Please select the eligibility criteria that correspond to the clinical trial below.
Title: Randomized Trial of Postplacental or Delayed Insertion of the Levonorgestrel-releasing Intrauterine Device After Vaginal Delivery
Brief Summary: This study is a randomized controlled trial comparing 6 month usage rates of the levonorgestrel-releasing intrauterine device (LNG-IUD) when inserted postplacentally after vaginal delivery or delayed placement at 6-8 weeks postpartum. Given the high rate of unintended pregnancy in the United States, particularly in postpartum women, there is a need for reliable, effective, long-term contraception such as the IUD in postpartum women. Postplacental insertion of intrauterine contraception would help to address this need. The primary hypothesis of this study is that use of the LNG-IUD at 6 months after vaginal delivery will be higher in women who have immediate postplacental insertion as compared to delayed insertion 6-8 weeks following delivery.


Options:
A: Inclusion Criteria:

* Women who desire to use the ENG implant as a contraceptive method and desire to breastfeed her newborn for ate least 3 months;
* With no contraindication to breastfeeding, whose newborn is healthy, without malformations, born at term (gestational age ≥ 37 weeks), with appropriate weight for gestational age and with normal sucking ability

Exclusion Criteria:

* Tobacco smokers, drug addicts or alcoholics;
* Women with educational levels lower than 5 years;
* Women with clinical conditions considered category 3 and 4 for implant use by the WHO;
* Women with histories of psychiatric illness;
* Women using medications that could alter the concentration of ENG,
* Women with known allergies to the local anesthetic lidocaine (used to place the implant);
* Women who wanted to keep their cyclic menstrual bleeding
B: Inclusion Criteria:

* Female
* 18 - 50 years old
* Voluntarily requesting contraceptive implants for postpartum contraception
* Vaginal delivery or cesarean delivery at Mulago Hospital
* Willing and able to give informed consent
* Agree to a possible home visit for follow up
* Access to a cellphone for the duration of the study

Exclusion Criteria:

* Current breast cancer or breast cancer within the past 5 years
* Decompensated cirrhosis or a liver tumor
* Unexplained vaginal bleeding prior to pregnancy
* Current (or planned) use of Efavirenz medication
C: Inclusion Criteria:

* Age greater than or equal to 18 years
* Greater than or equal to 24 0/7 weeks pregnant at time of enrollment
* Anticipates undergoing a vaginal delivery
* Desires to use the LNG-IUD (Mirena) for postpartum contraception
* Willing and able to sign an informed consent in English
* Willing to comply with the study protocol

Exclusion Criteria:

* Planning to undergo a scheduled cesarean section
* Allergy to either polyethylene or levonorgestrel or other contraindications to use of the LNG-IUD
* Exposure to or treatment for gonorrhea, chlamydia, or trichomoniasis during the pregnancy
* Presence of one or more leiomyomata greater than 3 centimeters in diameter
* Uterine anomaly (other than a repaired septate uterus)
* Current cervical cancer or carcinoma in-situ
* Desires repeat pregnancy within one year of delivery
D: Inclusion Criteria: Patients on the postpartum ward at University Hospital will be offered inclusion in the study if they are:

* healthy,
* 18-40 years old,
* delivered a healthy term infant,
* intend to breastfeed,
* desire Implanon as their method of contraception, and
* agree to be randomized to early versus standard postpartum insertion.

Exclusion Criteria:

* obstetric complications including anemia with hematocrit\<30,
* transfusion,
* infection,
* severe pregnancy induced hypertension,
* prolonged hospitalization,
* coagulopathy,
* liver disease,
* undiagnosed genital bleeding,
* or other relative contraindication to Implanon® insertion (known or suspected pregnancy, known, suspected, or history of breast cancer, or hypersensitivity to any of the components in Implanon®).
* Women taking drugs that are potent inducers of hepatic enzymes will also be excluded, including barbiturates, griseofulvin, rifampin, phenylbutazone, phenytoin, carbamazepine, felbamate, oxcarbazepine, topiramate, modafinil, protease inhibitors, and herbal products including St. John's Wort.

Answer: C