If you've just had a baby, getting pregnant is probably the last thing on your mind. And yet, it's not uncommon for new moms to become pregnant during the weeks and months following delivery.
"Women tend to think one of two things: they can't get pregnant shortly after having a baby, or they'll be especially fertile after delivery," says Melodee Babcock, CNM, a certified nurse midwife at Henry Ford Health. Of course, the truth lies somewhere in between.
Postpartum Fertility
While birth control may not be on your radar during pregnancy, you should begin thinking about it well before you deliver your baby. You can start many forms of birth control the same day you give birth, or immediately after.
"Your healthcare provider can insert an IUD on your delivery date, whether you deliver vaginally or via Cesarean section," Babcock says. "And if you're having a planned C-section, doctors can tie your tubes during the procedure."
Want to put birth control on the back burner? If you're nursing exclusively, at least every four to six hours, you may be able to buy yourself some time. Otherwise, you should begin using some form of birth control immediately after delivering your baby — even if you're still not having regular periods.
"You can still ovulate in the absence of menstrual bleeding," Babcock says. "And if you're ovulating, it's possible to become pregnant while you're still nursing."
Which Type Of Birth Control Is Best After Baby?
The type of birth control that's best for you depends on a variety of factors, including whether you prefer a low-maintenance method (set it and forget it) and whether and when you hope to become pregnant again.
Once you make a few key decisions, finding the right contraception is much easier. The options generally fall into the following three categories:
Hormonal Methods
Hormonal forms of birth control release estrogen, progestin (the synthetic form of progesterone) or a combination of the two. Hormonal birth control comes in many forms, from pills, patches and rings to implants and intrauterine devices, or IUDs.
If you're breastfeeding, hormonal birth control methods are more limited. Almost all of these methods contain estrogen. "Unfortunately, estrogen not only affects your milk supply, it can also increase your risk of blood clots and other complications during the weeks following delivery," Babcock says. The one exception: Progestin-only pills or "mini pills."
Set on a hormonal birth control method? Talk to your doctor about beginning birth control six weeks postpartum.
Barrier Methods
Barrier methods include condoms, diaphragms, cervical caps and sponges. The goal of all barrier methods is to block sperm from reaching and fertilizing an egg. They're easy to use and offer reliable protection without a hefty commitment.
The caveat: The cervical cap, diaphragm and birth control sponge may not be effective straight out of the gate. "You need to give your cervix time to return to its pre-birth size," Babcock says. If you used one of these methods before pregnancy, your healthcare provider will need to refit you after delivery.
Copper IUD
If you're sure you don't want to become pregnant again for several years, but you don't want to deal with hormonal forms of birth control, you may want to consider the copper IUD.
Unlike the hormonal IUD, this device is wrapped in copper to help prevent sperm from reaching the egg. Copper IUDs are 99% effective and can last up to 10 years. Want to get pregnant before a decade has passed? Once doctors remove the device, your fertility returns.
Post-Baby Birth Control Safety
Women today have a range of birth control options available immediately or shortly after delivery. The key is to be intentional about preventing pregnancy after delivery, particularly if you've had a surgical delivery.
"We recommend at least 12 to 18 months between pregnancies to give the body time to recover and reduce the risks of complications, including miscarriage, preterm birth or low birth weight," Babcock says.
Partner with your healthcare provider before you bring your baby home to determine the best birth control options for your unique circumstances. While the risks associated with birth control are minimal, keep in mind that hormonal methods containing estrogen carry an increased risk of developing a blood clot during the weeks after birth.
Done having babies? Permanent forms of birth control, such as tubal ligation (for women) or vasectomy (for men) may be your best bet.
To find a doctor or certified nurse midwife at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936). Learn more about safe pregnancy and delivery at Henry Ford during COVID-19.
Melodee Babcock is a certified nurse midwife, seeing patients at Henry Ford Medical Center – Livonia and Henry Ford West Bloomfield Hospital.
