<prompt> Contraceptive method of choice in lactating mothers is:Barrier methodProgesterone only pillOral contraceptive pillsLactational amenorrhea  <response>: Ans. is b, i.e. Progesterone only pillRef: Williams Obs, 23e, p 694, Dutta Obs, 7e, p 558According to the American college of obstetries and gynecologist 2000, progestin only contraceptives are the preferred choice in most of the cases. In addition IUDs may be recommended for the lactating sexually active woman after uterine involution. --Williams, Obs 24e, p 715Lactational amenorrheaFor mothers who are nursing exclusively, ovulation occurring during the first 10 weeks after delivery is unlikely. But it is not a reliable method if mother is nursing only in day time. Waiting for first menses involves a risk of pregnancy because ovulation usually antedates menstruation. -- Wiliams 24e, p 715Safe period method - In this method the fertile period is calculated and the female should refrain from having sex during that periodThe basic prerequisite of this method is that cycles should be regular which is usually not the case with lactating mothers - safe period method is not applicable in them.IUCDs - According to Williams 23e p 644 IUCDs can be used as an alternative to progesterone only pills by lactating mothers but only following complete uterine involution in woman who are sexually active.Remember in Nutshell1st contraceptive of choice in lactating mother - Progesterone only pill or progesterone implant or DMPA injection. IUCD can also be used. 