I think it’s fair to assume that most of you are pretty clued up when it comes to the different methods of contraception that are available to you, having spent a large parts of our adult lives actively trying not to get pregnant, before making the momentous decision to become a parent. However I often come across people who are unsure as to when they should be using contraception after having had a baby, as well as which kinds are most suitable, and exactly how fertile (or infertile) they are soon after giving birth. I thought it would be useful to answer some of these questions, and summarise which methods of contraception are best for you after having your baby.
Before I go any further, here is a general contraception guide (not specific to contraception after having a baby) that summarises all the different methods available, their pros and cons, and which are most suitable for you. Remember that all of these are available on the NHS, with free prescriptions even for those who usually pay, and can be arranged through your GP or family planning centre.
In terms of your risk of getting pregnant after having a baby, women fit into two groups: those who are exclusively breastfeeding, and those who are not. If you are breastfeeding your baby, and not using any bottle feeds at all, the hormones that maintain your milk supply will also prevent ovulation; so if you are not having any periods and your baby is under six months old, you will be protected from falling pregnant without the need for any further precautions. This is called the lactational amenorrhoea method, (lactational = breastfeeding and amenorrhoea = no periods) and is over 99% reliable. From six months of age, you should start using contraception if you do not wish to become pregnant. If, like many mums, you are exclusively breastfeeding but do give your baby the odd, infrequent bottle; the likelihood that you are still protected from becoming pregnant is high, especially if you are not having any periods, however the reliability of this method will be lower, and it is impossible to predict by how much – but you should be aware of this and choose to use additional contraception, depending on how important it is to you to avoid pregnancy.
If you are bottle or combination feeding, theoretically speaking you could get pregnant as little as three weeks after giving birth, even though your first period will be later than this, so it’s possible that you may think that your periods have not yet returned, when in fact you are pregnant! It’s advisable to start using contraception as soon as you feel ready to start having sex again.
There’s a school of thought that after giving birth (if you’re not exclusively breastfeeding), and also after stopping breastfeeding, women may have higher fertility than usual, and may fall pregnant more quickly or easily than they had expected. I’ve done some research into this, and although I was unable to find any reliable evidence that this is indeed true, I’ve certainly heard of several cases anecdotally: one, where a GP I know fell pregnant when her baby was only 3 months, even though her periods hadn’t returned; another friend fell pregnant only two weeks after she had stopped breastfeeding her baby; and another friend who tried to conceive for 3 years with her first, thought it would take a long time to conceive again but fell pregnant after only 6 months of trying with her second. It’s possible that this theory regarding fertility is true, but that not enough studies have been done to prove it yet!
So, if you have recently given birth, and wish to avoid pregnancy, here are your options:
If you are brave enough to resume having sex straight away, you can use condoms or the progestogen-only pill (also known as the mini-pill) from birth.
From Three Weeks
From 21 days after birth, you can use the contraceptive implant, combined pill (contains oestrogen and a progestogen), vaginal ring and contraceptive patch, however if you are breastfeeding, methods that contain oestrogen (the combined pill, vaginal ring and contraceptive patch) are not advised, as they may affect your milk supply.
From Six Weeks
From 6 weeks after birth, you can have the contraceptive injection or use a diaphragm/cap. If you have a diaphragm from before your pregnancy, make sure you are fitted for a new one after birth.
From Six To Eight Weeks
From 6-8 weeks after birth you can have a coil fitted (either a Mirena or copper coil). These can be fitted earlier in some circumstances, but it is generally advised to wait as they may become dislodged with very heavy bleeding after birth, or introduce infection.
For further information on any of the methods mentioned, see the linked contraception guide, or visit your GP or family planning clinic.
I hope that this has been useful, and answered any questions you may have had about contraception after having a baby. I’d recommend bookmarking this post, or the link to the contraception guide, especially if you are currently pregnant or this isn’t relevant to you at the moment; as the long-suffering women that we are it’s something that we will keep having to deal with and return to! Please do drop me any questions that you may have.
Image by Little Beanies