DMPA is the most commonly used hormonal contraceptive method in South Africa. Researchers did this study to determine whether DMPA increases PND risk than the copper-containing IUD when administered after delivery. The present study was a single-blind randomized controlled trial conducted at two teaching hospitals in East London, South Africa.

Two hundred and forty-two Eligible, consenting women requiring postnatal contraception were randomized to receive DMPA or an IUD within 48 hours of childbirth and interviewed at 1 and 3 months postpartum. Depression was measured using the BDI-II and the EPDS.

One-month EPDS depression scores were statistically significantly higher in the DMPA arm compared with the IUD arm. Three-month BDI-II scores were substantially higher in the DMPA arm than in the IUD arm, and, according to the BDI-II but not the EPDS, more women in the DMPA arm had significant depression at this time-point. There were no statistically significant differences in other outcome measures except that fewer women had resumed sexual activity by one month postpartum in the DMPA arm.

The study concluded that the possibility that immediate postnatal DMPA use is associated with depression could not be excluded. These findings justify further research with longer follow-up.