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Birth control after giving birth

Birth control after giving birth

Birth Control Birth

The time it takes to become fertile again after childbirth varies for every woman, and you could get pregnant as early as three weeks after giving birth. This is even if you’re breastfeeding and your period hasn’t started yet. 

Many believe breastfeeding prevents pregnancy, but there’s more to the story. Let’s find out when it’s best to start using birth control after having a baby and how efficient breastfeeding is as a contraceptive method.

So when should you start birth control after giving birth?

You can start taking birth control about 21 days after giving birth. For some forms of contraceptives (like the mini-pill), healthcare professionals sometimes recommend waiting until around six weeks postpartum, to avoid any impact on your milk production. So it’s best to check with a trusted professional before starting any form of birth control.

What options do I have for birth control while breastfeeding?

When it comes to birth control while breastfeeding, you have several methods of contraception to choose from, which can seem overwhelming. To help you, it’s important to first know the different types and their main characteristics.

Birth Control Options

Condoms

You can start using male or female condoms as soon as you’re ready to have sex again. This is up to you and how you feel both physically and emotionally, but specialists recommend waiting for at least two weeks after giving birth to reduce the risk of complications.

If you prefer hormonal options, you can choose from the progestogen-only pill (you take it every day), implant (up to 3 years depending on the product), or injection (every 12 weeks). Contraceptives containing only progestogen have a much lower effect (if any) on your milk production.[1]

Progestogen-only mini-pill

It’s best to take the mini-pill at the same time every day, with no more than a three-hour gap (or 12 for other mini-pills like Cerazette). Missing this timeframe could reduce its contraceptive protection. 

You can start the mini-pill anytime, ideally between three and six weeks after birth, so that it doesn’t affect your milk production. But if you start taking the pill later than 21 days postpartum, you’ll need to use additional barrier methods (like condoms) for the first seven days.

Progesterone implants 

The implant is effective on its own if you get it within the first 21 days after birth, and there’s no need for extra protection. Any later than that, you’ll need to use backup protection like condoms for the next seven days. 

It’s inserted under your skin by a doctor or a nurse – it’s a quick, painless procedure. And it can last from eight weeks to three years, depending on the implant. Removing it is also easy—only taking a few minutes—but it requires local anaesthesia.

Progesterone injection

The progesterone injection (for instance Depo Provera) is a hassle-free choice for new mums who don’t want to remember daily pills. Breastfeeding mums can begin using it after six weeks (five days for non-breastfeeding mums) post-delivery, with jabs every 12 weeks. You need to be careful, though, about using it earlier than that, as it might affect the production of breast milk.

Intrauterine device

An Intrauterine Device (IUD) is a small plastic and copper device placed inside your uterus. It comes in various types and sizes to suit different women, and it can stay active in your body for five to ten years, depending on the type. Often called a ‘coil,’ IUDs are a safe option for breastfeeding mothers as they don’t involve any medication.

Is it safe to take hormonal birth control while breastfeeding?

Yes, some methods are typically safe and won’t hurt you or your baby. If you’re breastfeeding, you can start using the injection, implant, IUD, or mini-pill 21 days after giving birth. No matter which method you choose, it’s important to discuss it with your doctor, pharmacist or nurse, who will make sure that the benefits outweigh the potential risks.

Is breastfeeding a form of birth control?

Birth Control Options

It can be. Breastfeeding can work as a form of birth control if you only feed your baby breast milk for the first six months. This method, called the lactational amenorrhea method (LAM), stops you from ovulating (producing eggs), delays your periods and stops you from getting pregnant.

But there are certain limitations. It only works well if you’re doing it perfectly. You need to feed your baby only breast milk every four hours during the day and every six hours at night. If you introduce anything other than breast milk, like formula or solid foods, or if you use a breast pump instead of nursing directly, its effectiveness drops.

When done perfectly, LAM is about as good as the pill. Up to two out of 100 people using LAM correctly get pregnant within the first six months after having a baby.[2] But it’s important to know that LAM becomes less reliable as your baby grows and starts eating solids. So, if you’re relying on breastfeeding as your main birth control, consider switching after the initial six months or when your period returns. And, if you’re introducing other foods to your baby’s diet or your feeding patterns change, it’s a good idea to explore other birth control options.

Is there a best birth control method to use while breastfeeding?

Unfortunately, no method is 100% effective, but condoms have a 98% success rate,[3] and some mini-pills can have up to 99% effectiveness when used correctly.[4] 

If you prefer hormonal options, you can also choose based on your preferred method of administration and how often you want to take it: from the progestogen-only pill (you take it every day), implant (varies from every eight weeks to three years), or injection (every 12 weeks). 

While this is entirely up to you, you might want to consider starting with the pill. If you’re happy with your treatment and have no side effects, you can switch later to the implant or injection, which stay in your system for longer.

But no matter what you choose, you should consult with your healthcare provider to help you make an informed decision.

References

[1] Fraser, I.S. (1991). A review of the use of progestogen-only minipills for contraception during lactation. Reproduction, Fertility, and Development, [online] 3(3), pp.245–254.

[2] The World Health Organization multinational study of breast-feeding and lactational amenorrhea. III. Pregnancy during breast-feeding. (1999). Fertility and Sterility, 72(3), pp.431–440.

[3] Mahdy H, Shaeffer AD, McNabb DM. Condoms. In: StatPearls. StatPearls Publishing, Treasure Island (FL).

[4] Zuniga, C., Blanchard, K., Harper, C.C., Wollum, A., Key, K. and Henderson, J.T. (2022). Effectiveness and efficacy rates of progestin-only pills: A comprehensive literature review. Contraception, p.109925.


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