With a new baby in the house, getting pregnant again is probably the last thing on your mind. But if you’re up for it, 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 life as a busy mom.
It Starts with Ovulation
After giving birth, your uterus returns to its normal cycle, meaning that you can get pregnant again within a month. 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, area physician market lead for The Southeast 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 a week. “If you miss taking one birth control pill, you’re no longer protected from pregnancy,” says Dr. 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 Dr. Redmond.
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Types of Birth Control
There are 11 basic temporary birth control options to consider:
Combination pills: These are oral contraceptives that contain estrogen and progestin and prevent ovaries from releasing eggs.
Extended pills: Extended-use hormonal birth control is when you extend the amount of time you take active hormones to delay your period.
Mini pills: These are birth control pills that do not contain estrogen. Mini pills are often prescribed when women have undesirable side effects from traditional birth control pills.
The patch: As its name implies, the patch is a bandage-like patch you wear. It works like the pill, but you only have to change it out once a week.
Implant: This method involves inserting a small rod under the skin of a woman’s upper arm to administer birth control. It’s effective for up to four years.
Intrauterine devices (IUDs): The IUD is a t-shaped device that’s inserted into the uterus. There are hormonal IUDs and non-hormonal copper IUDs.
Injection: The birth control shot contains the hormone progestin. It prevents ovulation and has to be administered once every 12-14 weeks.
Vaginal ring: Vaginal rings are soft, plastic rings that are placed inside the vagina to release continuous hormones to prevent pregnancy.
Diaphragm: This is a shallow, bendable cup that covers the cervix and the area around it during sex. (Note: A cervical cap is similar, but fits more snugly around the cervix itself.)
Condom: A traditional condom is a stealth-shaped barrier that’s placed over a man’s penis during intercourse. A female condom (or an internal condom), is a pouch that’s inserted into the vagina before sex. Condoms help prevent pregnancy as well as sexually transmitted diseases.
Gel: Recently the FDA approved a vaginal gel that’s applied to the vagina right before intercourse. It changes the PH level of the vagina by making it more acidic, and consequently, harder for sperm to survive and cause pregnancy.
Permanent measures range from tubal ligation (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.
How Much Do I Want to Spend?
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 methods of contraception are out of the average woman’s budget. However, Dr. Redmond says that’s changing. “Because of 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 contraceptive 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 healthcare provider may not cover the full cost, you might be able to get a reduced rate.
Do I Plan to Breastfeed?
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 breast milk or supply. “Generally, contraceptives with estrogen are not considered safe for breastfeeding mothers,” says Dr. 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 on lactation in the future. “There’s no buildup of the hormones [from birth control in your body],” says Dr. Redmond. “It’s definitely safe for you to breastfeed in the future.”
Do I Want Another Baby?
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 Dr. 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.
By Sarah Gilbreath