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Birth Control Options After Pregnancy

Medically Reviewed by Traci C. Johnson, MD on November 04, 2020

If you’ve recently had a baby or if you'll give birth soon, it's important to know that you can get pregnant again very soon after having a baby. Studies show that women who don’t breastfeed can ovulate as early as a month after giving birth. And as many of half of all women have sexual activity within 6 weeks of having a baby.

That’s why it’s important to have a birth control plan if you’re not ready for another child.

How to Choose the Best Birth Control for You

When choosing a birth control method, you’ll want to think about:

  1. If you want to have more children, and if so, how soon
  2. Whether you’ll breastfeed your baby. All birth control is safe for breastfeeding mothers. But some types of birth control may impact your milk supply right after you give birth, so you may need to wait to use them.
  3. How effective you want your birth control to be. Some methods are more reliable than others.
  4. How often you want to use birth control. You have to take some types of birth control every day, while others work for months or even years after you first use them.
  5. Whether you need protection against sexually transmitted diseases
  6. If you have health issues, such as a history of cancer. Some birth control methods might not be safe for people with current or previous health conditions.  
  7. Whether you want to use a method that’s available over the counter or that requires a prescription from a doctor

There are many different types of birth control to choose from. But not all of them may fit your needs.

Lactational Amenorrhea Method (LAM)

When you breastfeed, you might stop ovulating. That prevents you from getting pregnant. But to be sure to prevent pregnancy, you have to breastfeed your baby at least every 4 hours during the day, and every 6 hours at night.

LAM is effective only for the first 6 months after childbirth or until your period returns. Even during that time, if you’re not breastfeeding your baby every 4 hours during the day or every 6 hours at night, you may begin ovulating again, so you could get pregnant.

Some experts say LAM is neither practical nor reliable. Most notably, you won't know if you've ovulated with this method. Talk with your doctor about it.

The Rhythm Method

With this, you track your periods to figure out when you’ll ovulate. (Many women ovulate in the middle of their cycles.) Then you avoid having unprotected sex during the time period when you’re ovulating.

If you’re a new mom, the rhythm method probably isn’t practical and may not work well. Most women don’t have regular periods right after giving birth, even if they’re not breastfeeding. That would make it hard to figure out when you’re ovulating.

What’s more, some women may ovulate during irregular times, such as right before or after their periods.

The rhythm method isn’t a good choice if you really want to avoid getting pregnant.

Barrier Methods

These prevent sperm from reaching an egg, which prevents pregnancy.

There are several types of barrier methods, including:

Spermicide, a substance that contains chemicals that keep sperm from entering your uterus. It’s available over the counter and comes in:

  • Cream
  • Foam
  • Gel
  • Suppositories
  • Tablets

It's important to know that using spermicide every day may raise your chances of getting HIV from an infected partner.

Male condoms, which are thin sheaths that cover a man’s penis. Condoms are the only kind of birth control that protect against sexually transmitted diseases. Used correctly, they’re 98% effective for preventing pregnancy. You can get them over the counter.

Female condoms, which work like male condoms, but the sheath goes in your vagina. These are about 95% effective for preventing pregnancy. They’re also available over the counter.

A diaphragm, which is a small, reusable cup made of rubber or silicone. It covers your cervix, keeping sperm from entering your uterus. Diaphragms are about 83% to 88% effective at preventing pregnancy.

You can get a diaphragm from your doctor.

The cervical cap, which is similar to the diaphragm. It’s a reusable silicone cup that fits over your cervix. Suction holds it in place, and you need to use spermicide with it.

Cervical caps are 68% effective at preventing pregnancy in women who’ve had a child vaginally. They're 84% effective for women who’ve only given birth by cesarean section. That’s because giving birth vaginally changes the shape and size of your vagina and cervix.

You can get the cervical cap from your doctor.

The sponge, a soft disc-shaped device that’s made of foam. The sponge contains spermicide that prevents sperm from entering the uterus. The sponge is 76% effective in preventing pregnancy in women who’ve given birth.

You can get it over the counter.

