CONTRACEPTION WHAT & WHEN

Various factors are considered when making a decision about a suitable contraceptive after birth. It is therefore important to discuss this with your healthcare practitioner, because your needs might have changed. Some women who used oral contraception before pregnancy, might opt for the Mirena (an intrauterine device or IUD) now that the cervix is slightly stretched due to pregnancy and birth. Or you might fear that your new unpredictable lifestyle will make you forget to take your pill.

The likelihood that you will ovulate in the first six weeks post birth is extremely low. The majority of women are not sexually active for the first few weeks after birth due to bleeding and general need for recovery, so most gynaecologists will only discuss and prescribe a contraceptive at your six week check-up. But if you are serious about not getting pregnant again soon, do not rely on breastfeeding as a method of birth control. Dr Peter Koll, a gynaecologist and obstetrician at Sandton Mediclinic, recommends additional contraception (such as condoms) for lactating mothers as soon as you become sexually active. Estrogen during breastfeeding is a no-no, making the mini pill (progestin only), contraceptive injection or progestin-only implant (Implanon) suitable options for lactating moms. An IUD is perfectly safe to use for nursing moms and it can be inserted straight after your caesarean section, says Dr Koll.

Women who decide not to breastfeed at all are advised to start with a contraceptive as soon as two weeks after the birth.

If you do breastfeed, you will use one type of contraceptive while breastfeeding. Once baby is weaned, you might need to revise your contraceptive – depending on what you were using. Dr Koll recommends that you start your usual contraceptive again two weeks before you stop breastfeeding completely. This will not harm your baby. If anything, it could reduce your milk production, which could make weaning a bit easier.