CONTRACEPTION AFTER HAVING A BABY

Why is contraception immediately after delivery important?

One may wonder why birth control is being talked about immediately after one’s delivery. However, it is important to understand that although the time for fertility to return is very variable between women, it can return by 3 weeks after delivery! A healthy interval between 2 pregnancies would be about a year after normal delivery and at least 2 years following a caesarean section.

Many-a-times, having no periods after delivery are attributed to breast feeding and an ongoing pregnancy may get missed until much later when termination may not be possible for various reasons.

Hence, the type of contraception should be discussed as soon as possible after having a baby, usually at 6-8 weeks check. In breast feeding mothers, the periods may not return for a few months.

Is breast-feeding an effective contraceptive?

Unfortunately, breast feeding is not an effective birth control method unless exclusive and regular without any top feeds. To reduce the risk of unwanted pregnancy, it is always better to use effective birth control methods which will not affect the ability to produce milk.

How soon can one have sex again?

Wanting to be intimate is absolutely for a new mother and can be a good stress-buster and sleep-inducer. Sex can be indulged in as soon as the woman feels ready to do so. If there have been stitches, they heel up completely in about 2-3 weeks. Initially a vaginal lubricant may be required.

How does one choose a birth control method?

The choice of the method of contraception will need some counselling. The effectiveness depends on the method as well the consistency of use.

These are some factors to discuss before choosing a method of birth control.
• How effective it is
• Possible risks and side-effects
• Plans for future pregnancies
• Personal preference
• Any existing medical conditions and interaction of medicine already being taken

What are the different methods of contraception?

The different methods available are
• Barrier methods such as condoms- these are useful and safe methods and are effective with consistent and careful use. However, the failure rate is about 10-15 per 100 users
• Oral pills
o Progestogen-only pill (POP)- these protect from pregnancy and do not affect the quality or quantity of breast milk
o Combined oral contraceptive pill (COCP)- these are used after 6 weeks of delivery and are very effective

• Intrauterine contraceptive device (IUCD) or Intrauterine system (IUS)- these methods have the advantage of not having to remember to use any pills or condoms. These are long term contraceptives and provide good inter-pregnancy gap.
• Patches, vaginal rings and implants (not easily available in India)
• Sterilisation (tubectomy for the woman, vasectomy for the man) is a permanent method of contraception and should be requested only if the family is considered complete.

Contraception or birth control after pregnancy helps a couple in having control over their family planning and would help achieve better outcomes for the pregnancy to mother, baby and the family.

Dr. ARUNA MURALIDHAR
Authored by Dr. ARUNA MURALIDHAR
(MD, MRCOG (UK), FRCOG (UK), FICM)
Senior Consultant Obstetrician and Gynaecologist,
Associate Director, Fortis La Femme

Vinod Kumar

Health Journalist & writer. Editor of monthly health magazine "Health Spectrum."

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