Which Contraceptive Do I Choose After Childbirth?

Which Contraceptive Do I Choose After Childbirth?

Following the birth of your baby, birth control might not be high on your priority list. However, it’s essential that you seriously consider a contraceptive before you resume sexual activity, as you can fall pregnant again soon after having a baby.

Leaving the decision about postpartum contraception until your first period arrives might be too late, because ovulation, and the chance of conception, occurs a two weeks before menstruation.  You may decide to use the same method of birth control as pre-pregnancy, but depending on your circumstances, you may need to look at alternative contraceptives.

Breastfeeding as a Contraceptive

If you choose to breastfeed, you might think that birth control isn’t necessary.  While it’s true that breastfeeding can be used for contraceptive purposes during the first six months after birth, you have to adhere to some pretty strict criteria:

  1. Your period hasn’t returned.
  2. Your breast milk must provide your baby’s sole source of nutrition.
  3. You need to breastfeed (very) often. At least 6 hours per night, and 4 hours per day.

If you meet these requirements, the chance of pregnancy is less than 2%.  The effectiveness of breastfeeding is also higher when you feed on demand, keep your baby close to you, co-sleep, feed for comfort, and avoid the use of bottles and pacifiers.

Contraceptives for Breastfeeding Moms

Barrier methods of contraception, such as condoms, a cap or diaphragm, or an IUD, are the preferred methods of birth control if you are breastfeeding.

This is because barrier contraceptives and IUDs don’t release any hormones, so won’t  interfere with your milk supply or expose your baby to additional hormones through breast milk.  If you’ve used a contraceptive cap or diaphragm before your pregnancy, you should get it refitted;  changes that occur to your body after childbirth require a cap or diaphragm adjustment to remain effective.

If you would prefer to use a hormonal birth control method, use a progestin-only contraceptive such as the mini pill, contraceptive injection or contraceptive implant. Progestin-only methods of birth control should not adversely affect your milk supply, though it’s still recommended to delay their use until your milk supply is more established.

The American College of Obstetricians and Gynecologists advises waiting at least two weeks post-delivery to start progestin-only pills and six weeks for other progestin-only contraceptives. There is a risk that estrogen-containing contraceptives, like the combined pill, vaginal ring and contraceptive patch, may reduce your milk supply.  The World Health Organization goes as far as to advise delaying their introduction till your baby is six months old.

Contraception if you use Infant Formula

If you choose to bottle feed your baby, you have a greater range of contraceptives available to you sooner. The American Academy of Family Physicians explains that you can start using estrogen-containing birth control methods three weeks after delivery, but not before. The delay is due to your increased risk of a blood clot following childbirth, as it takes around three weeks for your blood clotting to return to normal.

Contraception if you want a Small Age Gap

If you don’t want another child straightaway, but equally do not want to wait for your fertility to resume after you stop using birth control, you should consider the impact that certain hormonal contraceptives have on fertility. For instance, the American Pregnancy Association reports that after you discontinue Depo-Provera injections, it may take up to 18 months for your menstrual cycle to restart. You are not limited to natural or barrier methods of birth control though, as fertility returns within a few months of stopping the contraceptive pill, vaginal ring, implant or patch.

Contraception when your Family is Complete

If you are sure that you don’t want any more children, you or your partner could consider sterilization, which offers a permanent form of birth control. A vasectomy in men or tubal sterilization in women offers almost complete protection against pregnancy, but as you cannot know what your future holds, you may prefer to choose a long-term method of birth control that is reversible such as an IUD or implant.

As this article shows, there are a range of contraceptives suitable after your give birth, but your situation will determine which birth control options are open to you.  Each form of contraception has its pros and cons, so to help you make an informed decision, you may wish to discuss your options further with your doctor.

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