Birth Control Options after ChildbirthKatlyn Joy | 7, January 2011
You may be pregnant, your due date looming as large as your expanding tummy, or perhaps you've recently delivered your baby, and the last thing on your mind is avoiding a repeat of recent history...at least right away. However, this is the ideal time to choose your birth control option. Many women decide to change methods after giving birth.
At the end of your pregnancy or during the first weeks following childbirth, you should read up on your options and discuss them with your partner. When you go in for your six week postpartum checkup you can be prepared to ask your health provider more questions about the methods you're considering and get more information.
While it's a big decision, remember you can choose something for the short term and switch later should you decide to. But don't delay making any decision at all for too long. Many unplanned pregnancies occur soon after childbirth.
Male condom: One advantage of using condoms is that you can use them just as soon as you resume sexual relations. They can also help with post-baby vaginal dryness since they are lubricated. Another plus, they are excellent in preventing STI's. Downside is that you have to stop in the midst of things to put it on, and some couples honestly aren't so reliable at using them which means a much lower success rate. Failure rates with condom use is typically around 15%. This method is compatible with breastfeeding.
Female condom: No fitting is required for the female condom, and like the male condom it is OK for breastfeeding mothers and able to be used right after birth. However, it may cause vaginal irritation or allergic reactions. The failure rate typically for the first year of use is about 21%.
Diaphragm: The diaphragm requires a fitting, and if you used one previously, you'll need resized after childbirth. This will be done at the 6 week postpartum check up most likely. The realistic failure rate for this method is about 16%, and some women experience allergic reactions, irritation or urinary tract infections. It can inserted hours prior to sex and must be left in place for 6 hours after sex.
Cervical cap (FemCap)—The irritation that can be experienced with diaphragms can also be present with the cap. It may cause abnormal PAP results. It can be left in place 6 hours after sex and placed hours prior to sex, so it may not necessarily interrupt a passionate night. It is less effective once a woman has given birth vaginally, with a failure rate of 32% compared to those who have not given birth having a failure rate of 16%.
Lea's Shield: This barrier device must be left in place for 8 hours after sex and must be replaced every 6 months. Since it's newer, little data exists and the FDA has yet to determine it's efficacy or safety following childbirth. It's believed the typical failure rate is about 15%.
Pill (combination pill): The combination pill, so named because it delivers both progesterone and estrogen, is not recommended for breastfeeding mothers at least for the first six months after birth because it affects both the quantity and quality of the mother's milk. It is highly effective at preventing pregnancy. Side effects include risk of stroke or blood clots and other hormonal side effects.
Minipill: This pill does not contain estrogen and so is the only hormonal birth control recommended by the American College of Obstetricians and Gynecologists for breastfeeding mothers. It may even increase the volume of breastmilk. You must wait a few weeks following birth to begin, and a few more weeks before it becomes effective at preventing pregnancy. It is 92% effective.
Other hormonal options
None of these are recommended for breastfeeding mothers. Most require a wait until the postpartum check up before starting. The Patch(Ortho Evra) must be replaced every 7 days for 3 weeks with no patch on the fourth week. The Vaginal Ring (NuvaRing)must be replaced every 28 days, while the Shot (Depo-Provera) is given every 3 months. The Implant lasts 3 years and may be given after delivery if not nursing. The IUD may be either a copper one (ParaGard), or a hormone one (Mirena) which lasts several years and is nearly 99% effective.
Primarily this consists of LAM or Lactational Amenorrhea Method. Basically this is the natural hormonal suppression which causes temporary infertility during breastfeeding. Studies indicate it is actually more effective than most nonhormonal methods of contraception when all requirements are met. Those requirements are exclusive breastfeeding in the first six months following birth, nursing at least every four hours during the day, and every six hours at night. The baby should be getting 90 to 95% of food intake from breastmilk and your period cannot have returned. If you want to be completely safe, use a backup form of birth control such as condoms.
If you are certain you don't want to add to your family in the future you might consider sterilization. For a women this would mean a tubal ligation or having your tubes tied. Another variation on the typical surgical procedure where the fallopian tubes are cut, clamped or burned to prevent eggs from traveling to the uterus and being fertilized is a nonsurgical method called Essure. This method involves the doctor inserting metal springs into each tube. Over a few months scar tissue builds up blocking the tubes. The failure rate is .5 percent, but increases to 1 percent over a decade, and 2 percent in twenty years. Since the tubes are blocked, should a pregnancy occur it will likely be an ectopic pregnancy. If you are considering sterilization, consult prior to your due date with your doctor as some states have a waiting period to give consent for the procedure.
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