Planning your family
Learn about the most popular contraception options for you and your partner post-birth
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.
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!
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.
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.