When we think about birth control, we think about avoiding pregnancy before being able to plan a conception. We rarely think about what happens afterward! If you don’t think about using postpartum birth control, it’s very possible to conceive soon after having a baby. Using a form of birth control in the postpartum weeks after having a baby helps you avoid unplanned pregnancies.

Is it Safe to Use Birth Control While Breastfeeding?

One common question new mothers have is the safety of using birth control while breastfeeding. Many postpartum women choose to breastfeed exclusively for several months. However, there’s concern over how birth control methods might affect the milk supply or the infant. Fortunately, most forms of birth control, especially those without estrogen, are safe during breastfeeding.

Methods such as progestin-only pills, IUDs, and implants are typically recommended, as they have little to no impact on breast milk production. However, combined hormonal methods containing estrogen should be approached with caution as they can potentially reduce milk supply. Consulting your healthcare provider will help you make an informed decision that protects both your breastfeeding routine and family planning goals.

Postpartum Birth Control: An Essential Consideration

When thinking about birth control contraception after having a baby, there are a few factors to consider that may be in the following:

• Timing: Some birth control methods can be started right after childbirth. With other methods, you need to wait a few weeks to start.
• Breastfeeding: All methods are safe to use while breastfeeding. However, there are a few methods that are not recommended during the first weeks of breastfeeding. This is because there is a very small risk that they can affect your milk supply.
• Effectiveness: The method you used before pregnancy may not be the best choice to use after pregnancy. For example, the sponge and cervical cap are much less effective in women who have given birth.

IUDs for Postpartum Birth Control

IUDs or intrauterine devices are small T-shaped devices that your OB/GYN or other healthcare provider inserts into your uterus. An IUD can be used right after a C-section or vaginal birth. It can also be used at your first postpartum health care visit.

IUDs release small amounts of progestin into the uterus. It can be set and left for up to 3 to 6 years, depending on which IUD device you choose. An alternate IUD device called the Copper IUD releases a small amount of copper into the uterus. The device can be used for up to 10 years.

No matter which you choose, both work by stopping the sperm from fertilizing the egg.

Benefits of IUDs

IUDs have little to no effect on you and your daily activities. Once the IUD is inserted into the uterus, there are no other steps to prevent pregnancy. The hormonal IUD (not the copper) has also been known to decrease menstrual pain and heavy bleeding altogether.

 Risks And Side Effects of IUDs

• The IUD may come out of the uterus. This happens in about 2-10 percent of users in the first year of using the IUD. Serious complications from using an IUD such as infection or injury, are rare.
• The hormonal IUD may cause spotting and irregular bleeding in the first 3 to 6 months of use. Other side effects include headaches, nausea, depression, and breast tenderness.
• The copper IUD may increase menstrual pain and bleeding or cause bleeding between periods, mainly in the first few months of use. It usually decreases within 1 year of use.

Birth Control Implant

The birth control implant is a flexible singular rod the size of a matchstick. The implant gets inserted under the skin in your upper arm by your OB/GYN or healthcare professional.

The implant can be inserted immediately after a vaginal birth or C-section. The implant works by releasing progestin into the body – much like the hormonal IUD – and can be used for up to 3 years.

The Benefits of Birth Control Implants

Like the IUD, the implant doesn’t interfere with daily or sexual activities. Once it’s placed, there are no additional steps to pregnancy prevention. This implant is also good for all women.

Risks And Side Effects of The Birth Control Implant

Common side effects could include:

• Mood swing
• Acne
• Depression
• Headaches

Some women said they experienced heavier, lighter, or sometimes longer periods. Additionally, some experienced infrequent periods or bleeding in between periods.

Birth Control Injection

The birth control injection contains a type of progestin called depot medroxyprogesterone acetate (DMPA). It works by preventing ovulation. Your ob-gyn or other healthcare professional will give you a shot of DMPA in your arm or buttock every 3 months. You can get your first shot right after a vaginal or cesarean birth.

The Benefits of Birth Control Injection

An injection does not interfere with sex. Almost all women are able to use the injection.

Risks And Side Effects of The Birth Control Injection

• Bone loss may occur with the use of the injection. When injections are discontinued, some or all of the lost bone density may be regained.
• An injection should not be used if you have multiple risk factors for cardiovascular disease.
• May cause irregular bleeding
• Headaches
• Slight weight gain

Combined Hormonal Methods

Methods that are considered hormonal birth control are options like the vaginal ring, birth control pills, and the patch. All of these options contain estrogen and progestin. These two hormones help prevent ovulation. Each method comes with its own maintenance.

The Benefits of Hormonal Birth Control

The benefits of these methods do not interfere with any sexual activities. However, it does change your period to either shorter, lighter, or more regular periods. They may also help improve acne, cramping, unwanted hair growth, and menstrual migraine frequency.

