Contraception after childbirth - what are your options?
So you’ve just had a baby, your body is on a wild ride of recovery and hormones and a well meaning health visitor or GP asks you about your plans for contraception. Your first thought might be ‘There is no way I’ll be needing that, how on earth would I get pregnant right now, is it even possible?!’
Considering contraception postnatally can be very difficult. Many people will not feel physically or emotionally ready to have sex for some time after childbirth and that is absolutely normal, you must take physical relationships at a pace that suits you and your body. But the reason contraception is often spoken about so early – sometimes as early as the day you’ve had your baby - is that it can get overlooked and it is important that people are aware of their options and choices. You can actually be very fertile after birth and get pregnant as soon as 3 weeks after having your baby, even when breastfeeding.
Your periods can return any time after giving birth, although if you are breastfeeding, it is common for your periods to be delayed. Although bleeding is usually a sign of ovulation, you can actually ovulate before your periods return so be mindful that you can be fertile even if you’re not experiencing your period.
In terms of contraceptive choices, these vary based on whether you are breastfeeding or not, as some methods of contraception are hormone-based, which can affect your milk supply.
If you are breastfeeding, you generally have 4 methods of contraception available to you;
Immediately after birth:
Barrier contraception - male and female condoms
Progesterone-only methods - options include implant, pill and injection
Natural family planning methods – where you closely monitor your cycles and note physical symptoms and bodily changes to track ovulation, you can read more about this in our Natural Family Planning blog
Around 6 weeks after birth
Intrauterine methods - the coil
If you are formula feeding your baby, you have a wider choice of contraceptive methods, with the addition of oestrogen secreting hormonal alternatives.
Breastfeeding as a form of contraception
Breastfeeding as a form of ‘natural family planning contraception’ is an extremely interesting topic. If you are exclusively breastfeeding and your baby is under 6 months old, it is unlikely that your periods will have returned, however in some cases it can be normal for them to return before this.
If used correctly and consistently, natural family planning is 98% effective in the first 6
months after having a baby, meaning that only 2:100 mothers having unprotected sex will get pregnant using this method.
However, natural family planning can become unreliable if you:
Have longer gaps in-between feeds (4 hours in the day, 6 hours at night)
Use a dummy as a comforter
Are regularly expressing milk
Are combi-feeding or substituting breastmilk with other liquids/foods
Are having periods
Or your baby suffer some illnesses or stress (NHS, 2023)
Gave birth over 6 months ago, even if your periods have not returned
Whatever your preference is, we encourage you to discuss your own options with your health visitor or GP, it may depend on the of birth you have had and your recovery, along with family history and blood clot risk as to when you can start using each type of contraception.
Just keep in mind that it is possible to get pregnant 3 weeks after birth, with your first cycle of ovulation often falling at about 2 weeks, so while contraception feels like a topic that doesn’t need to be discussed around the time of birth, there is a good reason for your health visitor or GP to bring it up!
You can find further information on your choices here. https://www.nhs.uk/conditions/contraception/when-contraception-after-baby/
For more information on natural family planning or breastfeeding as contraception, please use the resources below: