 Contraception
- after you've had your baby
One of the first questions you will be asked in the first 48
hours after having your baby is: have you thought about contraception?
After what you've just gone through, having sex is likely to be the last
thing on your mind, but a lot of unplanned pregnancies happen in the first
few months after childbirth, so it's wise to think about what you plan
to do. Here, we take a look at the commonly asked questions and advice
offered by the Family Planning Association online.
You can have sex as soon as you and your partner want to. Having a baby
causes many physical and emotional changes for both partners, and it may
take some time before you feel ready to have sex. It is common to feel
nervous about having sex again, but there is usually no reason why you
should not enjoy sex just as much as before. If you have any discomfort
which might affect your enjoyment of sex, such as stitches which have
not healed, discuss this with your GP, nurse, midwife or health visitor.
You might want to use a vaginal lubricant if you are uncomfortably dry.
Use lubricants like KY jelly and Senselle, which are water soluble. (Products
such as baby oil and Vaseline will damage latex (rubber) condoms or diaphragms).
If you bottlefeed, or combine bottle and breastfeeding, your first period
could start five to eight weeks, or longer, after the birth. If you fully
breastfeed (see page 7) your periods may not come back until you stop
breastfeeding.
You can become pregnant again quickly after the birth, so it's a good
idea to think about which method you are going to use before you have
sex again. Don't wait for your periods to return, or until you have your
postnatal check, before you use contraception as you could get pregnant
again before then. This is because you ovulate (release an egg) about
two weeks before a period, so you can be fertile but not realise it.
You can use male and female condoms as soon as you want to have sex.
You can start to use the combined pill, progestogen-only pill and implants
three weeks (21 days) after the birth. You can usually have a contraceptive
injection or start using a diaphragm or cap around six weeks after giving
birth. An IUD or IUS is usually fitted around six weeks after giving birth
or eight weeks after having a caesarian.
This depends on what you and your partner prefer. Short-term methods
of contraception If you think you'll want to have another baby in the
next year or so or you don't want to use a method that has to be used
for a long time, you could try:
- The progestogen-only pill
- The combined pill
- Male or female condoms
- Diaphragm or cap with spermicide
- Natural family planning
These can all be effective methods of contraception, but how well they
work depends upon how well you use them.
The combined pill is not suitable if you breastfeed as it can reduce
the milk flow.
If you used a diaphragm or cap before you became pregnant, check with
your doctor or clinic to make sure it still fits. This is because your
cervix and vagina change shape during pregnancy and birth. If you later
lose or gain more than 3kg (7 pounds) you must get the fitting checked
again.
Natural family planning can be more difficult to learn and use just after
you have had a baby. If you used this before your pregnancy, ask your
natural family planning teacher for advice.
If you don't want to get pregnant again for some time one of the following
methods might suit you:
- Contraceptive injection - contains a progesterone hormone. They last
for around 8-12 weeks
- Implant - this is a small flexible rod placed under the skin in your
upper arm which releases a progesterone hormone. They last between 3
to 5 years depending on type
- IUD (intrauterine device, used to be called a coil) - it's a small
plastic and copper device that is fitted in the uterus and stops the
egg settling in the uterus. Can stay in for 3 to 10 years (depending
on type)
- IUS (intrauterine system eg Mirena) - positioned in the uterus by
a doctor or nurse this contraceptive device can stay in place for up
to 5 years. The hormones work when they are needed meaning you're taking
fewer hormones than with the Pill (which means fewer side-efects).
These methods of contraception are very effective. You don't need to
worry about contraception for as long as the method works, except for
check up visits.
If you wait until six weeks after you have given birth before you have
the injection, you will be less likely to have heavy and irregular bleeding.
An injection lasts for 12 or 8 weeks but your usual fertility may not
return for several months after your last injection has worn off. So if
you want to get pregnant again fairly quickly this may not be the best
method to choose.
Implants, an IUS or an IUD can be taken out at any time you choose and
your normal fertility will return quickly.
Sterilisation is for people who are absolutely sure they never want any
more children. It is not usually a good idea for either a man or woman
to be sterilised at the time of childbirth, as you need time to be really
sure that you never want any more children. Be sure to use contraception
while you are deciding.
Breastfeeding can act as a very effective contraceptive when you are
fully breastfeeding a baby under six months old. This means you must:
- be breastfeeding at regular intervals, day and night
- be giving your baby no other food or drink, so no breastfeeds are
missed, and
- have no periods.
Once you stop fully breastfeeding you can release an egg and get pregnant.
And once your baby is over six months the risk of getting pregnant increases,
so even if you continue not to have periods and are fully breastfeeding,
you should use another contraceptive method. If it is very important for
you not to get pregnant, use contraception however you choose to feed
your baby.
Any method except the combined pill. If you use the progestogen-only
pill, a contraceptive injection or an implant, a small amount of hormone
will enter the milk, but research has not shown it will harm your baby.
Many women are vaccinated against German measles (rubella) at school.
During your antenatal care you will have had a blood test to see if you
have had German measles. If the test showed you were not immune during
your pregnancy you will probably be offered the injection after birth,
before you leave hospital. It is recommended not to get pregnant for one
month after a rubella vaccination. Use a reliable method of contraception
during this time. Do not have this vaccination if you are pregnant.
You can find out more about contraception while you are in hospital or
from your midwife or health visitor when you get home. You and your partner
can also visit your GP, practice nurse, family planning clinic or sexual
health clinic. If your GP does not provide contraceptive services, or
you would prefer not to see your own GP about contraception, you can go
to another GP just for contraception or to a family planning clinic.
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