Pregnancy: There is little or no increased risk of birth defects in women who inadvertently use COCs during early pregnancy. No increased risk of genital or non-genital birth defects (including cardiac anomalies and limb-reduction defects) has been reported following exposure to low dose COCs prior to conception or during early pregnancy.
The administration of COCs to induce withdrawal bleeding should not be used as a test for pregnancy. COCs should not be used during pregnancy to treat threatened or habitual abortion.
Women who do not breastfeed may start COCs no earlier than four weeks postpartum.
Nursing Mothers: When possible, advise the nursing mother to use other forms of contraception until she has weaned her child. Estrogen-containing COCs can reduce milk production in breastfeeding mothers. This is less likely to occur once breastfeeding is well-established; however, it can occur at any time in some women. Small amounts of oral contraceptive steroids and/or metabolites are reported to be present in breast milk.
After oral administration of drospirenone 3 mg and ethinyl estradiol 0.03 mg combination, about 0.02% of the drospirenone dose was reported to be excreted into the breast milk of postpartum women within 24 hours. This results in a maximal daily dose of about 0.003 mg drospirenone in an infant.
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