Risks And Side Effects of Hormonal Birth Control Methods

• During the postpartum period, women have a higher risk of developing blood clots in veins located deep in the body. This condition is called deep vein thrombosis (DVT). Combined hormonal methods increase the risk of DVT even further. If you have no additional risk factors for DVT, you can start using these methods 3 weeks after childbirth.
• There is a very small risk that the estrogen in these methods can affect your milk supply if you are breastfeeding. You should avoid these methods for the first 4 to 6 weeks after childbirth until breastfeeding is established.
• Combined hormonal methods have been linked to a small risk of stroke and heart attacks. These methods are not recommended for women over 35 who smoke or have high blood pressure, a history of stroke, heart attack, or deep vein thrombosis (DVT). They should also be avoided by those with a history of migraines with aura or certain medical conditions. Additionally, women with current or past breast cancer should not use these methods.
• Side effects may include breakthrough bleeding, headaches, breast tenderness, and nausea.

Progestin-Only Birth Control Pills

These birth control pills only contain progestin. It works mostly by preventing fertilization of the egg. These birth control pills must be taken at the same time every day with only a 3-hour window. After that 3-hour window, you will need a backup method for up to 48 hours.

The Benefits of Progestin-Only Pills

Progestin-only pills do not interfere with sex. The pills are less likely to affect milk supply and provide reliable protection when taken correctly. It may also reduce menstrual bleeding or stop periods altogether.

Risks And Side Effects of Progestin-Only Birth Control Pills

Side effects include:

• Headaches
• Nausea
• Breast tenderness

If you have or have breast cancer, progestin birth control pills are not recommended.

Barrier Methods

Barrier methods are:

• Female condoms
• Male condoms
• Spermicide
• Diaphragm
• Cervical cap
• Sponge

These work by preventing the sperm from reaching the egg. The diaphragm, sponge, and cervical cap can be used after 6 weeks postpartum. Around this time, the cervix would have returned to its normal size. If you used a diaphragm prior to childbirth, a second diaphragm should be fitted after 6 weeks.

The Benefits of Barrier Methods

When it comes to condoms, they are the only form of birth control that protects you from sexually transmitted infections. The rest of the barrier methods can be bought over the counter and have no effect on a woman’s natural hormone balance.

Risks And Side Effects of Barrier Methods

Some people have allergic reactions to spermicides, or they can cause irritation or burning. Also, spermicides frequently used – at least every day – can increase the risk of getting HIV from an infected partner.

The Lactational Amenorrhea Method

The Lactational amenorrhea method (LAM) is a temporary method of birth control based on the natural way the body prevents ovulation when a woman is breastfeeding.

It requires exclusive, frequent breastfeeding. The time between feedings should not be longer than 4 hours during the day or 6 hours at night. LAM may not be practical for many women.

The Benefits of LAM

It is a natural form of birth control. It does not cost anything.

Risks And Side Effects of The Lactational Amenorrhea Method

There are no known side effects or risks for using LAM. It can be used for only 6 months after childbirth, till the menstrual cycle begins again.

Sterilization

This is a permanent method of birth control for women and men. For women, the fallopian tubes are closed off or removed in a procedure called tubal sterilization. It prevents the egg from moving down the fallopian tube to the uterus.

The Benefits of Sterilization

This is a permanent method. Once you have done it, there is no other need or use for any other birth control method.

Risks And Side Effects of Sterilization

The risks are small, but with female and male sterilization there is a risk of bleeding and infection. This method is a permanent method for couples who no longer wish to get pregnant again in the future. Changing your mind may not be an option. Attempts to reverse the procedure are not guaranteed to work.

If you’re not looking to get pregnant again right away, talk to your doctor about the many postpartum birth control methods to find what is right for you.

FAQs About Postpartum Birth Control

What is the best birth control for postpartum?

The best birth control depends on individual factors such as your health, breastfeeding status, and family planning goals. Long-acting methods like IUDs and implants are popular due to their convenience and effectiveness.

How soon can I get on birth control after having a baby?

Many birth control methods can be initiated immediately after childbirth, including IUDs, implants, and birth control injections. However, combined hormonal methods should be delayed for at least three weeks.

Why wait 6 weeks postpartum for birth control?

Waiting six weeks allows the body to recover from childbirth and reduces the risk of complications, such as blood clots. It’s also important to wait for the cervix to return to its normal size before using certain barrier methods.

What is the postpartum contraception of choice?

Long-acting reversible contraceptives (LARCs) such as IUDs and implants, are often the contraception of choice for postpartum women due to their effectiveness and ease of use.

Call Rosh Maternal & Fetal Medicine in NYC

Wondering which postpartum birth control would be good for you? Talk to our team at Rosh Maternal & Fetal Medicine by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today about IUDs for birth control.