Plan­ning your family

Learn about the most pop­u­lar con­tra­cep­tion op­tions for you and your part­ner post-birth

Mother & Baby (Australia) - - Contents -

It’s a com­mon mis­con­cep­tion that when you’re breast­feed­ing you can’t fall preg­nant.

There’s no doubt that be­com­ing a mum is one of the most lifechang­ing events you’ll ever ex­pe­ri­ence. There’s a whole new world to dis­cover and you’re sud­denly re­spon­si­ble for a tiny hu­man who com­mands all of your at­ten­tion, wakes you up at strange times in the night, and re­lies on you for food and com­fort. It can be a time of real con­fu­sion and, on top of all that, it can be a roller­coaster of emo­tions as you adapt to your new life and your new body.

When you and your part­ner are ready to have sex again, your pri­or­i­ties will be dif­fer­ent, and you might want to give your­selves some breath­ing space be­fore an­other lit­tle baby comes along. It may also be the first time you’ve con­sid­ered your con­tra­cep­tion op­tions in a long time.

We’ve looked at the most com­mon op­tions so you can choose the right birth con­trol for your sit­u­a­tion.

MYTH de­bunked

It is a com­mon mis­con­cep­tion that when you’re breast­feed­ing you can’t fall preg­nant. Jean Hailes for Women’s Health GP Dr Amanda New­man says this is cer­tainly not the case. “Breast­feed­ing re­duces the chance of get­ting preg­nant, es­pe­cially in the early months, but it’s not guar­an­teed,” she ex­plains. “If a cou­ple def­i­nitely doesn’t want to con­ceive, they should use a re­li­able form of con­tra­cep­tion once their baby is three weeks old.” While some birth-con­trol op­tions aren’t suit­able for breast­feed­ing mums, oth­ers, such as the mini-pill, are com­pletely safe.

“If you are breast­feed­ing, gen­er­ally most women take the mini-pill, as it al­lows for the con­tin­u­a­tion of nor­mal breast­feed­ing, whilst con­fer­ring con­cep­tion,” says Deme­ter Fer­til­ity spe­cial­ist Dr So­nia Jes­sup.

No mat­ter what your sit­u­a­tion, there is a con­tra­cep­tive that is right for you. If you and your part­ner are un­sure, your GP or gy­nae­col­o­gist can suggest the best op­tion for your sit­u­a­tion.

PLAY­ING it safe

The least in­va­sive form of con­tra­cep­tion – con­doms – can be an easy, cost-ef­fec­tive birth-con­trol op­tion post-birth. If you’ve just given birth, your hor­mones can be a mess, so using con­doms can be eas­ier on your re­cov­er­ing body.

There’s also a lot less pres­sure be­cause you don’t have to re­mem­ber to take med­i­ca­tion at the same time ev­ery day, es­pe­cially when you’ve got a new bub and a new rou­tine that you’re get­ting used to. The im­por­tant thing to re­mem­ber is that you need to be strict about using con­doms all the time for them to be as ef­fec­tive as pos­si­ble.

“If you and your part­ner are ded­i­cated and par­tic­u­lar, con­doms can work re­ally well,” So­nia ad­vises. How­ever, if you’re using con­doms, be sure to use a lu­bri­cant – it can help com­bat any dis­com­fort or dry­ness, and it also strength­ens the con­dom’s ma­te­rial. “Post-de­liv­ery, the ma­ter­nal oe­stro­gen lev­els are lower, and there­fore there is more vag­i­nal dry­ness, which can pre­dis­pose to bro­ken con­doms if lu­bri­ca­tion is not used,” says So­nia.

CAP it off

Not keen on using a con­dom, but like the idea of some­thing you don’t have to wear all the time? A di­aphragm, or ‘cap’, could be the op­tion for you and your part­ner. It’s a so­lu­tion that won’t lead to any long-term ef­fects, if you are keen on a short-term so­lu­tion or want to con­ceive again quite

quickly. A di­aphragm is a soft, sil­i­cone cap that is in­serted into your vagina and acts as a phys­i­cal bar­rier be­tween your part­ner’s sperm and your eggs. You in­sert the di­aphragm right be­fore hav­ing sex and it cov­ers the cervix com­pletely.

Just like con­doms, these de­vices won’t af­fect your hor­monal bal­ance, but they need to be used cor­rectly ev­ery sin­gle time in or­der for them to pro­tect against an unexpected preg­nancy. “Some women swear by these de­vices, and if they are com­bined with a sper­mi­ci­dal gel, they can be very ef­fec­tive,” says So­nia. This gel should be spread onto the di­aphragm be­fore ev­ery in­ser­tion and slows sperm down so that it can­not reach the egg. It’s im­por­tant to ap­ply it ev­ery time you have sex; sper­mi­cides also come in the form of creams and foams. Using a di­aphragm can in­ter­rupt the spon­tane­ity of sex and re­quires some for­ward plan­ning, but some cou­ples swear by it.

