Patient education: Birth control after having a baby (The Basics)

Is it possible to get pregnant again soon after giving birth? — Yes. It can take some time after giving birth for your body to recover and your period to come back. But it is still possible to get pregnant if you have sex. This is true even if your period has not yet returned.

For the first few months after giving birth, if your baby exclusively breastfeeds, you are less likely to get pregnant than at other times. ("Exclusive" breastfeeding means the baby does not get any formula or other foods.) But it is still possible.

If you do not want to get pregnant again soon, there are different types of birth control you can choose from. It's a good idea to start thinking about this even before you give birth.

Can I use breastfeeding as birth control? — Some people choose to do this. Doctors call this the "lactational amenorrhea method." But it is not as reliable as other forms of birth control.

If you do choose this method, it's important to know that it can only work if:

●Your period has not yet returned since giving birth.

●Your baby is less than 6 months old.

●Your baby only eats by breastfeeding, and does not get any formula or other foods.

●You breastfeed at least every 4 to 6 hours.

●You breastfeed directly without using a breast pump.

If you are certain that you do not want to get pregnant again, other forms of birth control are more reliable. These are discussed more below.

What are the options for birth control? — There are many different types of birth control. They prevent pregnancy in different ways (table 1).

The main types include:

●Long-acting methods – These are forms of birth control that can prevent pregnancy for years at a time. They include intrauterine devices ("IUDs") and the implant. Some IUDs as well as the implant use hormones to prevent pregnancy. An IUD or implant can be removed if you want to get pregnant again. Some of the IUDs can make your period lighter.

●Permanent procedures – These make a person permanently unable to get pregnant, or get a partner pregnant. They include:

•Tubal ligation (having your "tubes tied")

•Vasectomy (for the male partner)

●Hormonal birth control – These methods use hormones to prevent pregnancy. They include pills, injections, patches, and vaginal rings. These can make your period lighter and more regular.

●Condoms – These are also called a "barrier" method. They prevent sperm from getting into the uterus and reaching an egg. "External" condoms go over the penis, and "internal" condoms go inside of the vagina.

●"Pericoital" methods – This refers to birth control you use at the time of sex. Examples include diaphragms, sponges, and spermicides. Condoms are also a type of pericoital birth control.

There are also a few forms of "natural" birth control. This means that they require no medicines or devices. These forms of birth control are less reliable than other methods, so if you feel strongly that you do not want to get pregnant again, you might want to choose another method. Natural methods include:

●Withdrawal – This is when the male partner pulls out before ejaculating.

●Fertility awareness – This involves keeping track of your monthly periods. You use this information to predict when you are most likely to get pregnant each month. Then, you can avoid sex during that time, or use some form of birth control then, like condoms.

What should I think about when choosing birth control? — There are a few things to think about. These include:

●Your plans for future pregnancy – Think about whether you want to get pregnant again in the future, and how soon that might be. Some types of birth control can be started and stopped quickly. Other types can prevent pregnancy for several years, or permanently.

In general, doctors recommend waiting at least 6 months before trying to get pregnant again. That's because having 2 pregnancies very close together can be hard on your body and increase the risk of problems. But this is a personal decision.

●Whether you plan to breastfeed – Some types of birth control use hormones to prevent pregnancy. Of these, some contain the hormones estrogen and progestin, while others contain only progestin. These hormones are not harmful for your baby. But many doctors recommend that people who are breastfeeding delay starting birth control that contains estrogen for at least 3 weeks after giving birth.

Types of hormonal birth control without estrogen include the progestin-only pill, the hormone-containing IUD, the shot, and the implant. Types of birth control without any hormones at all include the copper IUD, condoms, diaphragms, sponges, and spermicides. Any of these can be started right away after giving birth.

●When you can start birth control – With some types of birth control, you can start them immediately after giving birth.

If you choose birth control that does contain estrogen, you will need to wait at least a few weeks after giving birth to start using it. Examples include the pill, patch, or vaginal ring. This is because there is a higher risk of blood clots in the weeks after giving birth.

●What you want most from your birth control – These are questions that anyone choosing birth control should consider, whether or not they recently gave birth. For each type of birth control, think about:

•How likely you are to use it correctly and consistently

•How well it works to prevent pregnancy

•How easy it is to get

•How much it costs

•Whether it has side effects

•Whether it has benefits besides preventing pregnancy

•Whether you also want protection from sexually transmitted infections

Your doctor or nurse can talk to you about the different options. They can help you choose birth control that is right for you.

What is emergency contraception? — Emergency contraception is a way to try to prevent pregnancy if you recently had sex. It can be used to lower the risk of pregnancy if you had sex and forgot to use birth control, or there was a problem like the condom broke. There are 2 types of emergency contraception: the IUD and pills. Some pills require a prescription, but others you can buy in a pharmacy.

If you need to use emergency contraception, do it as soon as possible after unprotected sex.

What if I have problems or questions? — Talk to your doctor or nurse if you:

●Have any side effects or problems with your birth control

●Want to switch to a different type of birth control

●Think that your birth control is affecting your milk supply

●Have pain or other problems with sex

●Have questions about breastfeeding

More on this topic

Patient education: Choosing birth control (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Intrauterine devices (IUDs) (The Basics)
Patient education: IUD insertion (The Basics)
Patient education: IUD removal (The Basics)
Patient education: Barrier methods of birth control (The Basics)
Patient education: Permanent birth control for women (The Basics)
Patient education: Vasectomy (The Basics)
Patient education: Emergency contraception (The Basics)

Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Hormonal methods of birth control (Beyond the Basics)
Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Barrier and pericoital methods of birth control (Beyond the Basics)
Patient education: Permanent birth control for women (Beyond the Basics)
Patient education: Vasectomy (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)