Womens Health Clinic Blog

Postpartum Birth Control

By Dr Tom Manley - Obstetrician and Gynaecologist
Young family with 3 small children walking through a field

After a woman has had her baby, she is ‘postpartum’. This is a pretty crazy time for most new parents with lots of interrupted sleep and trying to recover from birth while looking after a newborn.

In this blog we will explore some of the options for birth control (contraception) after having a baby. Some of the do’s and don’ts as well as some potential risks to avoid.

How soon do I need to start?

It is not necessary to start birth control in the first 21 days after birth or until you start having sex after this time. It is, however, safe to start something as soon as you are ready with the exception of a couple of options.

An IUD (Intra-Uterine Device) such as a Mirena or Copper IUD are safe to place within 48 hours of delivery. This is not usually the preferred case as there is a higher risk that the IUD will be expelled. It is advisable that you wait until at least 6 weeks to have an IUD inserted.

Options

Broadly speaking birth control can be broken up into ‘hormonal’ and ‘non-hormonal’ options. The hormones we are talking about are either progesterone alone or a combination of estrogen and progesterone.

The combined oral contraceptive pill (COCP) and the Nuvaring are the two available combination options. These shouldn’t be used until breastfeeding is fully established (not before 6 weeks) if you are intending to breastfeed. After 6 weeks it doesn’t seem to make a significant difference to milk supply if you are using one of these.1

All other types of birth control will not have an impact on breastfeeding so most can be started from 3 weeks with the exception of IUD’s (as mentioned above) and the diaphragm (vaginal device) which shouldn’t be used before 6 weeks.

These include:

  • Progesterone only pill (Microlut)
  • Implanon
  • Depot Provera
  • Condoms

Breastfeeding

A little note on breastfeeding. If you have decided to breastfeed and this is the only source of food for your baby, this can be relied on for birth control in the first 6 months. After 6 months or when your period starts again (whichever is sooner) it should not be relied on as an effective birth control option.2

Other things you might consider

Your previous experiences with any of these options may influence your decision on the type of birth control you use. Your personal history of side effects to hormones might mean a non-hormonal option might be right for you.

Conversely, hormonal options may be the best option for control of symptoms related to periods or a condition such as endometriosis. The pregnancy specialists at Create Health will analyse your personal medical history to help recommend the best option for you.

The type of birth control might also depend on your family planning and the spacing of future babies or you might have finished your family. If this is the case a permanent form of birth control might be the best option such as tubal sterilisation or vasectomy.

Who can I talk to?

Your obstetrician or midwife will discuss these options with you before you leave the hospital with your baby. You will also usually have a follow up with your doctor or midwife at around 3 to 6 weeks and this will be discussed then as well.

Our pregnancy specialists at Create Health are always eager to discuss your individual situation and provide personalised advice regarding contraception regardless of whether you have just had a baby or planning for the future. Particularly if you think you might have risk factors, we are experts in this area and are here to help.


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