PUT A ring on it

If you want an alternative that won’t have you fum­bling around each time you want to have sex, a vag­i­nal ring in­serted on a monthly ba­sis stops sperm from meet­ing the egg, with a small amount of hor­mone re­lease. Like the con­tra­cep­tive pill, the ring con­tains a very small amount of pro­gesto­gen and oe­stro­gen; just enough to stop ovu­la­tion from oc­cur­ring. The ring also thick­ens the mu­cus that lines the cervix, mak­ing it in­creas­ingly dif­fi­cult for sperm to get through in the first place.

So­nia says a vag­i­nal ring can work well for women who are happy to in­sert and re­move it on a monthly ba­sis. “This method can work very well and has the low­est dose of oe­stro­gens on the mar­ket for a con­tra­cep­tion method,” she says.

How­ever, if you’re breast­feed­ing, it’s ad­vised that you steer clear of the ring, as it can af­fect your milk flow.

Amanda adds: “They can be used six months af­ter de­liv­ery if breast­feed­ing, and af­ter three to six weeks if you’re not breast­feed­ing.” The good news? There are very min­i­mal side ef­fects, as there is such a low dose of hor­mones in the vag­i­nal ring. Just re­mem­ber to change it ev­ery month. A re­minder on your phone should do the trick!

LONGERTERM so­lu­tion

IUDs are small con­tra­cep­tive de­vices in­serted into the uterus by a doc­tor. There are two types of IUDs avail­able in Aus­tralia – the cop­per IUD (or coil) and the hor­monal IUD, in­clud­ing the Mirena.

Ideal for longer-term protection, IUDs last up to five and even 10 years, and are at least 99 per cent ef­fec­tive. “The ad­van­tage of an IUD is that once in­serted, it gen­er­ally does not have to be checked or re­moved for five years,” So­nia says.

Both IUDs have a fine ny­lon string at­tached to the end of the de­vice, which sits at the top end of your vagina and can eas­ily be re­moved by your doc­tor should you de­cide it’s time to try for an­other baby. The cop­per IUD is made from plas­tic and has a cop­per wire wrapped around the stem, whereas the Mirena is T-shaped and made wholly from plas­tic. These de­vices act as a bar­rier, keep­ing the egg and sperm apart, as well as chang­ing the make-up of the vagina’s lin­ing so it’s in­creas­ingly dif­fi­cult to fall preg­nant. The cop­per IUD re­leases no hor­mones into your body, whereas the Mirena does. Both op­tions are re­li­able and help man­age heavy, painful pe­ri­ods.

An IUD can be in­serted shortly af­ter you’ve given birth. “As soon as the uterus has con­tracted back to the nor­mal size (about six-weeks’ post-par­tum), it is rea­son­able to have an IUD in­serted, even if you are still breast­feed­ing,” says So­nia.

THE mini-pill

Com­monly re­ferred to as the ‘mini-pill’, the pro­gesto­gen-only pill (POP) is an oral con­tra­cep­tive that con­tains only one hor­mone (pro­gesto­gen) and is suit­able to use if you’re breast­feed­ing. Un­like the tra­di­tional, com­bi­na­tion pill con­tain­ing pro­gesto­gen and oe­stro­gen, you can start tak­ing the mini-pill at any time and you’ll be pro­tected from preg­nancy just two days af­ter be­gin­ning your course.

If you’ve had is­sues with a com­bined oral pill in the past, or you have a his­tory of mi­graines or blood clots, the pro­gesto­gen-only op­tion may suit your needs.

Like any form of con­tra­cep­tive, the mini-pill has the best chance of work­ing when you closely fol­low the in­struc­tions for use. “The only tricky bit is re­mem­ber­ing to take the pill within the same three-hour win­dow each day to en­sure it is ef­fec­tive,” ad­vises Amanda. For busy mums try­ing to en­force a rou­tine, this can be a chal­lenge, but make your pill a pri­or­ity in your day and you’ll have noth­ing to worry about.

IM­PLANTS and in­jec­tions

Tak­ing oral con­tra­cep­tives can be the last thing on your mind when you’re busy look­ing af­ter a new­born. “The long-act­ing meth­ods of con­tra­cep­tion have the great ad­van­tage of not need­ing to be re­mem­bered once in­serted, and are ex­tremely ef­fec­tive,” says Amanda. The Im­planon NXT, or ‘rod’, is small, flex­i­ble and in­serted un­der the skin on your up­per arm, where it re­leases pro­gesto­gen to pre­vent ovu­la­tion. One of the most ef­fec­tive con­tra­cep­tions on the mar­ket, it has a life span of three to 10 years, and once re­moved, there are no per­ma­nent changes to your fer­til­ity.

Con­tra­cep­tive in­jec­tions (also known as the Depo Provera or Depo-Ralovera), halt ovu­la­tion in the same way, but you need a jab ev­ery 12 weeks. “The pro­gesto­gen in­jec­tion can be given straight af­ter de­liv­ery even if you’re breast­feed­ing,” Amanda says. How­ever, the im­plant and in­jec­tions need to be used within 48 hours of giv­ing birth, or you’ll have to wait un­til four weeks’ post-par­tum. It pays to be pre­pared.

Tak­ing oral con­tra­cep­tives can be the last thing on your mind.

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