Basic principles of postpartum care:
- Spawning can be started as early as three weeks after birth.
- Couples have choices that are right for them – there are several options.
- No birth control is 100% effective in preventing pregnancy.
But I just had a baby!
If you want to avoid pregnancy, you need to choose the best method of birth control. You and your partner have choices about what is right for you. The most common methods of birth control recommended after birth are condoms, progestogen-only pills or a birth control implant.
Many women find that they do not want to have sex after giving birth and feel that contraception is unnecessary. Most advice from health professionals is to wait four to six weeks after birth for recovery. The best time to discuss your birth control is during your postpartum check-up.
Is this a period of menstruation or bleeding?
It is not uncommon to bleed for six weeks after giving birth. Initially, the bleeding (lochia) is heavy and very red for the first few days. The color gradually changes to reddish brown before stopping. Two weeks after giving birth, it is good to have a clean discharge that can also be stained with old blood.
There is no known pattern of bleeding after childbirth. However, many women find that they have more bleeding than usual. They also have a few weeks (or months) of rest after giving birth, before their period starts.
One way to tell the difference between a baby’s bleeding and the actual period is that the lochia can be light and watery. It also smells different than bleeding.
When to start using birth control after giving birth
Most women become fertile two weeks before their period. However, breastfeeding can delay the return of menstruation, making it difficult for women to know with any confidence when their ‘fertile window’ might be. This is why some women also hope to get pregnant before their period.
They usually return any time from six weeks to three months after the baby is born. Breastfeeding, breast milk or combined breastfeeding can affect how often your period returns.
Safe contraception if you are breastfeeding
These contraceptive methods are considered safe for breastfeeding women:
A small pill – Also called progesterone only pills. It is important to take small pills at the same time every day so that they can work up to 99.7%.
Condoms – The male condom is a very fine rubber or synthetic condom that is worn over the erect penis. Condoms prevent sperm from entering the vagina and uterus. When used correctly, condoms are 98% effective. A female condom is a soft, rubber-like pouch with adjustable rings at each end, closed at one end. Female condoms are considered 95% effective at preventing pregnancy.
Diaphragm – A cap made of silicone that covers the cervix and prevents sperm from entering the uterus. When used correctly, diaphragms are rated to be 84% effective.
Birth control injection – It is often referred to by its trade name ‘Depo-Provera® or ‘Depo Ralovera®. These are hormone injections that need to be given every twelve weeks. When used perfectly, this injection is 99.8%.
Implanon – A small plastic rod that is inserted under the skin inside a woman’s upper arm. This contains progesterone which prevents the ovaries from ovulating each month. Implantation of Implanon takes three years and is 99.95%.
An intrauterine device – Also called IUD. This is a small device that is placed in the uterus. Copper IUDs are designed to last up to 10 years and progesterone IUDs up to five years. Copper IUDs are 99.4% effective and Progesterone IUDs are 99.8% effective.
Permanent blocking – For women this is also called tubal ligation. This is a surgical procedure where the tubes are cut, blocked and glued. For men, total castration means a vasectomy which involves cutting the testicle tubes that carry sperm to the penis. All these methods are considered to be 99% effective in preventing pregnancy.
genital ring* – These work in the same way as birth control pills by releasing hormones that prevent the ovaries from releasing an egg every month. *The ring is prohibited for women whose baby is less than six weeks old and who are breastfeeding.
Avoiding pregnancy if you are breastfeeding
Avoid using birth control pills that contain estrogen if you are breastfeeding. The vaginal ring and combined pills (oestrogen and progesterone) are not recommended for breastfeeding women, unless their baby is six weeks old. This is because estrogen can reduce the absorption of breast milk.
Is breastfeeding the best method of parenting?
Breastfeeding can be a good method of birth control because it delays the return of ovulation and menstruation. There is a risk that you can get pregnant while breastfeeding and you may choose to use other methods of birth control.
Reduce your risk of pregnancy by breastfeeding everything of these:
- You are breastfeeding regularly and regularly.
- Your child is younger than 6 months.
- Your baby is being fed ‘on demand’ night and day with no more than four hours between feedings.
- Your periods have not returned.
Emergency contraception
Also called the ‘morning after’ pill, emergency contraceptive pills should be taken as soon as possible (not too early in the morning) after unprotected sex. There are two types of pills that are available at pharmacies and do not require a doctor’s prescription.
- Ulipristal (UPA-EC) – can be taken up to 5 days after unprotected sex. Not recommended while breastfeeding.
- Levonorgestrel (LNG-EC) – can be taken up to 3 days after unprotected sex.
Before birth
Make sure you are not pregnant. Take a pregnancy test and talk to your doctor or health care provider if you’re not sure. Discuss with your partner what is right for both of you.
Efficacy, convenience, cost and lifestyle are important considerations when making birth control decisions if you want to avoid an unplanned pregnancy.
For more information on postpartum care:
Talk to your GP, midwife or midwife.
You can also search:
Parenting | Parenting NSW (fpnsw.org.au)
Parenting in Australia
Call – Family Planning Talk Line – 1300 658 886
What is parenting? – Play Safe (nsw.gov.au)
About the Author:
Posted in Nourish Baby by Jane Barry. Jane is fully qualified in paediatrics, immunisation, midwifery and pediatric nursing. She holds a Bachelor’s Degree in Applied Science (Nursing) and has approximately 35 years of pediatric health nursing experience. She is a member of a number of professional associations including AHPRA, The Australasian Medical Writer’s Association and the Australian College of Children and Young People’s Nurses.
References
Condoms | healthdirect
Birth control – female condoms (internal) – Better Health Channel
Postnatal care – Better Health Channel
Birth control implant | healthdirect