A nurse is providing teaching to a client who has a new prescription for oral contraceptives (OCs).

Which of the following statements by the client indicates an understanding of how to initiate OCs?

The correct answer is choice D.“You should wait until your baby is 6 weeks old before starting the injections.” This is because medroxyprogesterone may pass into breast milk and cause side effects in a child who is breastfed.The product labeling states that it should be started no sooner than 6 weeks postpartum, based on data submitted for product approval.

The World Health Organization also recommends that injectable depot medroxyprogesterone acetate should not be used before 6 weeks postpartum.

Choice A is wrong because starting the injections immediately after delivery could interfere with the exclusivity or duration of lactation, and could affect the newborn infant adversely because of slower metabolism of the drug than older infants.

Choice B is wrong because waiting until the baby is 6 months old is unnecessary and could expose the mother to a higher risk of unintended pregnancy.

Choice C is wrong because medroxyprogesterone has not been known to cause any decrease in milk supply while using the injections

The correct answer is choice C. The patient needs further teaching if they think that the implant can be inserted immediately after childbirth.According to Mayo Clinic, the implant should not be inserted until at least 21 days after giving birth, or until the milk supply is well established if breastfeeding.

Inserting the implant too soon may increase the risk of blood clots or decrease milk production.

Choice A is correct because condoms are still needed to protect against STIs, even if using the implant as a birth control method.Choice B is correct because irregular and unpredictable menstruation is a common side effect of the implant.Choice D is correct because the implant can prevent pregnancy for up to three years.