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Birth control probably isn’t top of mind during pregnancy and postpartum, but it’s important to think about.
Without contraception, it’s possible to become pregnant not long after giving birth. (Contrary to popular belief, breastfeeding should not be considered a reliable form of birth control in most cases.)
Making a plan for postpartum birth control before your baby’s arrival can help ease the transition into life with a newborn.
Given the many physical changes that happen during pregnancy and postpartum, you may find that you need a different form of birth control from what you’ve used previously.
Learning more about the available options can help you make the best choice for you. Here’s what to consider when choosing your method of postpartum birth control.
Once you’ve ovulated for the first time after giving birth, it’s possible to become pregnant again.
Since ovulation typically occurs about two weeks before the start of a menstrual period, this means that you can become pregnant before getting your first postpartum period.
For individuals who aren’t breastfeeding, ovulation may resume as early as two weeks after giving birth. Most birthing people will have ovulated by about six months postpartum.
Due to hormones involved in milk production, breastfeeding may delay the restart of ovulation, depending on how often you breastfeed.
However, since you must breastfeed very frequently to prevent pregnancy — typically every three to four hours — breastfeeding isn’t a practical form of postpartum birth control for many women.
Even small changes to your breastfeeding schedule — for example, delaying just one session by a couple hours if your baby sleeps longer than anticipated — can potentially lead to ovulation.
Even if you’ve used one or more forms of birth control previously, taking birth control after giving birth is a different experience.
There are many considerations specific to postpartum birth control, including the following:
Some progestin-only birth control methods are safe to use immediately after giving birth, such as an intrauterine device (IUD). However, combined hormonal methods like the pill or the patch cannot be used until at least three to four weeks postpartum.
This is because the combination of estrogen in these birth control methods on top of postpartum hormonal changes can lead to an increased risk for blood clots.
Some birth control methods are known to be less effective in women who have given birth, including the sponge and cervical cap.
While estrogen-based birth control is generally considered safe to take while breastfeeding, it can potentially decrease your milk supply.
For this reason, your healthcare provider may recommend progestin-only hormonal birth control or non-hormonal birth control.
To help you make an informed choice about postpartum birth control, we’ve compiled an overview of the options, including considerations specific to the postpartum period.
There are two types of hormonal birth control pills: combination pills, which contain both estrogen and progestin, and progestin-only pills (sometimes referred to as mini pills).
Both types are safe for most women to take after giving birth. However, hormones from birth control do pass through breast milk. Combination pills typically aren’t recommended if you are breastfeeding as the estrogen can potentially affect milk supply.
(Note that there isn’t extensive research on the effects of synthetic hormones on newborns, so you may encounter conflicting information.)
While both affordable and effective, the pill must be taken on time every day to offer reliable birth control.
Like the pill, the patch contains both estrogen and progestin. It works on a four-week cycle.
You wear the patch for three weeks, replacing it once a week. You do not wear it during the fourth week to allow menstrual bleeding to occur.
It may be an appropriate option for those who find it inconvenient to take the pill every day but aren’t considering permanent birth control. Like the combination pill, it isn’t the best option for those who are breastfeeding.
The ring functions similarly to the combination pill and the patch but contains slightly lower levels of hormones. It also has to be replaced on an ongoing basis.
The birth control ring is not recommended for breastfeeding individuals.
The birth control shot — sometimes referred to as Depo-Provera® — is effective for about three months. Since it is progestin-only, it’s safe to begin using right after giving birth and will not impact breastfeeding.
For ongoing, continuous pregnancy prevention, you must have the shot administered four times a year.
It may take time for your menstrual cycle to return to normal after using this form of birth control. If you are planning to try to conceive again in the near future, this may not be the best option for your family building goals.
An IUD is a small device implanted into your uterus by a healthcare professional. There are several options for hormonal IUDs, which contain progestin, as well as the copper IUD, which does not contain any hormones.
Different types of IUDs offer pregnancy prevention for varying lengths of time, from three to twelve years.
IUDs are safe to begin using immediately after giving birth and will not affect breast milk production.
It can be painful to have an IUD inserted during postpartum recovery. If you are interested in using this method of postpartum birth control, it’s best to have it inserted immediately after labor and delivery while your cervix is still dilated.
A permanent form of hormonal birth control along with IUDs, the implant is a thin rod implanted into your arm that can prevent pregnancy for up to five years. Your doctor can remove it at any point during that time if you decide to grow your family.
As a progestin-only option, it may be a good fit for breastfeeding individuals.
Condoms, diaphragms, and cervical caps are effective, non-hormonal options. If using a diaphragm again after pregnancy, you will likely need to be refitted since the shape and/or size of your cervix may have changed.
The rhythm method consists of tracking your menstrual cycle and using this information to predict ovulation dates, abstaining from sex during your most fertile days.
While the rhythm method has worked for many individuals, it is significantly less reliable than the methods above and often requires much troubleshooting. Even when properly practiced, it is only about 75% effective.
For more reliable pregnancy prevention, speak with a trusted health professional about your options.
At Ruth Health, we understand that nobody knows what you need better than you. We provide expert, evidence-based maternal advice so that you can make the best decisions for yourself.
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