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Contraception after giving birth

21st February 2019

There’s no question that having a baby is a big deal, and every woman experiences it differently (from the contractions to the time it takes to natural birth vs cesarean). And like with the birth itself, new mums all approach various aspects to the “after” part differently. What do you want to do with your placenta? Do you want to breastfeed? How long do you want to wait before having sex? For a lot of women, sex may be the last thing on their minds and some even wait months before venturing into it. If you are considering sex then there are a few different things to consider.

The sex itself

After giving birth, you will likely feel very sore (regardless of which type of birth you’ve had) and so any sex should be done with care. Sex is not going to be pleasurable or enjoyable if you’re in pain so be sure you communicate with your partner and stop if it begins to hurt. You may notice that your vagina is drier than usual, which is caused by hormonal changes after giving birth. Try using a lubricant to decrease friction, of which there are many different options. Water-based lubricants are the easiest to wash away afterwards, which could be a big plus point in not adding to your list of chores.

Practically, you may want to plan sex in advance, as a newborn baby sleeps for very short intervals and as new parents, you’ll likely be very tired by the evening. Make time to relax together and focus on being close in other ways too, so that the sex doesn’t become the be all and end all if things don’t go to plan.

Contraception

It’s something that can often slip your mind but in fact, you can, in theory, get pregnant just a couple of weeks after giving birth, even though your periods may not have returned. Some people of course, plan it this way; they may want their children to be close in age or they may want to have two pregnancies close together so that their hormones and body can return back to normal afterwards. Most women however, do not consider having another child so quickly after giving birth, and need to think carefully about contraception to avoid this.

A lot of people don’t know this, but breastfeeding can act as a natural form of birth control, if that’s the path you choose to go down. Known as the lactational amenorrhea method (LAM) of contraception, breastfeeding and the hormones that come with milk production can delay the return of ovulation. Exactly how long breastfeeding can delay fertility varies and so it’s not an entirely reliable form of birth control. Ovulation occurs before you get your period, which means that this could happen without you noticing and you could, in theory, fall pregnant again.

Because it’s not an entirely reliable form of contraception (especially over 6 months after giving birth), it’s wise to consider other options. Condoms are always a good option, as they offer effective protection against pregnancy and are naturally lubricated to aid sex and make it more comfortable and pleasurable.

There are a lot of different condoms that you can choose from, with thin ones for increased sensitivity, ribbed ones for increased pleasure and flavoured or coloured ones for increased playfulness. Because you’re likely to be extra sensitive anyway, you probably won’t need (or want) any additional features to increase this side of things. The standard ones are a safe bet, or you could look into the ‘extra safe’ ones if you are particularly worried about getting pregnant again. These are slightly thicker and less prone to breaking, so they offer additional peace of mind.

Remember that when you use condoms, it is advised that you use personal lubricant.

You may be cautious about any contraception methods that mess with your body’s hormonal balance, especially since pregnancy and post-birth is such a highly hormonal time anyway. However, contrary to popular belief, they are not unsuitable.

The contraceptive pill is the most popular form of hormonal contraception and these can be split into two categories; the combined pill and the progestogen-only pill. The combined pill is the slightly more effective of the two, as it contains oestrogen and progestogen, and this is the one where you have a 7 day break from pills in every 28 day period. If you want to go down the combined pill route then you will need to wait at least 3 weeks after giving birth to start it, and it’s worth noting that small amounts of oestrogen can make its way into your breast milk. Although it’s unlikely to have an effect on your baby, most women who are breastfeeding choose to stay away from the combined pill. Instead, you could use the progestogen-only pill (or “the mini pill”), which does not interfere with breastfeeding and is suitable to be started straight after giving birth.

For any alternative methods of contraception (like patches and rings) then it will largely depend on the hormones they contain as to whether or not they’re suitable. If they contain oestrogen then the same rules apply as with the combined pill, and you should proceed with guidance from your doctor. It’s likely you’ll want to stay away from any intrusive forms of contraception (like the coil) while your body heals from the birth, but if this is something you are interested in then again, a doctor can guide you.