Chapter 17: Family planning
Most birth control pills and some injections contain two hormones: estrogen
and progestin. Implants, some pills, and some injections contain only progestin.
Some women should not use a method that contains estrogen.
These women should use progestin-only methods:
• Women who have high blood pressure that is not
controlled by medicine.
• Women who have diabetes.
• Women who have epilepsy.
• Women who have ever had a stroke, paralysis, or
• Women who have hepatitis or liver problems (yellow skin and eyes).
• Women who have ever had a blood clot in the veins (this usually
causes a deep and steady pain in one leg or hip). Varicose veins
(swollen veins) are usually not a problem.
• Women who get migraine headaches (especially with vision changes).
• Women who are breastfeeding, in the first 3 weeks after birth. Be sure
to wait until your milk is coming in well before using a method that
Some women should not use any hormonal method.
• Women who have ever had cancer of the breast or uterus.
• Women who might be pregnant already.
• Women who have very heavy monthly bleeding, monthly
bleeding that lasts for more than 8 days, or bleeding
from the vagina from an unknown cause.
These women should not use pills, injections, implants,
or any other hormonal method.
Hormonal methods sometimes have side effects. These effects are not dangerous,
but they are often uncomfortable. Hormonal methods can make a woman have:
These effects usually get better after a few months. If they do not
get better, the woman can try a different family planning method.
A Book for Midwives (2010)