It is important to thing about contraception after having a baby. You can get pregnant again from 3 weeks postpartum, even if you haven’t had a period, even if you are breastfeeding. Don’t wait until your 6-week check, get the information you need now.
If you are breastfeeding there are a number of effective contraceptive methods:
You will probably not get periods while you are breastfeeding but you can still ovulate and get pregnant.
Immediately postpartum your contraceptive options include condoms, progesterone only pills, progesterone injection, progesterone implant and the mirena coil, an intrauterine contraceptive device that has the added benefit of treating heavy periods for those that need it.
Progesterone only pill (cerazette) can be started in the first 3 weeks postpartum. If you start if after this then you should use addition contraception for the first 2 days until it becomes effective. Cerazette works by stopping ovulation. The commonest side effect experience is irregular spotting.
Progesterone injection (depoprovera) can be given in the first 3 weeks postpartum. If you start if after this then you should use addition contraception for the first 7 days until it becomes effective. It also works by stopping ovulation. Side effects include weight gain, skin changes. The advantage of the injection is that you don’t have to think about your contraception on a daily basis. For some women there can be a delay in their periods and ovulation returning after the 3 month injection has worn off. So consider this if you are thinking about a short interpregnancy interval.
Progesterone implant (implanon) can be inserted in the first 3 weeks postpartum. If you start if after this then you should use addition contraception for the first 7 days until it becomes effective. Side effects are similar to those with depoprovera. It can also be difficult to remove.
Mirena coil can be inserted from 4 weeks postpartum. In America it is inserted from 2 days postpartum but the early insertion is associated with a higher risk of it falling out. The device is inserted by a doctor in a clinic/GP surgery, in a way that is similar to having a smear test. It only takes a few minutes and only causes minor discomfort to insert it. It can stay in for up to 5 years but is easily removed should you decide to have another baby before then. Common side effects of the mirena are irregular spotting and settling-in crampy pain, in the first few weeks after insertion. The mirena coil is the most effective female contraceptive method and I would recommend this to all women. You can even have it inserted if you have had caesarean sections to deliver you babies. It has the added benefit of treating heavy periods for women who also have this problem.
If you are bottlefeeding
You can use a combined oral contraceptive pill. This can be restarted from 3 weeks postpartum. If you are fully breastfeeding and other methods of contraception are unacceptable the combined pill can be used from 6 weeks postpartum.
Permanent contraceptive options:
Vasectomy (male option) or laparosopic tubal ligation (female option). However, the mirena coil has largely replaced tubal ligation as it is more affective and associated with less complications than tubal ligation.