Birth control after baby

Everything you need to know about postpartum contraception.
By Sarah Gilbreath

With a new baby in the house, getting pregnant again is probably the last thing on your mind. But you and your partner can return to intimacy around six weeks after you give birth, and you may find that your previous birth control method of choice isn’t right for your new lifestyle.

cutecouplebedSooner than you think
After giving birth, your uterus returns to its normal cycle, meaning that you can get pregnant again within a month. (Remember Tori Spelling’s fourth baby, whom she welcomed just 10 months after her third baby?) The average length of time between giving birth and ovulating is 45 days, but some women can ovulate again in as few as 25 days. “Many women think they can’t get pregnant again until after they’ve had their first postpregnancy period, but the fact is by that point, they’ve already ovulated,” says Aisha Redmond, OB/GYN, healthcare team lead for Kaiser Permanente TownPark Medical Center and area physician for The Southeastern Permanente Medical Group. “All it takes is once to get pregnant. You can absolutely conceive before you’ve had your first period.”

Your new routine may not be conducive to your previous method of birth control; for example, taking an oral contraceptive at the same time every day might slip your mind when you haven’t slept in days. “If you miss one pill, you’re no longer protected from pregnancy,” says Redmond.

Instead, you may want to switch to condoms, which you can use when you’re already focused on the deed, or an implant, which you can put in and promptly not give another thought. Alternatively, you may find that condoms are no longer comfortable and want to switch to something out of the way, like the patch. “It’s just a matter of taking the time to find which method is right for you,” says Redmond.

Decisions, decisions
There are 10 basic types of temporary birth control: combination pills, extended pills, mini pills, the patch, implants, intrauterine devices (IUDs), injection, vaginal ring, diaphragm, and condom (permanent measures range from getting your “tubes tied” to removing your uterus). We know this list is long, but don’t panic: There are a few simple questions to ask yourself that can help narrow down your options.

  • Money matters
    The first question to consider is how much money you’re comfortable spending. For many women, cost has traditionally been a deciding factor, since several types of contraception are out of the average woman’s budget. However, Redmond says that’s changing. “Because of recent healthcare reform, many insurance companies and Medicaid now cover various forms of birth control, from pills to injections. Check with your insurance or Medicaid provider for the list of newly supported types.” The more costly items are usually the ones that last the longest. For example, the implant, a flexible rod that your doctor implants under your skin, can cost as much as $900, but lasts for three years. IUDs, which your doctor will fit into your vagina, are much the same—the cost can range from $500 to $1,000, but protection lasts for years. Though your care provider may not cover the full cost, you might be able to get a reduced rate.
  • Milk it
    Another important item to think about is whether you will breastfeed, as the hormones in some forms of contraception can have a negative impact on your milk or supply. “Generally, contraceptives with estrogen are not considered safe for breastfeeding mothers,” says Redmond. “If you are breastfeeding, you’ll want to choose either a nonhormonal form or one with progesterone only.” Certain types of oral contraception, such as the mini pill, as well as implants and IUDs are safe for breastfeeding, but combination pills are out. And if you’re not currently breastfeeding, don’t worry about the hormones you’re taking now making an impact in the future. “There’s no buildup of the hormones [from birth control in your body],” says Redmond. “It’s definitely safe for you to breastfeed in the future.”
  • Baby one more time
    Finally, consider when you might want to get pregnant again in the future. Talk to your partner about a possible timeline for expanding your family. “Fertility usually returns about one to two months after removal of methods like IUDs,” says Redmond, “but for oral contraceptives, I usually recommend switching to another form of birth control [such as condoms] about three to four months before you want to conceive. It’s usually a similar timeline for the ring and the patch.” Consider how long a method remains effective before you buy it—you wouldn’t want to pay for a pricey three-year method only to remove it a few months later.

Make sure to do your research before you become sexually active again, ideally before you’ve had the baby. Talk to your doctor during a regular pregnancy checkup about when you can start having sex again and which methods of birth control will be best for you. It may seem like a ridiculous conversation to have when you feel about as sexy as a baked potato, but you’re much better off deciding before your bundle of joy arrives than when you’re preoccupied with her every coo and gurgle.

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