Contraception after giving birth
Sex and relationships

Contraception after giving birth

Family planning is something you will need to think about quite soon after your baby is born. We examine your options for contraception after giving birth.

Contraception after giving birth

Contraception is something you need to consider sooner than you might think, as you can become fertile as little three weeks after your baby’s birth. If you are satisfied that your family is complete, then ask your GP about long-acting methods of contraception. But if you want to have more children, it’s a good idea to choose an option that can easily be paused allowing your body to return back to normal.

Contraceptives can be divided into short-acting, long-acting and permanent; unless you are planning to have another baby in the next year or two, then you should consider using a short-acting contraceptive.

When choosing contraception, you need to consider:

  • How effective it is.
  • Possible risks and side-effects.
  • Plans for future pregnancies.
  • Personal preference.
  • If you have a medical condition, or take medicines that interact with the method.

Natural family planning is a form of birth control where natural signs, such as body temperature, are used to identify when a woman is at her least and most fertile during each menstrual cycle. There are two main methods of natural family planning: methods based on fertility awareness, which involve avoiding sex during fertile periods and the lactational amenorrhoea method (LAM), which can be used during the first six months after giving birth. Talk to your GP or public health nurse about the different contraceptive options for you and your partner.

Contraception after giving birth

Dr Catriona Henchion, medical director of the Irish Family Planning Association (IFPA) answers our question about contraception.

Q. When can a woman expect to start ovulating again post birth?

A. A woman can expect to start ovulating any time after three weeks post birth. If she is breastfeeding, there are some guidelines to follow if she is relying on the lactational amenorheoea methtod (LAM) as a form of contraception:

1. If a woman is fully breastfeeding (no bottles or supplements)

2. The baby feeds every four hours minimum by day

3. There is no more than a six hour break at night

4. She does not get any periods, she is protected against pregnancy by about 98% up to six months postnatal. If any of the above conditions are not met, a woman could ovulate at any time. For example, if a woman expresses a feed to have a break of longer than four hours (to go work for instance), she breaks guideline two.

Q. What type of contraceptive is safe to take/use when breastfeeding?

A. All barrier methods (male/ female condom, cap/ diaphragm) or progesterone only contraception can be used while breastfeeding. The progesterone only pill can be used from three weeks, the contraceptive injection (Depo-Provera) from six weeks, the contraceptive implant (Implanon) from three weeks and intrauterine systems (IUS), for example Mirena, Jaydess and the copper coil, can be used from four-five weeks. Breastfeeding significantly increases the risk of uterine perforation during IUS; insertions are usually deferred to 12-16 weeks.

Q. How soon after childbirth can a woman start to have sex again?

A. As soon as a woman feels ready. It depends on a woman’s birth experience and recovery period, for example a woman who had a difficult birth, a Caesarean section or who experiences postnatal depression or similar, may want to delay having sex.

Q. What is safest amount of time to leave between pregnancies?

A. The World Health Organisation (WHO) recommends to leave the same length as a pregnancy between pregnancies (usually 9-12 months minimum), as it takes this much time to recover.

More like this:

Family planning – get it right
Contraception after kids
Holistic alternative to the pill?

Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.