The postpartum phase is a time for recuperation and settling into the busy routine of caring for a newborn. Many women do not want to conceive again during the following weeks and months after childbirth. However, women who don't breastfeed may begin ovulating six weeks postpartum. Because ovulation occurs before a woman gets her period, she could become pregnant before she realizes she is fertile again. Planning for reliable contraception makes one less thing to worry about when adjusting to postpartum life.
Short-acting hormonal birth control prevents pregnancy when used daily or every few weeks or months, depending on the method. Birth control pills, skin patches, vaginal rings, and injections provide hormone-based contraception. Pills must be taken daily, while patches and rings remain in place for three weeks. Injections require an office visit where they are administered regularly.
Short-acting hormonal methods may combine estrogen and progestin or may contain only progestin. Some birth control pills, the patch, and the ring use both hormones. Some pills and the shot use progestin only. These hormone-based methods work by preventing ovulation.
Long-acting reversible contraception (LARC) provides birth control protection that lasts for 3-10 years and doesn't require daily, weekly, or monthly planning. LARC includes IUDs and birth control implants. A women's healthcare provider inserts the IUD into the uterus, where it works by preventing sperm from fertilizing the egg. Birth control implants, small rods that release progestin, also require an office visit to insert the implant under the skin in the upper arm area.
Women who choose to breastfeed exclusively can prevent pregnancy for several months post-partum. Exclusive breastfeeding naturally prevents ovulation and the return of the woman's menstrual cycle, a condition called lactational amenorrhea. The efficacy of this method depends on the mother breastfeeding or pumping milk regularly around the clock. When the baby drinks formula or begins to eat solid foods, the demand for breastmilk decreases and ovulation resumes.
Postpartum women should avoid any birth control methods that use estrogen for at least the first few weeks after giving birth. During this time, women have a greater chance of developing blood clots, which is exacerbated by estrogen. Breastfeeding moms may want to avoid hormonal birth control that uses estrogen until the baby weans because estrogen can reduce milk production.
Birth Control Decisions
Before the baby arrives is the best time for women to discuss their postpartum birth control options with their healthcare provider and make a plan. When scheduling the postpartum office visit, women should decide if they want to have a long-term device inserted or get a prescription for a short-term birth control method. Planning ahead can help make the transition back to work less stressful and will help with family spacing for future children if desired.
For more information, contact a women's healthcare service near you.