Contraception after delivery
After delivery, your body will readjust itself including the return of your menstrual period and with this fertility as well.
Usually at your post-natal check (usually around 2 -6 weeks after delivery), your doctor will usually take this opportunity to discuss with you regarding contraceptive options. The type of contraception method that is suitable for each woman varies as it depends on you and your partner’s preference, your past medical history and also whether you are breastfeeding.
When will I be fertile again?
The time for fertility to return varies between women. It is important not to take any risks if you do not want to become pregnant again. Therefore, it is advisable to decide on the type of contraception you are going to use soon after having a baby or once you start having sex again.
If you are formula-feeding your baby, your period may return anytime between 5 weeks to three months so you could be fertile as early as 3 weeks after having your baby even before your period return as ovulation precedes menstruation in the monthly cycle. Which means you will need to start using contraception from 3 weeks after the birth if you are sexually active.
While you are breastfeeding, a hormone called prolactin is released which stimulates milk production and also usually suppresses ovulation. However, even if you are exclusively breastfeeding, there is still a chance you may be ovulating, which means it is therefore possible to become pregnant.
Breastfeeding as a form of contraception?
Women who have just given birth may use continuous breastfeeding as a form of contraception also known as LAM (Lactational amenorrhea method). With this method, a woman breastfeeds her baby exclusively, meaning the baby does not drink anything but breast milk. While a woman is exclusively breastfeeding, hormonal changes can suppress ovulation (the release of an egg from an ovary) so that the chance of pregnancy is very low. However, as noted above, please remember that this is not a failsafe method of contraception.
So how effective is breastfeeding as a form of contraception?
I am sure most of you will be wondering how effective is breastfeeding as a sole method for contraception? The good news is it is up to 98% effective in preventing pregnancy in the first 6 months after delivery only if the woman fulfils all 3 criteria below:
- Exclusively breastfeeding (not substituting any breast milk with other types of food)
- Has not had a period since the delivery of her baby
- Baby is < 6 months old
After 6 months post delivery, you should start using another form of contraception and not rely on breastfeeding as the sole method of contraception. Also, some women may find it difficult to breastfeed exclusively. If formula milk is given to the baby to supplement breastfeeding, the woman has a higher chance of getting pregnant again.
Types of contraceptive methods:
There are many kinds of contraception options out there. In general, you may be able to resume using the birth control method you have used previously.
The caveat is if you are breastfeeding your baby, it is recommended that you avoid any oestrogen containing contraceptive methods such as the combined oral contraceptive pill, the vaginal ring or the contraceptive patch. This is because oestrogen may reduce the quantity and quality of breast milk.
Options of contraception for breast feeding mothers includes barrier methods such as condoms or the progesterone only contraceptive methods such as the mini-pill (eg: micronor, cerazette, cerelle), implants (implanon or nexplanon), injections (Depo-Provera), or intrauterine devices (mirena or skyla).
Can I use emergency contraception after giving birth?
Yes, you can use emergency contraceptive pills (ECPs) if you have had unprotected sex.
If you are breastfeeding, using ECPs will not harm the baby or affect your breast milk.
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