational drugs in the first trimester of pregnancy and genital abnormalities in male and female fetuses. The risk of hypospadias (five to eight per 1,000 male births in the general population) may be approximately doubled with exposure to these drugs. There
are insufficient data to quantify the risk to exposed female fetuses, but because some of these drugs induce mild virilization of the external genitalia of the female fetus and
because of the increased association of hypospadias in the male fetus, it is prudent to avoid the use of these drugs during the first trimester of pregnancy. To ensure that DEPO-PROVERA CI is not administered inadvertently to a
pregnant woman, it is important that the first injection be given only during the first 5 days after the onset of a normal menstrual period within 5 days postpartum if not breastfeeding
and if breast-feeding, at the sixth week postpartum (see DOSAGE AND ADMINISTRATION).

This does not explain really what we were talking about but thought it was some interesting insight.
*
 
*4. Return of Fertility
*DEPO-PROVERA CI has a prolonged contraceptive effect. In a large US study of women who discontinued use of DEPO-PROVERA CI to become pregnant, data are available for 61% of them. Based on Life-Table analysis of these data, it is expected that 68% of women who do become pregnant may conceive within 12 months, 83% may conceive within 15 months, and 93% may conceive within 18 months from the last injection. The median time to conception for those who do conceive is 10 months following the last injection with a range of 4 to 31 months, and is unrelated to the duration of use. No data are available for 39% of the patients who discontinued DEPOPROVERA CI to become pregnant and who were lost to follow-up or changed their mind.
 
*4. Unexpected Pregnancy
*Because DEPO-PROVERA Contraceptive Injection is such an effective contraceptive method, the risk of unexpected pregnancy for women who get their shots regularly (every
3 months [13 weeks] ) is very low. While there have been reports of an increased risk of low birth weight and neonatal infant death or other health problems in infants conceived
close to the time of injection, such pregnancies are uncommon. If you think you may have become pregnant while using DEPO-PROVERA Contraceptive Injection for
contraception, see your health-care provider as soon as possible.
 
This is from the University of Illinois at Chicago.

**QUESTION: is ovulation still possible while on the depo shot? (February 24, 2005)

ANSWER: **Depo-Provera is a progesterone contraceptive method which prohibits ovulation; if ovulation does not occur, pregnancy is not possible. Depo-Provera is approximately 99% effective in preventing pregnancy, but does not protect against any sexually transmitted infections.

What about the other 1%?
 
NFP is NOT 100% effective. The only 100% effective method is complete and total abstinence. NFP is highly effective, don’t get me wrong, but if you are really in a situation that requires you absolutely can’t become pregnant, you need to take some time off. 🙂
 
rxlist.com/rxboard/provera.pl?read=233This is really sad. Check out the comments as well.
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This is sad but it is not evidence that Depo increases the risk of miscarriage. It is common to look for a cause when a woman suffers the loss of a baby and if there is a history of contraceptive use there is a tendency to blame the method, but a history of use is not evidence. I do question the relabilitiy of some of the posts (ie., a negative pregnancy test at 3 1/2 months).

I want to add that I am not objective about Depo and wish it were not available for use; however, I am troubled when the information given to women/couples discontinuing it may not be accurate and evidenced based.
What about the other 1%?
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None of the methods listed on the instructions Deb referred to are 100%. I agree that abstinence is the only reliable method.
 
astegallrnc said:
None of the methods listed on the instructions Deb referred to are 100%. I agree that abstinence is the only reliable method.
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That is my problem with the list. Why not simply tell a female that she can not have sex if she gets the small pox vaccine? The other methods do not seem more reliable then NFP.

I wonder if the CDC is concerned of accusations of sexism? After all, men can’t get pregnant, therefore a male receiving the small pox inoculation would not have to abstain. It is only the female who would have to abstain. There are some people who would see the different rules as being prejudical toward women.
 
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