Skip to content
BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access December 16, 2010

Postpartum examination, breastfeeding, and contraception in the postpartum period in the Czech Republic

Jozef Zahumensky, Jana Sykorova, Oldrich Sottner, Barbora Zmrhalova, Jiri Vojtech, Erika Menzlova, Ian Vasicka, Monika Dvorska, Katerina Maxova, Jaromir Vlacil, Helena Hrubantova and Michael Halaska
From the journal Open Medicine


In the majority of recent textbooks of obstetrics, a routine follow-up examination at the end of the postpartum period is recommended. To date, no studies have been done in the Czech Republic addressing use of contraception and follow-up care in the postpartum period. Questionnaires were sent to 672 participants who gave birth in the year 2008, inquiring about follow-up examinations in the postpartum period and use of contraception. In total, 458 (68.2%) questionnaires were returned. 430 women (93.9%) underwent routine examinations at 6 weeks into the postpartum period. At the time of examination, 36 women were asked about their particular health problems (8.4%). In 130 instances, the question most often addressed by the outpatient gynecologist concerned use of contraception (30.2%). However, only 34 physicians expressed concern about changes in sexual life or other sexually related problems. 426 women (93.0%) were sexually active and 310 women (72.8%) did not use any contraception with the exception of breastfeeding. The current practice of outpatient gynecological visits at 6 weeks postpartum and advice on contraception both seem inadequate.

[1] Dudenhasen J.W., Pschyrembel W., Das normale Wochenbett., In: Dudenhasen J.W., Pschyrembel W. (Eds.), Praktische Gebursthilfe mit gebursthilflichen Operationen, 19, de Gruyter, Berlin, 2001 Search in Google Scholar

[2] Blenning C.E., Paladine H., An approach to the postpartum office visit, Am. Fam. Physician, 2005, 72, 2491–2496 Search in Google Scholar

[3] Gunn J., Lumley J., Young D., The role of the general practitioner in postnatal care: a survey from Australian general practice, Br. J. Gen. Pract., 1998, 48, 1570–1574 Search in Google Scholar

[4] Labbok M.H., Hight-Laukaran V., Peterson A.E., Fletcher V., von Hertzen H., Van Look P.F., Multicenter study of the Lactational Amenorrhea Method (LAM): I. Efficacy, duration, and implications for clinical application, Contraception, 1997, 55, 327–336 in Google Scholar

[5] Kaharuza F.M., Sabroe S., Basso O., Choice and chance: determinants of short interpregnancy intervals in Denmark, Acta Obstet. Gynecol. Scand., 2001, 80, 532–538 in Google Scholar

[6] Conde-Agudelo A., Rosas-Bermudez A., Kafury-Goeta A.C., Birth spacing and risk of adverse perinatal outcomes: a meta-analysis, JAMA, 2006, 295, 1809–1823 in Google Scholar PubMed

[7] Conde-Agudelo A., Rosas-Bermudez A., Kafury-Goeta A.C., Effects of birth spacing on maternal health: a systematic review, Am. J. Obstet. Gynecol., 2007, 196, 297–308 in Google Scholar PubMed

[8] DaVanzo J., Hale L., Razzaque A., Rahman M., Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh, BJOG., 2007, 114, 1079–1087 in Google Scholar PubMed PubMed Central

[9] Speroff L., Mishell D.R., Jr., The postpartum visit: it’s time for a change in order to optimally initiate contraception, Contraception, 2008, 78, 90–98 in Google Scholar PubMed

[10] Levitt C., Shaw E., Wong S., Kaczorowski J., Springate R., Sellors J., Enkin M., Systematic review of the literature on postpartum care: selected contraception methods, postpartum Papanicolaou test, and rubella immunization, Birth, 2004, 31, 203–212 in Google Scholar PubMed

[11] FFPRHC Guidance (July 2004): Contraceptive choices for breastfeeding women, J. Fam. Plann. Reprod. Health Care, 2004, 30, 181–189 10.1783/1471189041261429Search in Google Scholar PubMed

[12] ACOG Committee Opinion No. 361: Breastfeeding: maternal and infant aspects, Obstet. Gynecol., 2007, 109, 479–480 10.1097/00006250-200702000-00064Search in Google Scholar PubMed

[13] Cole L.P., McCann M.F., Higgins J.E., Waszak C.S., Effects of breastfeeding on IUD performance, Am. J. Public Health, 1983, 73, 384–388 in Google Scholar

[14] Sannisto T., Kosunen E., Initiation of postpartum contraception: a survey among health centre physicians and nurses in Finland, Scand. J. Prim. Health Care, 2009, 27, 244–249 in Google Scholar

