divulge to Contraceptives after Birth: What Are Your Options? After giving birth, it s time think about what form of contraception to use to prevent future pregnancies. The time until you re fertile again and able get pregnant is variable, but it s not likely that you ll be able to conceive again until your baby is at least 3 weeks old. Still, you need to be ready when your fertility returns. Breastfeeding Offers Some Protection If you re breastfeeding, you have a very low risk of becoming pregnant, as long you continue to breastfeed. This assumes that you re breastfeeding only and not feeding your baby other forms of nourishment. You should be breastfeeding at least every four hours during the day and every six hours at night to get the most protection against pregnancy. It also assumes that you re not having periods yet and no more than six months have passed since you gave birth. Breastfeeding as a form of birth control is unreliable if you re not fully breastfeeding, if your periods have returned, or it s been longer than six months since you began breastfeeding. When you visit your doctor for your six-week check-up, they ll likely ask you about what form of birth control you plan on using. It s a good idea to be ready BEFORE that time arrives. If you don t breastfeed, you ll begin ovulating, on average, 45 days after giving birth and can become pregnant at the point. Keep in mind, ovulation can return earlier or later than this. You can even become pregnant before your period returns. That s because you ovulate two weeks before your period and the egg can be fertilized at that time. Also, keep in mind that some forms of birth control aren t effective right away. What Form of Contraceptives After Birth Are Available? Confused about what to use? You have a variety of options. If you choose a hormonal method, one that contains estrogen, you won t be able to use it until at least 6 weeks after delivery. This includes the ring, patch, or pill. Estrogen increases the risk for blood clots and your risk is already higher when you re pregnant. It s also not a good idea to use a hormonal form of birth control that contains estrogen when you re breastfeeding. Doing so can reduce milk flow. Wait until your baby is at least 6 months old before using a form of birth control with estrogen. If you do take a hormonal form of birth control, make sure it s a pill that contains only a progestin. Although hormonal methods are the most effective, they have a higher risk of side effects, including an increased risk of blood clots. Another birth control option is to use a barrier method. Diaphragms and IUDS are an option, although they don t carry the same degree of effectiveness as hormonal methods. Another form of barrier birth control is condoms. Although condoms have a higher rate of failure, you can increase their effectiveness by using them with a spermicide. If you prefer the most natural, side-effect free approach possible, a natural family planning method might suit you. You ll have to learn when you re ovulating by tracking your temperature or monitoring your cervical mucus and avoid intercourse around that time. It takes commitment and attention to detail to make this method work. If you know you don t want to become pregnant again, you might opt for a more permanent method like having your tubes tied, also known as tubal ligation. You can have this done immediately after birth if you re ready. This is an option to discuss with your physician. References: Thromb Res. 2011 Feb;127 Suppl 3:S35-9. doi: 10.1016/S0049-3848(11)70010-X. Medscape Multispecialty. Maternal and Neonatal Outcomes in Obese Women Who Lose Weight During Pregnancy forty six
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