Contraception

Don’t forget to use birth control until you are ready for another child.

Exclusive breastfeeding can reduce – but not eliminate – your chances of getting pregnant in the first six months after childbirth. However, since you can get pregnant again, it is important to use birth control at all times.

Some hormonal contraceptives which contain estrogen should not be used during the early stages of breastfeeding, as they may reduce your milk supply. This does not apply to vaginally-applied estrogen products, which are sometimes taken for vaginal atrophy experienced during breastfeeding.

Speak with your health-care provider about birth control options.

Oral contraceptive pill (OCP)

  • Can be started at 3 weeks if not breastfeeding.
  • The combined pill (estrogen + a progestin) can decrease breast milk production so should not be started until at least 6 weeks postpartum.
  • The progestin-only pill does not affect milk supply and can be used during breastfeeding. When combined with the decreased fertility of breastfeeding, it makes a great choice for breastfeeding moms.

Contraceptive patch or vaginal ring

  • Similar to the combined OCP, can be started after three weeks if not breastfeeding or six weeks if breastfeeding.

Injection

  • One shot every 12 weeks
  • Can be given immediately postpartum regardless of breastfeeding
  • No known effects on breast milk or infant ingestion of the hormone

Intrauterine device or intrauterine system

  • Inserted into the uterus by a doctor more than six weeks after delivery
  • Reliable, long-term birth control for up to five years, but can be removed at any time
  • The hormonal intrauterine system is as effective as tubal ligation

Barrier methods

  • Hormone-free, only needed when you are actually having sex
  • Condoms can be used anytime, and are commonly used temporarily while breastfeeding
  • Use non-spermicidal condoms with lots of extra water-based lubricant to avoid vaginal irritation
  • Diaphragms and cervical caps need to be re-fitted at six weeks postpartum

Emergency contraception

  • Emergency contraception (EC) pills are effective up to five days after unprotected intercourse but best if used within the first 24-48 hours.
  • Emergency IUD insertion is available up to 7 days after unprotected intercourse

Sterilization

  1. Female sterilization (tubal ligation)
  • Permanent; only for couples who are absolutely sure their family is complete
  • Abdominal surgery can be performed the day after delivery while still in hospital through a 2 – 3 cm incision at the belly button
  • Laparoscopic surgery is done through one or two small incisions after six weeks

    2. Male sterilization (vasectomy)

  • Permanent; only for couples who are absolutely sure their family is complete
  • An outpatient procedure
  • Less risk and more effective than tubal ligation

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