[15] Damm P., Mathiesen E.R., Petersen K.R., Kjos S., Contraception after gestational diabetes, Diabetes Care, 2007, 30 Suppl 2, S236–S241 in Google Scholar

[16] Aubeny E., Colau J.C., Nandeuil A., Local spermicidal contraception: a comparative study of the acceptability and safety of a new pharmaceutical formulation of benzalkonium chloride, the vaginal capsule, with a reference formulation, the pessary, Eur. J. Contracept. Reprod. Health Care, 2000, 5, 61–67 in Google Scholar

[17] Dicle O., Kucukler C., Pirnar T., Erata Y., Posaci C., Magnetic resonance imaging evaluation of incision healing after cesarean sections, Eur. Radiol., 1997, 7, 31–34 in Google Scholar

[18] Shipp T.D., Zelop C.M., Repke J.T., Cohen A., Lieberman E., Interdelivery interval and risk of symptomatic uterine rupture, Obstet. Gynecol., 2001, 97, 175–177 in Google Scholar

[19] Bick D.E., MacArthur C., Attendance, content and relevance of the six week postnatal examination, Midwifery, 1995, 11, 69–73 in Google Scholar

[20] Mrisho M., Obrist B., Schellenberg J.A., Haws R.A., Mushi A.K., Mshinda H., Tanner M., Schellenberg D., The use of antenatal and postnatal care: perspectives and experiences of women and health care providers in rural southern Tanzania, BMC. Pregnancy. Childbirth., 2009, 9, 10 10.1186/1471-2393-9-10Search in Google Scholar PubMed PubMed Central

[21] Piejko E., The postpartum visit—why wait 6 weeks?, Aust. Fam. Physician, 2006, 35, 674–678 Search in Google Scholar

[22] Barrett G., Pendry E., Peacock J., Victor C., Thakar R., Manyonda I., Women’s sexual health after childbirth, BJOG., 2000, 107, 186–195 in Google Scholar PubMed

[23] Wilson P.D., Herbison R.M., Herbison G.P., Obstetric practice and the prevalence of urinary incontinence three months after delivery, Br. J. Obstet. Gynaecol., 1996, 103, 154–161 10.1111/j.1471-0528.1996.tb09668.xSearch in Google Scholar PubMed

[24] Hay-Smith J., Morkved S., Fairbrother K.A., Herbison G.P., Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women, Cochrane. Database. Syst. Rev., 2008, CD007471 10.1002/14651858.CD007471Search in Google Scholar PubMed

[25] Byrd J.E., Hyde J.S., Delamater J.D., Plant E.A., Sexuality during pregnancy and the year postpartum, J. Fam. Pract., 1998, 47, 305–308 Search in Google Scholar

[26] Zahumensky J., Zverina J., Sottner O., Zmrhalova B., Driak D., Brtnicka H., Dvorska M., Krcmar M., Kolarik D., Citterbart K., Otcenasek M., Halaska M., Comparison of labor course and women’s sexuality in planned and unplanned pregnancy, J. Psychosom. Obstet. Gynaecol., 2008, 29, 157–163 in Google Scholar

[27] Glazener C.M., Sexual function after childbirth: women’s experiences, persistent morbidity and lack of professional recognition, Br. J. Obstet. Gynaecol., 1997, 104, 330–335 10.1111/j.1471-0528.1997.tb11463.xSearch in Google Scholar

[28] van Wouwe J.P., Lanting C.I., van Dommelen P., Treffers P.E., van Buuren S., Breastfeeding duration related to practised contraception in the Netherlands, Acta Paediatr., 2009, 98, 86–90 in Google Scholar

[29] Halderman L.D., Nelson A.L., Impact of early postpartum administration of progestin-only hormonal contraceptives compared with nonhormonal contraceptives on short-term breastfeeding patterns, Am. J. Obstet. Gynecol., 2002, 186, 1250–1256 in Google Scholar

[30] Nilsson S., Mellbin T., Hofvander Y., Sundelin C., Valentin J., Nygren K.G., Long-term followup of children breast-fed by mothers using oral contraceptives, Contraception, 1986, 34, 443–457 in Google Scholar

[31] Engin-Ustun Y., Ustun Y., Cetin F., Meydanli M.M., Kafkasli A., Sezgin B., Effect of postpartum counseling on postpartum contraceptive use, Arch. Gynecol. Obstet., 2007, 275, 429–432 in Google Scholar PubMed

Published Online: 2010-12-16
Published in Print: 2011-2-1

© 2010 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Scroll Up Arrow