PIP: Oral combination contraceptives (OCs) can exert a beneficial effect on the hypo-estrogenic condition of the lactating mother postpartum as well as on flushes and dyspareunia resulting from genital atrophy. During the 1st week after delivery there is an increased risk of thromboembolic episodes, especially for women who breast-feed. A 1989 meta analysis indicated that OC use considerably increases the risk of suspension of breast-feeding within 3 months postpartum (odds ratio 7.3). Although hormones reach the child via the mother's milk, negative consequences have not been reported. The minipills contain progestins alone, but they have been hardly used in the Netherlands because of irregular bleeding. The IUD is reliable and does not adversely affect breast-feeding, but after delivery there is an increased chance of perforation, expulsion, and infection associated with its use, especially when it is inserted in the weeks after delivery. Insertion 4-6 weeks postpartum reduces this risk. Echoscopic controls are necessary to preclude expulsion. Condoms are suitable when short-term contraception is desired before another pregnancy. They can also protect against ascending infections, but they are less reliable than OCs or the IUD. The diaphragm cannot be used in the first months because of changes in the genital tract that can occur until 3-6 months postpartum. During this time an alternative is needed, possibly the female condom. Sterilization in general should be avoided after childbirth because of the emotionally unstable period, and subsequent regret. Also postpartum sterilization is more difficult because of thickened tubes. The Bellagio consensus in 1988 recommended exclusive breast-feeding also for contraception because during the first 6 months postpartum the risk of getting pregnant is less than 2%. In the Netherlands in 1991, only 26% of women were still fully breast-feeding after 3 months. Contraceptive counseling should consider individual factors such as contraceptive experience, breast-feeding or bottle feeding, and whether the risk of pregnancy is acceptable.