Post-natal contraception

After giving birth, probably the last thing on your mind is getting pregnant again. However, you will be able to conceive again, and possibly sooner than you think. It is widely held that women cannot fall pregnant while they are breastfeeding. This is only partly true.

If your breastfed baby is under six months and your periods have not returned, you are experiencing lactation amenorrhoea, which means that due to nursing your child your menstrual cycle has been suspended. If you do not supplement your baby’s breastfeeds with formula milk, (i.e., you solely breastfeed), it is unlikely that you will become pregnant at this time, but it is generally advisable to use additional contraception as it is hard to predict when your periods might return. In all other circumstances, (if you are supplementing your breastfeeding, using formula milk to feed your baby etc), unless you want to get pregnant, you should make sure you find a suitable method of contraception.

What kind of contraception should I choose?
If you are thinking about trying for another baby relatively soon, there are three methods of contraception which are suitable for you:

- Condoms (male and female) – male condoms offer the simplest birth control method to use in the weeks directly after the birth of your baby. You may find that you need to use lubricating jelly to begin with, to alleviate any dryness. Female condoms, which sit inside the vagina, may not be as comfortable to use in the early stages, in particular if you have had tears or stitches during delivery. Condoms are 98 per cent effective.

- The combined pill - this contains two hormones, progestogen and oestrogen, which work by preventing your body from releasing eggs. It is not recommended if you are breastfeeding, as it can reduce your milk flow. The combined pill is 99 per cent effective.

- Mini pill -- this is a progestogen-only pill and does not affect your milk supply, so is suitable for breastfeeding mums. The mini pill is 99 per cent effective.

If you are not thinking about trying to conceive again for a while, there are other methods of contraception which you may want to consider. These may affect your fertility over a longer term, and are not suitable if you are considering trying to get pregnant again soon:

- Progestogen injections – Two kinds are available, lasting for 8 weeks and 12 weeks respectively, and providing over 99 per cent protection. Using the same hormone as the combined and mini pills, the injections work by releasing small amounts of hormone into the body, and while a small amount of hormone will be passed on to your baby if your are breastfeeding, this is not thought to be harmful, although many doctors recommend not starting courses of injections until 6 weeks after the birth of your baby.

- Progestogen implants – Similar to the injections above, these are small plastic tubes containing progestogen which are inserted, usually under your arm, under local anaesthetic. They can work for anything up to three years at a time, so you should think carefully about if and when you want to think about having another baby. These can be used from 6 weeks after your baby is born, and are 99 per cent effective.

- Intrauterine device (IUD) - the IUD, or coil, is a device which sits inside the womb and prevents sperm from reaching the egg, or by stopping a fertilized from becoming implanted. This can be fitted six weeks after your baby is born (8 weeks or possibly longer in you have had a c-section), and can also help alleviate the problems of heavy periods. The IUD is 98-99 per cent effective.

- The diaphragm – this device, also known as the cap, sits over the cervix and blocks sperm from reaching the egg. It is usually used in conjunction with spermicidal jelly for maximum effectiveness. If you used one before becoming pregnant the first time, you will need to be re-measured to check that it still fits properly, as your cervix can alter in shape and size after birth. The cap is 92-96 per cent effective.

If you have any unanswered questions, use our answers page to gain wisdom from other mums or our resident experts for all those pregnancy or baby-related niggles.