From the Guidelines
Nexplanon can be inserted as early as 10 minutes after delivery of the placenta for non-breastfeeding mothers, and at least 4 weeks postpartum for breastfeeding mothers, according to the most recent guidelines 1. The timing of Nexplanon insertion is crucial to ensure its effectiveness and minimize potential risks.
- For non-breastfeeding mothers, the implant can be inserted immediately postpartum, as long as it is reasonably certain that the woman is not pregnant 1.
- For breastfeeding mothers, it is recommended to wait at least 4 weeks postpartum to ensure milk supply is well established, although some providers may insert it earlier 1. The American College of Obstetricians and Gynecologists (ACOG) and the CDC support immediate postpartum insertion of implants as a safe and effective practice that removes barriers to care 1. Before getting Nexplanon, it is essential to discuss medical history with a healthcare provider, as certain conditions like liver disease, unexplained vaginal bleeding, or history of breast cancer may affect eligibility 1. Side effects of Nexplanon may include irregular bleeding, headaches, and mood changes 1. It is also important to note that Nexplanon is a progestin-only contraceptive implant that prevents pregnancy by inhibiting ovulation, thickening cervical mucus, and thinning the uterine lining, and it is over 99% effective and lasts for up to 5 years 1. If inserted within the recommended timeframe, it provides immediate contraceptive protection 1. The most recent guidelines from 2024 provide the most up-to-date information on the use of Nexplanon in the postpartum period, and should be followed to ensure the best possible outcomes for patients 1.
From the Research
Postpartum Contraception Options
- The choice of a postpartum contraceptive method depends on various factors, including the need for a temporary versus a permanent method, infant feeding choice, and informed consent prior to delivery 2.
- For non-breastfeeding women, implants can be administered immediately postpartum, while for breastfeeding women, they should ideally be postponed for 6 weeks 2.
Nexplanon (Etonogestrel Implant) Specifics
- There is no specific information in the provided studies regarding the exact timing for Nexplanon insertion postpartum.
- However, studies suggest that implants, in general, can be safely used by non-breastfeeding women immediately postpartum, and by breastfeeding women after 6 weeks 2, 3.
- One study found that offering IUD placement at 3 weeks postpartum compared to standard scheduling at 6 weeks does not result in increased use at 3 months, but early placement is acceptable to women and without increased pain 4.
- Another study evaluated the effectiveness of the etonogestrel implant beyond the U.S. Food and Drug Administration-approved duration and found it to be highly effective for an additional year beyond the approved 3 years 5.
Key Considerations
- Breastfeeding women should avoid combined hormonal contraceptives for 6 weeks postpartum, while non-breastfeeding women can use them after 21 days, depending on their personal venous thromboembolism risk profile 6.
- Progestogen-only pills, implants, and injectables are appropriate for breastfeeding women, but the timing of initiation may vary depending on individual circumstances 2, 3, 6.