How Soon Can You Start Contraceptives After Childbirth?

Did you know many pregnancies happen within the first year itself because people aren’t informed about postpartum contraception methods? 

As the hormones are changing, many questions arise in a new mother’s mind. Will this contraception option affect milk production when I’ve just given birth? Is it safe to use hormonal birth control while breastfeeding? And so many more.

This blog aims to explain all the popular postpartum contraceptive options along with the reasoning behind their prescription. The correct time to start contraception after childbirth is also mentioned. Towards the end, we’ve also mentioned some additional tips and factors you should definitely consider.

A] When To Start Contraceptives After Childbirth

Some contraceptive options can be started immediately after childbirth, while others might require more time to adjust to your body. 

1. Immediately After Delivery

Some contraceptives can be chosen as early as 48 hours after childbirth. These include:

• Progestin-Only Implant

A progestin-only implant, such as Nexplanon, is a good example of a contraceptive option after childbirth that provides long-term protection. This is because it can last for 3 years. This contraceptive, in particular, is safe even if you’re breastfeeding. The reason behind this is that it works on progestin and not oestrogen. It’s mostly considered a quick procedure with minor side effects such as tenderness near the injection site. 

• Progestin-Only Pill

This option is preferred by women who want to choose a non-invasive contraceptive method after childbirth. The progestin pill is a riskier option, as it needs to be taken at a fixed time every day. Like the progestin-only implant, the progestin-only pill is also safe for breastfeeding. If you aren’t somebody who likes to follow a strict routine, this option is not recommended. 

• DMPA Injection

Depo-Provera is an excellent example of a contraceptive option you can choose after childbirth. It provides protection for 12-13 weeks if you don’t prefer either pills or implants. Like progestin-based methods, this is also a safe option for breastfeeding. An important thing to note here is that this method takes longer to regain your fertility. 

• Immediate Postpartum IUD

Immediate postpartum IUD options in the form of copper or hormonal IUDs can be chosen. Copper IUDs provide more protection when compared to hormonal IUDs. Once inserted, a copper IUD generally lasts for 10 years. Just like other contraceptive options, this method is also safe for breastfeeding. While we mention this contraceptive option, it’s important to understand that the chance of your uterus expelling the IUD after childbirth is quite high.

2. 3-6 Weeks Postpartum

Choosing the right contraceptive is vital during the 3-6 weeks postpartum timeline. This is because your hormones are now stabilised, and breastfeeding follows a fixed pattern. Oestrogen-based contraceptives are usually not recommended, as they affect the mother’s milk production. Contraceptive options such as the progestin-only pill, progestin-only tablet, DMPA injection, and IUD are considered safe options. 

3. 6 Weeks And Beyond

After 6 weeks, all contraceptive options become available. This is because your body is now ready to tolerate several options. Some contraceptive options 6 weeks after childbirth include:

Combined Hormonal Contraceptives

This method combines both oestrogen and progestin. To avoid interfering with milk production, this contraceptive method becomes available 6 weeks after childbirth. Some commonly known options include:

• Combined Oral Contraceptive Pills (COCPs)

COCPs are prescribed to regulate your menstrual cycle. One added advantage here is that it helps to clear your acne. This method is often chosen by women who prefer a more easily controllable method. 

• Combined Hormonal Patch

Unlike what most people think, the combined hormonal patch is applied externally and not inside your body. Like COCPs, these also help to prevent the mid-cycle LH surge. This method involves changes in the thickening of the mucus and thinning of the uterine lining. Once applied, it reduces the requirement to take pills daily. 

• Combined Vaginal Ring

Like combined hormonal contraceptives and patches, this method also helps to avoid the LH surge. Changes such as thickening of the cervical mucus and thinning of the uterine lining are observed. The ideal time to keep the ring inserted is 3 weeks. Unlike other contraceptive methods, 6 weeks after childbirth, this option utilises a much lower dose of oestrogen.

B] Factors Influencing the Choice of Contraceptive Postpartum

Choosing the right postpartum contraceptive method might require some time. As your body goes through a lot of hormonal changes, there are several factors that need to be considered. These involve:

• Breastfeeding Status

As mentioned earlier, progestin-only contraceptive methods are considered in the first 6 weeks postpartum. This is because they do not lead to any changes in the milk volume. 

• Type Of Delivery

The type of delivery may affect the choice of contraceptive you should opt for. In the case of a C-section delivery, certain contraceptive methods after childbirth might be delayed to prioritise healing. Options involving progestin-only methods and IUDs might be considered.

• Risk Of Blood Clots

During postpartum, the chances of VTE (venous thromboembolism), a condition that is responsible for causing blood clots, run high. Due to this, progestin-only contraceptive methods might be suggested in the first 6 weeks after childbirth. 

• Family Planning Goals

Your doctor may ask about your long-term goals for family planning after delivery. As per the NHS’s official guidelines, a gap of 1-2 years is suggested between pregnancies. When this gap becomes shorter, the use of progestin-only pills or injectables is suitable. 

C] Role Of A Private Gynaecologist In Postpartum Contraception

A good gynaecologist will first start with a hormonal assessment. Important details such as the mode of delivery and breastfeeding status will be noted. In case of certain conditions such as PCOS, anaemia or hypertension, methods involving the lowest risks might be recommended by your gynaecologist. Your gynaecologist will help you not just with the timings but also help you avoid any potential risks in the process. In case of high-risk conditions, your gynaecologist can suggest treatment options that will prevent further escalations. 

Consult Dr Nilesh Agarwal, the best private gynaecologist in London, to get expert advice on long-acting reversible contraception and more. 

D] Additional Tips For Safe Postpartum Contraception

Here are a few additional tips that will help you plan for safe postpartum contraception:

• Keep A Fixed Schedule

If you feel you could forget to take your dose, set timers on your phone to remind you of the same. Missing even one dose will lower its effectiveness.

• Issues With Hair Loss Or Acne

Concerns such as hair loss and acne are common after delivery. If these issues exist, you can ask your gynaecologist for postpartum contraceptive methods that can help with these concerns.

• Address Any Underlying Conditions

If you’ve previously dealt with any health condition, such as hypertension, diabetes, migraines, or others, it is vital to inform your doctor about the same. Mental health conditions such as anxiety or depression should also be discussed.

• Your Sleep Routine

If you suffer from any sleep disturbances, your gynaecologist can start with low-hormone contraceptive options. 

Conclusion

While understanding all this information may seem confusing, it doesn’t need to be. With the help of an experienced gynaecologist, you can explore various postpartum contraceptive options and select the right one. 

At Women’s Healthcare, we provide personalised services that are evidence-based. Lastly, remember that with the right support, embracing motherhood can feel safe and comfortable. Contact us if you’re looking for care and choices tailored to your well-being. Women’s Healthcare is here to guide you every step along your journey.