To begin with, obstetricians-gynecologists advise abstaining from sexual relations for the first four to six weeks after giving birth. At this time, the uterus has not yet completely contracted, the wound surface in it has not completely healed, there is always blood discharge, which means there is a risk of bringing some kind of infection into the uterus. Therefore, it is worth waiting until the woman’s health returns to normal, and only then return to sex.
However, if enough time has already passed since giving birth to the child and a woman plans on returning to active sexual life, it is high time to think on birth control method if she doe not want to have one more baby in the nearest future.
Well, which contraceptive to choose will depend primarily on whether the mother is breastfeeding. If the baby is artificially fed, the woman can use any of the contraceptives that are suitable for her. If the mother is breastfeeding, then she should choose only those contraceptives that do not penetrate into breast milk and, therefore, do not affect the baby’s health.
In this article, we will dwell on different birth control options suitable for breastfeeding mothers.
1. Natural Contraception
One of the simplest and most effective methods of contraception is provided by nature itself. As it turns out, during lactation, a woman usually does not become pregnant. The fact is that after childbirth, the female body produces the hormone prolactin. It stimulates milk production and at the same time suppresses ovulation. However, for all those who intend to use this method, there are several important points to consider. First, this method is most effective when feeding on demand, with breaks of no more than 4 hours during the day and 6 hours at night. That is, you need to feed at least 7-8 times a day. Secondly, you can use this method of contraception only before the onset of menstruation. Thirdly, when lactation crises occur, additional means of protection are required.
2. Barrier Methods of Birth Control
The so-called barrier contraception method is the most common among all methods of contraception. Its essence is to create an obstacle in the path of sperm to the egg. And the simplest type of barrier contraception is a condom. It is available, easy to use, does not affect the milk supply and health of the child in any way, and most importantly, it can be used at any time, that is, as soon as “you want”. In addition, the majority of modern “rubber products” are additionally treated with special spermicides and lubricants, which practically negates the discomfort during sexual intercourse. But the condom also has a minus – it is not very reliable (it can break), and men do not always like the condom.
3. Inhibit sperm
This method of contraception is based on the local use of spermicides, special chemicals that kill sperm. They are available in the form of creams, suppositories, vaginal tablets so that a woman always has a choice of which spermicide to prefer. Spermicides are absolutely safe for health, they can be used immediately after childbirth and, most importantly, during breastfeeding. The advantage of spermicides is that they are very easy to use: just before intercourse, the drug is simply injected into the vagina. They also have additional bonuses – spermicides not only protect against unwanted pregnancy but also protect against some sexually transmitted infections. The only thing is that, as with any medicine, there may be an allergy to spermicides.
1. Hormonal Birth Control Pills
Almost all women have heard about hormonal contraceptive pills (oral contraceptives – OK), and many took them even before pregnancy. Is it possible to use them now, after the birth of a child? If the mother is not breastfeeding, then pills can be used from the beginning of the first period after childbirth. If the mother is breastfeeding, she can also use oral contraceptives, but not all. During lactation, the so-called combination drugs, which include an estrogenic component and gestagens, are contraindicated. But you can take pills that contain only gestagen (they are also called mini-pills). Progestational drugs do not affect the quality of breast milk and the duration of milk supply. However, taking these pills will require a certain discipline from a woman – skipping a pill can lead to side effects and reduce the contraceptive effect. The disadvantage of hormonal contraception is that it has many contraindications and side effects.
Intrauterine devices (IUDs) are small T-shaped contraceptives inserted into the uterus to prevent pregnancy. They can be of 2 types: hormonal and non-hormonal IUD. To do not disturb milk supply, the breastfeeding mother should avoid any estrogen-containing methods of birth control. The most popular IUDs brands on the market are Skyla IUD with progestogen and Mirena IUD with levonorgestrel. These are hormonal birth control devices.
The non-hormonal IUD contains copper as an active substance to prevent pregnancy. SMB Copper IUD T 380 is a typical representative of these contraceptives. In any case, you need an individual consultation with your OB-GYN doctor to choose the most suitable method of birth control, but you should be aware of various available contraceptives.
It is another option appropriate for breastfeeding mothers that is not a thread of reduced milk supply. A popular brand of such contraceptives is Nexplanon. The active substance here is etonogestrel. It is a hormone, but it does not affect the milk supply.
The device is a small rod that is inserted under the skin and daily releases a small dose of a hormone into the bloodstream for birth control. The greatest benefit of Nexplanon, as well as the IUDs and unlike barrier methods, is its long-lasting effect. Nexplanon can remain in the woman’s body for 3-5 years. So, you insert the rod once and forget about it for the next 3 or 5 years, having safe sex without any risk of getting pregnant. At the same time, it can be removed at any time per the patient’s request.
Depo-Provera is an injectable form of birth control drugs with progestogen hormone. It provides the contraceptive effect for 12 weeks. It is suitable for women who do not want anything to be inserted into their bodies, but you will have to repeat the injection every 3 months.
The highest efficiency is in hormonal methods of contraception (up to 99%), about 98% – in the method of lactational amenorrhea (if you follow all the rules), up to 95% – in spermicides, followed by a condom – 86–96% (if used correctly). But for such common methods of contraception as interrupted intercourse and the so-called calendar method, the effectiveness is very low – about 40-50%. With interrupted sexual intercourse, everything is clear: there is never a guarantee that a man will “be in time”, the same is with the calendar method. It is based on the fact that a woman roughly determines the day of ovulation and counts “dangerous days”, but after childbirth, when the mother is breastfeeding or even if she stops feeding, it is very difficult to set the ovulation date, but it is easy to make a mistake. And even with an already regular menstrual cycle, there is always the likelihood that it is in this month that ovulation will shift and the calculations will be incorrect.
Each woman is individual, so there is no single, best contraceptive, and you should focus here not on advertising of pharmaceutical companies or advice from friends, but on your own health, family situation, and doctor’s recommendations.
Choice of contraception is crucial for every woman. It should be effective, safe, and comfortable. But this choice gets even more complicated when we talk about breastfeeding women as it should not affect or cause a low milk supply. We have provided you with a brief overview of various contraceptive forms available for mothers that will be both effective and safe for you and your baby. In any case, we strongly advise you have a personal consultation with your gynecology doctor who will help you select the best form of contraceptive suitable specifically for you!