Birth control options after having a baby

This blog is written by our clinicians and aims to keep patients informed with up to date information on medical conditions. The editor of the blog is Dr Cristina Romete.

Many joke that the best form of contraception is being the parent of a new-born baby. With all that broken sleep and the demands of life with an infant, contraception isn’t always high up on everyone’s to-do list but it is important to be aware that a woman’s fertility tends to resume pretty soon after birth.

Many unplanned pregnancies happen in the first few months after pregnancy so it is worth considering your contraceptive options early (and ideally sooner than the 6-8 week check).

How soon does fertility return after giving birth?

The answer to this depends on whether you are breastfeeding, combination feeding or formula feeding.

Generally speaking, you are unlikely to fall pregnant in the first 3 weeks after having a baby, however thereafter it is possible, especially if formula feeding or combination feeding.

Most women who breastfeed exclusively tend not to resume their periods until around the 6-month mark. However, this isn’t 100% the case and for example, if your baby isn’t breastfeeding much in the night or is starting to wean early, chances are your cycle will resume sooner than 6 months.

You can fall pregnant before your periods resume

Women ovulate 2 weeks BEFORE their period, so it is possible to have unprotected intercourse thinking that it is fine because your periods haven’t yet started, but actually find that you were ovulating at that point and your period was due 2 weeks later. This happens relatively commonly.

What contraceptive options are there?

When it comes to contraception after birth, pretty much any contraceptive can be used, except for those breastfeeding, where current guidance still recommends avoiding contraceptives with the hormone oestrogen in them for the first 6 weeks. This is because it is thought to impair the establishment of milk supply.

Non-hormonal options include:

  • male and female condoms
  • the copper coil (from 4 weeks after giving birth or inserted within 48 hours of birth/at the time of a caesarean)
  • diaphragm (from 6 weeks after birth)

Hormonal options that don’t affect milk supply (have no oestrogen):

  • intra uterine system (i.e. Mirena coil, from 4 weeks after birth or within 48 hours of birth/at time of caesarean)
  • contraceptive implant
  • progesterone only pill
  • contraceptive injection

Hormonal options that contain oestrogen and should be used from 3 weeks if not breastfeeding, or 6 weeks if breastfeeding:

  • combined pill
  • contraceptive patch
  • vaginal ring

How do you decide which one to use?

At RoC we can help you to run through what your contraceptive priorities are, what your future pregnancy plans might be and weigh this all up with your lifestyle choices and any other health concerns, to help you choose the best contraceptive option for you.

We can then follow up how you’re getting on with it and make suitable changes as needed.

References: https://www.fpa.org.uk/sites/default/files/contraception-after-having-baby-your-guide.pdf

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