You’ve just given birth, so getting pregnant right away might be the furthest thing from your mind. Know the facts about contraception after delivery.
“Some of my patients, provided they haven’t had stitches or a C-section, don’t wait six or eight weeks before having sex again. As long as they’re feeling well, it’s fine.” But there are things to consider.
Some women experience decreased libido due to breastfeeding, fear of getting pregnant again, sleep deprivation, or just the simple fact that couples might not be sleeping in the same room. And in some cases, healing from the delivery could delay intimacy. On the other hand, says Dr. Andrighetti, for some couples having a baby can increase their level of intimacy and lead to increased sex drive.
You can get pregnant before your period resumes, cautions Dr. Andrighetti, noting that the myth that you cannot persists. “The egg could already be in the Fallopian tube, get fertilized, and then your period won’t start again.”
Though breastfeeding produces the ovulation-inhibiting hormone prolactin, it is not a foolproof contraceptive method. “If you want 97 percent effectiveness, you have to breastfeed around the clock, every three hours without any lapse. So it depends on your tolerance of getting pregnant. I’ve seen it fail many times.”
Some women may worry that a pill with estrogen will increase the level of estrogen in breast milk and therefore feminize a male baby, says Dr. Andrighetti. “However, boys get exposed to estrogen while in utero, so it’s not a concern.” Estrogen can reduce milk supply though, so most doctors don’t recommend an estrogen-based oral contraceptive unless lactation is well established. Instead, a progesterone only pill, a so-called ‘mini-pill’ is often prescribed. However, to be 97 percent effective this pill has to be taken within the same three-hour window each day. “To be safe, I usually recommend the mini-pill with condoms.”
After about six weeks, an intra-uterine device is safe to implant, says Dr. Andrighetti. “These are becoming hugely popular.” A hormonal-based IUD does not affect milk supply because it doesn’t contain any estrogen, it lasts five years, it makes periods lighter and is easily reversible. “It’s as effective as tubal ligation,” she says. A copper IUD is also effective but can cause periods to become heavier.
If you are not that concerned about getting pregnant again, or are not using a reliable contraceptive method, then take a folic acid supplement. “Your body needs time to build up stores before getting pregnant, so get your body ready just in case.”