While sex after giving birth may sound awful to you in those initial months while your body is still healing, you may want to prepare yourself for avoiding another immediate pregnancy, just in case.
Just as your lifestyle, body and priorities might have changed after pregnancy, so too might your contraceptive needs. Most of the time, the normal contraceptive pill is not an option, so where to from here?
Sneha Wadwani is a GP and mum of two girls, and she shares the pros and cons of various contraceptions for new parents.
This is one of the biggest contraceptive myths people often believe. While breastfeeding does partially shut down your reproductive cycle, Sneha says it’s definitely not an effective form of contraception to rely on.
“It does partially shut down your reproductive cycle through the hormone that's released when you lactate, prolactin, and that does suppress your cycle,” Sneha says. “Even if women who don't breastfeed after children will notice that their periods don't come back for a little while. That's because prolactin is still being produced even if you don't use the breast milk.”
Sneha says that you won’t generally have periods when you’re breastfeeding, but that doesn't mean that ovulation stops completely. A few rogue eggs may break through and you still may fall pregnant.
Sneha sees a lot of women in the immediate postnatal period that want an easy contraception to use without worrying too much.
“For this, the progesterone-only pill is a really good option,” she explains. “This is a pill without oestrogen. And the reason we use that is because if you've got a baby boy and we give you a pill with oestrogen in it we could cause them to become a little bit more feminine than we would like.”
Listen to Sneha on Kinderling Conversation:
Also called the mini pill, it needs to be taken every day without a break.
“And generally speaking during the postnatal period most women won't bleed either. The only downside to it is that you do have to take it within the same two hours every day,” Sneha says.
Long acting reversible contraceptives
When women are breastfeeding, the regular pill isn’t really an option. But long acting reversible contraceptives are, says Sneha.
“These sound quite scary when we talk about them being long-acting,” she says. “The great thing about them is that they last for a significant period of time, sometimes three months, sometimes three years, sometimes five years, sometimes 10 years.”
These include nonhormal intrauterine devices with copper (IUDs), the hormonal intrauterine device (Mirena), and the subdermal contraceptive implant. Another positive is that when these are removed, they are reversible and you go back to your normal fertility quite quickly, unlike the pill.
“The reason for that is really with the longer acting contraceptives we're using lower doses of hormone for a longer period of time,” Sneha explains. “These are localised hormones … so we're not affecting your ovulation. We’re using the contraceptive mechanism a different way.”
Particularly for the Mirena, Sneha believes the gains potentially are far greater than the discomfort or the inconvenience of getting used to it. “70 percent of women who have this put in end up with no periods, which is quite fabulous.”
She also says it’s worth weighing up the cost of initially getting something like the Mirena, versus what you would be spending on sanitary items.
Turns out condoms aren’t as foolproof as some might think.
“Even when used 100 percent [correctly], condoms are only about 80 percent effective,” Sneha says. Often, they’re not put on at the very start of intercourse, but halfway through instead, which means your chances of falling pregnant are higher.
“Having said all that, you know there are women … who have had a normal vaginal delivery and are thinking about having another child soonish,” Sneha says. They might not need a definitive contraception to delay pregnancy and might use condoms for a period of time while knowing they may fall pregnant but aren’t concerned.
“So I think there's definitely a role for it. It all comes down to choice and your family planning.”
Male contraceptive pill?
Some of you may be thinking; ‘Hang on a minute! I’ve seen research about male contraceptive pills. Is that soon an option?’
Sadly, Sneha doesn’t see that as an option.
“Miles away. Forget it!”
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