Birth Control Options: Why You Should Have a Plan Postpartum

After giving birth, it’s possible to become pregnant again sooner than you’d think. To avoid an unplanned pregnancy, you should think about postpartum birth control while you’re still pregnant.

“Expectant couples usually focus their planning on the baby – buying clothing, decorating the nursery,” says obstetrician-gynecologist Jenny Akpe, M.D. “However, it’s essential to also create a postpartum, or post-pregnancy, birth control plan.”

How soon can you get pregnant after having a baby?

Most doctors recommend leaving 18 months between pregnancies, so a woman’s body can recover. But an unplanned pregnancy may occur much sooner than that, without birth control.

Once ovulation, a phase in the menstrual cycle where an egg (ovum) is released from the ovary, resumes after pregnancy, it’s possible to become pregnant again. Ovulation on average resumes within the first 4 to 12 weeks after childbirth, although breastfeeding can sometimes delay it for up to 6 months.

You may not realize that you’re ovulating, because it happens 2 weeks before menstruation. It’s possible to become pregnant before having your period again after pregnancy.

“With a newborn, having another baby may be the farthest thought from your mind,” Dr. Akpe says. “But the possibility of an unplanned pregnancy is very real, without birth control.”

When to Think About a Postpartum Birth Control Plan

The best time to formulate a postpartum birth control plan is during pregnancy. You’ll have time to weigh your options and ask your doctor questions.

Your doctor may suggest long-acting reversible birth-control options, like an intrauterine device (IUD) or a hormonal implant. Long-acting options let you forget about birth control and focus on your baby.

If you’re planning to breastfeed, your doctor may recommend low dose-hormonal birth control. Options containing hormones are safe for babies, but some of them may affect your milk supply.

Some birth control options are more effective at preventing pregnancy than others. Talking about everything with your doctor during prenatal visits may help you decide.

If you didn’t consider birth control before your baby was born, there’s still time. Most doctors recommend against sex for 6 weeks after childbirth; that’s 6 weeks to plan.

Birth Control Options for the Postpartum Period

Talk to your partner and figure out the best birth control method for you.

Long-acting birth-control options include:

• An IUD. It’s inserted into the uterus immediately after childbirth or at a 6-week checkup. One option contains hormones, and another is non-hormonal; both are effective for many years.
• A birth control implant. This thin hormonal stick is implanted under the skin of the upper arm. It can be implanted after childbirth, preventing pregnancy for 3 years.
• A birth control injection. Hormonal injections are able to prevent ovulation for 3 months at a time. Doctors can administer the first injection right after childbirth.
• Tubal ligation. This is permanent birth control, intended for women who don’t want more children. Doctors surgically remove/close the Fallopian tubes, which prevents sperm and eggs from meeting. 
• Vasectomy. During this procedure, doctors cut/seal the tubes that allow sperm to enter semen. Vasectomy is a permanent option for men who don’t want more children.

Shorter-acting birth-control options must be taken regularly or used before/during sex. They include:

• Combined estrogen/progestin methods. These options use two hormones, estrogen and progestin, to prevent ovulation. They include birth control pills, vaginal rings and birth control patches.
• Progestin-only methods. Doctors may recommend progestin-only over combined methods for breastfeeding women. The progestin-only “mini pill” and progestin injections keep sperm from fertilizing eggs.
• Condoms and spermicide. Male or female condoms block sperm from potentially reaching an egg. Spermicide damages/kills sperm, and it may be used as a vaginal lubricant.
• Other barrier methods. Diaphragms and cervical caps must be refitted 6 weeks after childbirth. Sponges and cervical caps are less effective after a woman has given birth.

“With all of these options, you should find something that meets your needs,”Dr. Akpe says. “Birth control lets you choose if or when you want to become pregnant again.”

Next Steps & Resources:

• Meet our source: Jenny Akpe, M.D.
• To make an appointment Dr. Apke, or a doctor near you, call 800-822-8905 or visit our website. 
• Learn more about our women’s health services.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.