Once that little bundle (or bundles) of joy has arrived, the first thing the midwife asks you is ‘what kind of contraception will you be using?’ to which you grimace and think the world has gone mad. However, even if you are breastfeeding you may start to ovulate very soon after your delivery and therefore you are at risk of pregnancy if you return to sexual intercourse without protection.
Your choices of contraception may have changed since delivery, for example some of the choices such as the combined pill are not suitable if you are breastfeeding, and in addition if you are still carrying some of your baby weight your BMI may be too high for certain choices.
The spacing of your family may also be important, if you are not planning to have another baby for at least a year, one of the long-acting contraception choices may be appropriate. Here are your options:
Combined Oral Contraception
This is ‘the pill’. Your BMI needs to be below 30 and if it is, you may be eligible to take it up to the age of 50.
- Pros: as soon as you stop taking it, fertility generally returns, and it usually lightens your monthly bleed.
- Cons: if you miss taking a pill, you may find yourself at risk of pregnancy. Also, it is not suitable if you are breast feeding.
Progesterone Only Pill
This is what people often refer to as ‘the mini pill’. You take this pill every day without the 7 day break you have when taking the combined oral contraception pill.
- Pros: you can continue to breast-feed whilst taking this pill and there are no restrictions on your BMI or smoking status. As with the combined oral contraception pill, fertility tends to return as soon as you stop taking it.
- Cons: some people find the intermittent bleeding difficult to handle: On the other hand, some people never have a period again so its always worth a try.
Both pills require you to be a reliable pill taker as they don’t work in the packet!
READ MORE: Debunking The Top 10 Contraceptive Myths
This is what is commonly referred to as the ‘coil’. IUS has some progesterone in it which leaks out and usually causes less bleeding. As hormone levels are low, there are generally fewer systemic side effects. The procedure to insert it takes a few minutes more than a smear test and is only a little more uncomfortable.
- Pros: Once it is in, if you are happy, it can be left in place for 5 years and fertility will return as soon as the coil is removed.
- Cons: some people experience heavy bleeding. Unfortunately, this is difficult to predict.
This used to be a three-monthly trip to the doctors office for an injection. However, a new product on the market will allow you to administer the injection yourself at home.
- Pros: 3 months and nothing to worry about remembering in between! No restrictions re your BMI or age. Usually, women stop having periods all together.
- Cons: it can take a while for fertility to return once you stop the injections. In some younger, thinner women there is a reversible effect on bone density (causing a thinning of the bones) and therefore this may not be suitable for everyone.
After having a baby, things can feel different. Make sure you speak to your healthcare provider about the choices available to you.