STI Clinic Dublin-Too soon for the next baby?
26, January 2015

This week Dr Aisling Loy writes on about contraception choices post partum.

Fertility and contraception is a minefield for many women. One minute we are doing all we can to avoid getting pregnant, then suddenly we find ourselves planning a baby, worrying about fertility and doing our best to conceive.

But what about when you’re at that in-between stage, having just had baby and not wanting a second any time soon… we’ve all heard those ‘accident’ stories.

Here are some top tips:

1 It’s recommended that women wait at least six months post partum before attempting to conceive again, this leads to better health outcomes for baby and mother. So what are the options?

2 Awaiting the return of your periods before thinking of contraception is not the best idea as ovulation and fertility return two weeks prior to this, so you may conceive before you even know you are fertile again. If you are not exclusively breastfeeding you need to consider contraception from when your baby is twenty-one days old.

3 Breastfeeding has many great benefits, one of which is that it can act as a contraceptive. However there are many caveats, so don’t be lulled into a false sense of security. For breastfeeding to be 98% effective as a contraceptive you need to be exclusively breastfeeding at least every four hours during the daytime and every six hours at night. Your baby should be under six months and not having any formula feeds or solids. You should not be using pumping as a means of breast feeding and your periods should also still be absent.

4 If you are breastfeeding and want further peace of mind there are additional options; condoms, diaphragm, cap, mini pill (progesterone only),  progesterone injection, progesterone implant, or the coil will all work in combination with breastfeeding. If your family is complete then female or male sterilisation are less common but effective choices.

5 For breastfeeding women, contraception with oestrogen is not recommended unless there are no alternatives until after six months as it interferes with breast milk supply.

All options are open to non-breastfeeding women depending on their own health circumstances and it’s important to investigate the choices out there. All-too often I hear from women who felt the pill was not for them and they just didn’t realise the myriad of other options: Condoms, the cap, diaphragms, combined oral contraceptive pill, mini pill, contraceptive ring, the patch, progesterone injection, contraceptive implant, coils, the natural method, and sterilisation are all good options.

It’s important to discuss what’s best for you with your doctor and to return if your initial choice does not feel right for any reason.

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