Birth Control After Baby

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Methods
What it is
For Nursing Mothers?
Effectiveness
Considerations
The Combination Pill
Oral contraceptive combining estrogen and progestin that suppresses ovulation
Should not be started until 2 to 6 weeks postpartum. Best for nonsmokers. Reduces breast milk production
The Mini Pill
Oral contraceptive containing progestin only
(80% if not nursing)
Should not be started before 4 to 6 weeks postpartum. Has no effect on breast milk production. Can cause vaginal spotting and irregular cycles. Effectiveness declines when breastfeeding is supplemented
Norplant
Six match-size plastic progestin capsules inserted by a doctor under the skin of the upper arm; the capsules suppress ovulation for up to 5 years but can be removed at any time and fertility is restored within days.
Best not started before 6 weeks postpartum when breastfeeding is
established. Expensive if used for fewer than 3 years. Possible
irregular periods for the first year.
Depo- Provera
Injections of synthetic progestin, given every 3
months to suppress
ovulation.
Best not started before 6 weeks postpartum until breastfeeding is
established. Can take 10 months or longer for fertility to return after usage is stopped. May cause weight gain that's difficult to lose, irregular periods, or breakthrough bleeding.
Condom
Male condoms fit over the penis to capture sperm; they are made of latex or polyurethane. The female condom (brand name Reality) is a sheath with a closed inner ring that fits over the cenix like a
diaphragm and an open outer ring that rests outside the lips of the vagina.
84% (male)
79% (female)
Best used with spermicidal jelly or foam (they appear to have no effect on breastfeeding).
Diaphragm
A round rubber dome that fits inside a woman's vagina and covers her cervix.
Proper fit is essential. After childbirth, a woman who previously used a diaphragm should be refitted, but not until 6 weeks postpartum.
IUD
A small plastic device placed in the uterus to prevent fertilization or the attachment of a fertilized egg to the uterine wall; most last one year.
Unlike the old Dalkon Shield model
associated with infection and infertility, today's IUDs (ParaGard and Progestasert) are considered very safe and a good choice for women who have children but don't want permanent sterilization. Wait until 6 weeks postpartum before insertion.
Natural Family Planning
Method of avoiding intercourse during peak fertility by monitoring body changes (also called periodic abstinence or the rhythm method).
Unpredictable. Relies on ovulatory changes that may be difficult to detect postpartum. After menstruation is clearly reestablished, it's best for women with very regular cycles.
Sterilization
In a woman, a tubal ligation involves blocking or severing her fallopian tubes so that sperm cannot reach eggs. In a man, a vasectomy cuts and seals his sperm ducts
If you want your tubes tied in the delivery room, you should discuss this with your doctor well in advance of your due date, as consent needs to be signed early
Birth Control After Baby
Since ovulation typically occurs 2 weeks before you menstruate, don't wait until your period resumes to discuss family planning with your doctor. Here's how contraceptive options stack up for postpartum use