At some point of time while you are pregnant, you may want to discuss with your physician about what kind of contraception will work best for you after delivery. You may be advised to resume the same method of contraception you have used in the past or you may be advised something else that would work better. In any case, it is good to plan in advance for time when you are ready to resume sex again. Here are different choices to choose from.
Barrier Methods
Condoms
Condoms are ideal for birth control after pregnancy especially for new parents because they don’t require fitting and don’t have hormones which can interfere with nursing. Their effectiveness is up to 86%. Your body’s hormonal balance will be off for a few weeks or a few months depending upon whether you are breastfeeding or not. In either case you may experience dryness of vagina due to this. You can use lubricated condoms and also use additional lubricant to ease the discomfort.
Diaphragm, Cervical Cap
The advantage of using diaphragm and cervical cap is that they don’t have hormones so they won’t interfere with nursing. The effectiveness of diaphragm is up to 80% and of cervical caps is up to 60% for women who have had a child. You are required to be either fitted for the first time or refitted during your first postpartum visit depending upon whether you have used them earlier or not. By the time of the first postpartum checkup, the vagina, cervix, and uterus will have recovered and reached the size and shape at which they will remain (usually a bit larger than they were before pregnancy). One disadvantage of using cervical cap is its high failure rate and even when it is refitted used after delivery.
The Intrauterine Device
IUD
When it comes to birth control after pregnancy, IUDs are considered as an effective and safe way by most health experts and can be used by majority of the females both before and after giving birth. There are two kinds of IUDs available presently. The first IUD is ParaGard, which is a T-shaped device, made of plastic and wrapped with copper wire. It can be kept for up to 10 years. The other IUD is Progestasert, which is also a T-shaped device that releases progestin hormone. It is required to be changed every year.
Hormonal Methods
The Mini-Pill
It is a type of oral contraceptive that contains a small quantity of hormone progestin. The mini-pill is available in packs of 28 and you are required to take one pill at the same time every day. If your baby takes nothing but breast milk, it is best for you to take the mini-pill six weeks after delivery. If you are not exclusively breastfeeding, you can take it right after you give birth.
The Pill
It is a type of oral contraceptive that contains hormones progesterone and estrogen. You are required to take one pill every day for 21 days and then take placebo pills or no pills for the next 7 days.
The Ring
The birth control ring also referred to as NuvaRing is a transparent, flexible ring that you have to insert into your vagina at the start of your menstrual cycle. Once it is inside, the ring releases a low dose of progestin and estrogen continuously. A new ring has to be inserted every 28 days.
The Patch
Ortho Evra or the birth control patch is a beige, thin square that is applied to the skin like an adhesive bandage. A low dose of progestin and estrogen is released continuously by the patch. A new patch is to be applied every week for 3 consecutive weeks and then no patch for 1 week before you start the cycle again.
The Shot
Depo-Provera or the birth control shot is an injection of hormone progestin that you have to get every 3 months. The shot is usually used by the females who are considering birth control after pregnancy but do not want to use an IUD, have trouble remembering to take a pill or cannot take estrogen. However, it is not a good choice for those who plan to get pregnant in the next couple of years because it can take more than a year after you got your last shot to become fertile again.
The Implant
The only implant that is available in the USA is referred to as Implanon. It is a flexible rod that is around the size of a matchstick. It is inserted beneath the skin of your upper arm from where it releases small quantities of progestin continuously. It is a highly effective method of birth control. You can have it remain in place for up to 3 years. Soon after the removal of the implant, your fertility returns.
Natural Methods
Lactational Amenorrhea Method (LAM)
This method is based on the fact that the return of fertility is delayed by breastfeeding. The effectiveness of LAM is 98% if you fulfill all of its conditions: you are breastfeeding your baby exclusively, your periods has not started and the delivery happened less than 6 months ago.
Fertility Awareness Methods (FAM)
In these methods, you are taught to observe patterns in your monthly menstrual cycle so that you can predict the days on which you would be fertile and on which days you would not be. You may be required to observe physical changes of fertility such as changes in the cervical mucus texture and fluctuations in basal body temperature.
Sterilization
Vasectomy
It is a highly effective and safe surgery to make a male sterile. A physician blocks or cuts the two tubes – the vas deferens which carry the sperm from the testes to the scrotal pouch that holds the semen before ejaculation. A male who get a vasectomy can still have sexual intercourse and ejaculate. There would be no sperm in their semen, hence it won’t fertilize an egg and cause pregnancy.
Female Sterilization
There are two main types of female sterilization: surgical (called tubal ligation) and nonsurgical. Tubal ligation is a surgery in which a female’s fallopian tubes are cut, cauterized or clipped so that the sperm cannot meet the egg. The procedure can be done during a C-section delivery or within 48 hours of a vaginal delivery. There is another option, referred to as Essure which is done 6 weeks after delivery. In this method, implants are inserted into your fallopian tubes via your vagina.
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