Hormone Methods

Hormonal birth control contains the hormones estrogen or progestin. Some contain both. These hormones prevent pregnancy. You should avoid using most hormone birth control methods for 4 to 6 weeks after pregnancy if you plan to breastfeed your baby. That’s because the hormones may impact your milk supply.

If you don’t plan to breastfeed, you can usually begin using them 3 weeks after you give birth.

Hormonal birth control might give you a slightly higher risk of stroke and heart attacks. Doctors don’t recommend using them if you:

  • Smoke
  • Are over 35
  • Have high blood pressure

You should also avoid them if you have a high risk or a history of:

  • Heart problems
  • Breast cancer
  • Deep vein thrombosis (DVT) 

Combination birth control pills contain estrogen and progestin. These hormones prevent ovulation and thicken the lining of your uterus to make it hard for sperm to enter.

If you use birth control pills as recommended, they’re about 99% effective at preventing pregnancy. But most women forget a pill from time to time, so experts say they’re really about 91% effective.

There are many different types of combination birth control pills, and they all require a prescription from your doctor.

Progestin-only pills or, as some call them, “minipills,” are unlike other hormonal forms of birth control in that they don’t prevent ovulation. Instead, they thin the lining of your uterus and thicken your cervical mucus, which keeps sperm from fertilizing eggs. You have to take them at the same time every day in order for them to be effective. Progestin-only pills are about 87% effective at preventing pregnancy.

To get these, you need a prescription from your doctor.

The birth control patch. You wear the birth control patch on your upper arm, belly, butt, or back, and change it once a week. It slowly releases estrogen and progestin into your skin, which your body absorbs. That prevents ovulation and thickens the mucus in your cervix, keeping sperm from fertilizing an egg. The patch is up to 99% effective at preventing pregnancy.

You'll need a prescription from your doctor to get a birth control patch.

Hormonal intrauterine device (IUD). An IUD is a small T-shaped device that your doctor inserts into your uterus. There, it releases small amounts of progestin in order to prevent pregnancy. You can keep it in for 3 to 6 years, and you can start using it right after giving birth. Some women choose to have their doctor insert an IUD right after giving birth.

IUDs are 99% effective at preventing pregnancy.

Copper IUD

The copper IUD works like the hormonal IUD. But instead of using progestin, it releases small amounts of copper, which creates an environment that sperm can't survive in. The copper IUD is 99% effective at preventing pregnancy.

Injection

Birth control injections contain depot medroxyprogesterone acetate (DMPA), a type of progestin that prevents ovulation. You get the shot from your doctor once every 3 months. You can get it right after having birth if you don’t plan to breastfeed.

Implant

The birth control implant is a small flexible rod. Your doctor inserts it under the skin in your upper arm. It releases progestin into your body, which prevents ovulation. It lasts about 3 years. You can get it right after giving birth if you don’t plan to breastfeed.

Tubal Ligation

With tubal ligation (sometimes called “having your tubes tied” or “tubal sterilization”), a doctor closes off or removes your fallopian tubes. This blocks the eggs from meeting with the sperm in the tubes since the tubes are blocked or gone.

Tubal ligation is permanent. You can have it done right after giving birth, but your doctor will ask you to make that decision before you give birth.

Tubal ligation doesn’t interfere with your ability to breastfeed.

WebMD Medical Reference

Sources

SOURCES:

American College of Obstetrics and Gynecology: “Postpartum Birth Control.”

UpToDate: “Postpartum contraception: Counseling and methods.”

Planned Parenthood: “What is the birth control patch?” “How effective is the birth control pill?” “Birth Control Patch,” “How effective is the birth control patch?” “How effective are IUDs?”

Mayo Clinic: “Rhythm method for natural family planning,” “Spermicide,” “Male condoms,” “Female condoms,” “Diaphragm,” “Cervical cap,” “Contraceptive sponge,” “Choosing a birth control pill,” “Minipill (progestin-only birth control pill),”

National Health Service (U.K.): “Female condoms.”

Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology, Yale University School of Medicine.

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