contraception
 

 

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Fertility and contraception after birth

Whether you’re feeling ready again or can’t think of anything less appealing than having sex right now, it’s good to know your contraceptive options. Here are the facts about contraception after giving birth.

When will I be fertile after giving birth?

This may shock you but you can actually get pregnant again as early as 21 days after having your baby (NHS Choices, 2016; Family Planning Association, 2017). This is still the case even if you’ve not had a period yet. Not that you’ll necessarily be ready to get pregnant again by then.

Many couples take their time before they get back to their old selves in the bedroom. On the other hand, some women feel more sexual than others after they give birth and are ready to do it much sooner.

When to think about contraception

Chat it through with your midwife. Contraception should be discussed within one week of giving birth as it may need some time to start working (NICE, 2006).

If you are bottle or mixed feeding your baby, your periods should come back around four to six weeks after the birth or later. That means that when it comes to contraception, it’s worth being prepared. Have a think about it and chat it through with your partner.  

What contraception is best after giving birth?

Your body and your needs will change after giving birth. If you were using contraception before you became pregnant, that method may no longer be right for you. This might be because your preferences have changed, or you’re breastfeeding or you had problems in pregnancy. You might also need to consider other things, especially if you’re breastfeeding. Here are your choices.

Condoms (male and female)

They can be used any time after giving birth (Family Planning Association, 2017).

Diaphragm/cap

You will need to wait until your vaginal area and cervix has fully recovered after you have had your baby. This normally happens by about six weeks. As a vaginal birth can alter your size, you will need to be refitted (Family Planning Association, 2017).

Intrauterine device (IUD)

This can be fitted within 48 hours of the birth. If it’s not fitted at this time, it will need to be fitted from four weeks after you had your baby (Family Planning Association, 2017).

Progestogen-only pill, injection or implant

The progestogen-only implant or mini pill can be used right away. If you are fitted with an implant by day 21 after you give birth, it is an effective contraceptive immediately (Family Planning Association, 2017). If you get the implant after day 21, it will not be effective for the first seven days and you will need additional contraception.

It’s best to wait until six weeks after birth for the progestogen-only injection if you are breastfeeding (Family Planning Association, 2017).  If you are formula feeding, you can have it when you want but may get some heavy and irregular bleeding if you wait less than six weeks.

Hormonal intrauterine system (IUS)

This can usually be fitted any time from four weeks after birth (Family Planning Association, 2017).

Combined oral contraceptive pill, patch or vaginal ring

These are not recommended if you’re breastfeeding. All contain oestrogen, which breastfeeding women should avoid as it can reduce milk supply.

You can take the combined pill from three weeks if you are formula feeding. If you are breastfeeding, you can start them six weeks after birth.

If you’re struggling to decide which method is best for you, have a chat to your GP or midwife and read more about the methods available at NHS Choices.

You could also try using the Family Planning Association’s contraceptive tool.

Lactational amenorrhoea method (LAM) or natural contraception

While the above are your main choices when it comes to contraception, you have another option. The lactational amenorrhoea method means that exclusively breastfeeding prevents you from getting pregnant again. It’s 98% effective because the hormone that stimulates milk production prevents your body releasing the hormone that triggers ovulation (Family Planning Association, 2017).

Just be aware that LAM becomes less effective if:

  • you are not breastfeeding exclusively and have introduced formula milk, drinks or solids
  • your periods have returned (even light spotting counts)
  • your baby is more than six months old
  • you start to breastfeed less often
  • there are long intervals between feeds, both during the day and night
  • you stop night feeds.

Natural contraception

This option is also known as the calendar method, and is when you plot your cycle and work out which are your fertile days. It can be more difficult to learn and use this method just after you have a baby as your cycle may have changed (Family Planning Association, 2017).

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.