Birth Control after Pregnancy – What are My Options?
Congratulations on your new baby! The first few months are exciting but exhausting times. Whether this is your first baby or your fourth, it is normal for every mom to feel stressed, worried and overwhelmed. There is so much to think about and decide. Two things you know for sure though, are that you are not ready to get pregnant again, and you want to breastfeed the baby. So what options are even available to you??
1. Breastfeeding as Birth Control
This is sometimes referred to as LAM (Lactational Amenorrhea Method) and is a natural way to prevent pregnancy after giving birth. It is effective, (only 1 in 100 will become pregnant if this method is used correctly), safe, convenient, and free. You can do this for up to six months after giving birth. In order for this to be effective, a mother needs to breastfeed her baby exclusively. When a mother breastfeeds continuously, a hormone that leads to ovulation is suppressed. She must breastfeed every 4 hours during the day and every 6 hours at night. When the baby is 6 months old, another form of birth control should be started.
2. Options Containing Estrogen
The birth control options that have the hormone estrogen in them include:
3. Options Containing Progesterone
Numerous studies have shown that taking exogenous progesterone does not affect milk supply, which is great news for breastfeeding moms. There are many choices of progesterone only birth control, including:
4. Copper IUD
This type of IUD does not have any hormones and is effective for up to 10 years after insertion. The copper does not affect milk production.
5. Barrier Methods
Condoms – Can prevent pregnancy if used the right way every time and can be combined with a spermicide (does not have hormones), that decrease chance of pregnancy further.
Diaphragm – Although not as popular as in the past, a diaphragm also prevents pregnancy and can be combined with a spermicide. Your doctor can fit you for it after 6 weeks postpartum to give your body time to heal and get back to normal after childbirth.
Cervical cap – This device covers the cervix and can also be fitted at your 6 week postpartum visit or later.
6. Permanent Birth Control Methods
Some women know that they do not want any more children after the birth of their baby and are interested in permanent forms of birth control. These options include:
– Tubal Ligation – Some practitioners will do a postpartum sterilization after the baby is born during the same hospital stay, others (like in my practice) will wait until at least 6 weeks postpartum and have the patient come back for an outpatient procedure. This will most likely be done laparscopically. The tubes will either be cut off, coagulated or clipped. It can also be done at the same time as a cesarean section, whether it is a scheduled or emergency section. Recent studies have shown that ovarian cancer often begins in the fallopian tubes and a tubal ligation will decrease the chance of getting ovarian cancer.
Your prenatal visits are a great time to discuss birth control after pregnancy. This will give you and your doctor adequate time to discuss your reproductive goals, and to pick the type of birth control that is the best fit for you and your family. Discussing your options beforehand will also give you one less thing to worry about after the baby is born.
Dr. Jessica Katz, MD is an obstetrics & gynecology doctor who practices in Cleveland, OH.
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