The last thing on my mind right after giving birth to my first child was birth control. Once I recovered, however, I had to think about it since I didn’t want to have another baby right away. As convenient as it sounds, the Lactational Amenorrhea Method, or breastfeeding as birth control, isn’t reliable; although ovulation will be delayed during breastfeeding, it’s hard to say for how long.
While talking to my midwife I learned that my postnatal birth control options were different than the birth control options I had before getting pregnant. Because I was breastfeeding, I couldn’t take the same oestrogen-heavy option I’d once used. “Oestrogen containing contraception can decrease a mum’s milk supply,” explains Dr Tara Abella, an doctor in private practice. The good news was that there were still a lot of options for me to choose from; I just needed to pick one.
So, if you’ve recently had a baby, you definitely have plenty of options to prevent pregnancy (because you will want to have sex again at some point, trust us). You’ll need to take into account whether you’re breastfeeding, as well as what method of birth control best suits your lifestyle and health history. Consider: Will you remember to take a pill every day? Do you have a history of blood clots in your family? Are you planning on getting pregnant within the next year or two? And so on. Here, we break down your different birth control options postnatal, with pros and cons for each one.
1. Oral Contraceptive Pill
What it is: The Pill comes in two basic forms, one combining the hormones oestrogen and progestogen and a progestogen-only pill (POP), called the “Mini Pill”.
Pros: It can be extremely effective, may reduce the duration of your period, and could reduce cramps. The Mini Pill does not affect breastmilk supply, so it’s a good option for breastfeeding mums.
Cons: You must remember to take it every day for it to be effective. There’s a possibility of blood clots, breast tenderness and weight gain. “Additionally, its effectiveness can be lessened by certain medications, such as antibiotics,” adds Dr Oren Keiser, MD, an ob-gyn in private practice.
2. Vaginal Ring (or NuvaRing)
What it is: This small plastic ring contains oestrogen and progestogen. You insert it into your vagina for three weeks, then remove it for one week, during which time you get your period; you’ll repeat this cycle every month. “It works the same way as a birth control pill,” says Dr Keiser. “It’s just that the hormone is introduced into your blood stream by being absorbed through the skin instead of the GI tract.”
Pros: It can be very effective, and you only need to change it once a month.
Cons: There’s a possibility of developing blood clots and gaining weight. If you’re breastfeeding, it may decrease your breastmilk supply.
What it is: This T-shaped piece of plastic is inserted into your uterus by your doctor; it blocks sperm from fertilising the egg. There are two types of copper IUDs currently available in Australia, one which lasts up to five years and one which lasts up to ten years. It is suitable for women who cannot (or prefer not to) use a hormonal form of contraception and can be removed at any time. The hormonal IUD available is Mirena, it lasts up to 5 years and is prescribed, inserted and removed by a doctor.
Pros: It’s long lasting, low maintenance and highly effective. The non-hormonal IUD is a good choice for nursing mums.
Cons: There is a possibility of irregular bleeding in the beginning (which usually resolves and results in shorter, lighter periods), and a small risk of perforation. According to Dr Abella, women with a history of very heavy or painful periods might not want to use a copper IUD, because it has been associated with some reports of heavier periods and increased cramping.
4. Depo Provera
What it is: Known as the “Birth Control Shot”, this progesterone-only injection is administered by a doctor every 12 weeks.
Pros: It can be very effective, and involves only four shots per year. You also may have lighter periods while taking it. Since it doesn’t contain oestrogen it’s a good choice for nursing mums.
Cons: “Using this method of birth control beyond two years may reduce bone density,” says Dr Keiser. In addition, there is possible weight gain, irregular bleeding and it might take you longer to get pregnant again.
5. Birth Control Implant
What it is: This is a progesterone-only, matchstick-size implantable device that is inserted by your doctor under the skin of the upper arm (an IUD, on the other hand, is inserted into the uterus). The brand name for the implant is Implanon.
Pros: It’s effective for up to three years, a good choice for nursing mums and might reduce the length of (or even eliminate) your period.
Cons: Similar to OCPs, the implant can be less effective in combination with other medications. Additionally, it may cause irregular bleeding for up to a year after the implant.
6. The Barrier Method
What it is: You know, condoms and diaphragms. Keep in mind that diaphragms may need to be refitted after you give birth, as the size and shape of your vagina may have changed.
Pros: Both are easy to use, effective when used correctly and have no side effects. They’re also a good choice for nursing mums.
Cons: They’re not very effective when used incorrectly, and they can break. You must remember to put it on (or in, in the case of a diaphragm) every single time.
And before you ask, no, doctors don’t recommend the “pull-out method.” It might have worked for you in the past, but there is never a guarantee with this method. “The only thing that is 100 percent effective against pregnancy is abstinence,” says Dr Abella. She adds that women who’ve experienced infertility and used IVF to become pregnant are not off the hook either. “They could still possibly get pregnant spontaneously in the future.” Discuss your options with your healthcare provider, and choose the best one for you. Hey, it’s great to have options, right?
More for postnatal mums:
- 5 Postnatal Essentials I Swear By
- 21 Things Only Breastfeeding Mums Know
- My Postnatal Depression Was So Severe I Didn’t Recognise Myself