Birth Control After Baby: 9 Popular Methods
Sure, becoming a mom is pretty amazing. And while doing the deed might be the furthest thing from your mind at the moment (those boobs belong to someone else right now!), we promise you’ll want to have sex again someday. So here are nine postpartum birth control methods that will help you get back in the sack without conceiving another baby before you’re ready. Talk to your doctor about what method is best for you.
The birth control pill, which uses hormones to halt ovulation, is fine to use once you’re green-lighted for sex, usually at your six-week postpartum checkup. It’s considered 99 percent effective when taken correctly. If you’re breastfeeding, your ob-gyn will likely prescribe a progestin-only pill, also known as the minipill, which won’t affect milk production. “Birth control pills are safe in breastfeeding patients,” says Rebecca Starck, MD, FACOG, department chair of regional obstetrics and gynecology for the Cleveland Clinic. “The amount of hormone excreted in breast milk is miniscule and not harmful to the baby.”
While we’re on the topic of nursing, don’t say you weren’t warned: Many women think they can’t get pregnant while they’re breastfeeding, because they haven’t started getting their period again. But that’s not actually true, since ovulation can occur before that first period without you even realizing it. “Exclusive breastfeeding does make it less likely that you’ll conceive, but I would never say it’s reliable enough to use as birth control if a woman doesn’t want to get pregnant,” Starck explains.
Connie Young, MD, director of Women’s Health Services at Community Healthcare Netwrok, says generic brands of the minipill come and go frequently, and your doctor can prescribe whichever one is best for you.
A popular choice among moms is an intrauterine device (IUD); there are three kinds. The synthetic progesterone IUD, called by the brand name Mirena, excretes a hormone for up to five years that immobilizes sperm, ending their march toward an egg. Skyla does the same thing, but for three years. Instead of hormones, the copper IUD (known by brand name ParaGard) releases a safe, small amount of the metal to similarly disable sperm for up to 10 years. But Young says ParaGard make your periods heavier and more crampy. All forms are about 99 percent effective. “Most women who have the IUD think it’s a great method because once it’s inserted, you don’t have to think about anything,” says Starck. “And it’s completely reversible.” Just have your doctor take it out when you’re ready to try to get pregnant again.
Withdrawal — where you trust your partner to pull out before he ejaculates — is the sixth most common form of birth control, believe it or not! (It’s almost as common as the IUD.) Some research suggests that when practiced perfectly, its failure rate is only 4 percent, but don’t count on it. That’s because perfection is pretty hard to achieve, so about one in five couples practicing withdrawal does conceive. (Yikes.) “Withdrawal is probably one of the biggest lies going,” says Terry Gibbs, DO, FACOG, ob-gyn at Toledo Hospital. “There’s a small amount of ejaculate that comes out before a man comes to climax. He can’t feel it, and so withdrawal should never be considered a reliable form of birth control.”
Women using the rhythm method avoid intercourse when they’re fertile. You can do this by counting days in your cycle and avoiding those right before and during your cycle. If you choose this method, be warned: Failure rates are as high as 25 percent. A couple of other ways women take cues from their cycle to regulate fertility: examining cervical mucus for clues of ovulation and taking their temperature each morning (the number can spike when you’re fertile). This is often differentiated from the rhythm method and called charting instead.
Condoms, when used properly — meaning they make it on at the very start of intercourse and remain on until finished — are up to 98 percent effective at preventing pregnancy. Condoms might be a good method for you if you’re not into the idea of medicines, devices or injections, or if you also want to protect yourself against sexually transmitted diseases.
The NuvaRing (currently the only vaginal ring on the market in the US) is a plastic ring about the size of a silver dollar that you insert in your vagina once a month. Similar to the Pill, it delivers hormones that suppress ovulation and is up to 99 percent effective at preventing pregnancy if used correctly. After three weeks, you remove the ring for a week while you get your period, and then you insert a new one. If you find yourself forgetting to take your daily pill, NuvaRing might be good for you. But because it contains estrogen, it’s not the preferred choice if you’re still nursing.
Injectable Birth Control
The Depo-Provera shot delivers a dose of progestin that provides three months of contraception, so you’ll have to see your doctor quarterly to get it. Think of it as the Pill by injection — this is also a good choice if you’re not good at remembering to take an oral contraceptive — and it’s 99 percent effective. Just make your appointments and you can’t make a mistake. And because it relies on progestin, not estrogen, it won’t interfere with breast milk production.
If you want something long-lasting but don’t want an IUD, consider Nexplanon. A small, flexible rod that delivers synthetic progesterone into the bloodstream is inserted under the skin on the inner part of your upper arm. It’s about 99 percent effective for up to three years and is okay for breastfeeding moms.
“Nexplanon has become increasing popular for postpartum women,” says Young. “That’s because it’s so easy — with a five-minute insertion, you don’t have to think about birth control for three years.”
If you’re sure that your family is complete — and we mean 100 percent, no doubt in your mind, you never want to be pregnant again — then nonsurgical sterilization might be for you. The Essure device is inserted vaginally into the fallopian tubes, creating a roadblock in the very place where fertilization must occur. Two small coils create scarring that ensures sperm and egg can never meet. The results are similar to tubal ligation — a type of laparoscopic sterilization, but without the surgery.
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