It is possible to become pregnant three weeks after giving birth, even before you have a period. As some women want to prevent another pregnancy after giving birth, it’s an ideal time for reassessing their options with their partner.
The contraceptive choice and reasons for it vary from person to person, so you are advised to have a consultation with your GP to discuss what methods are most suitable for you and your needs.
What contraception should I choose?
There’s an effective range of options available to you, including the pill and non-hormonal contraceptive methods. You also have long term options (known as LARCs – long-acting reversible contraceptives) including the coil, injection, implant and IUS.
The pill: You can start both the combined and progesterone-only-pill 21 days after giving birth if you’re not breastfeeding, but you will need to remember to take it at the same time every day. Breast milk production can be affected by combined contraception so it’s advised to see your GP for further advice. There is no such concerns with the mini pill. As the most common form of contraception in the UK, it’s a popular choice for many new mothers as they are already familiar with it.
The copper coil: This is a small plastic and copper device which is inserted into the uterus and can be fitted 4-6 weeks after giving birth. It’s an ideal alternative to the hormonal pill and is 99% effective. This is an appealing choice for some women as it’s a long acting form of contraception without the need to take a daily pill.
The IUS (intra-uterine system): is a plastic device that releases the hormone progesterone. It lasts for five years and is 99% effective, but in contrast to the IUD, your periods usually become much lighter and shorter, and may even stop completely. Some women say they are attracted to this method as they aren’t required to take a pill daily.
The injection: A good, effective option, although there is a chance you may put on weight. You can breastfeed while it’s in your system and our advice is to wait until your baby is six weeks old before starting your course. The injection needs to be given every 12 weeks and it may take anywhere from a few months to a year before full fertility returns if you will be trying for another baby.
The implant: It’s 99% effective and can be inserted at any time, being immediately effective if started within 21 days after giving birth. It needs to be fitted and removed under local anaesthetic by a doctor or nurse and lasts up to three years. Some mothers are attracted to the implant as they don’t need to think about contraception for three years once inserted.
Start thinking about the pros and cons of these now, and you’ll be ready for a conversation with your midwife after you have your baby. You’ll have a postnatal check up with the GP about six weeks after the birth and you can talk more about it then as well.
Is breastfeeding an effective contraceptive?
It can be, but you need to be breastfeeding almost exclusively, and frequently, to get the full contraceptive effect. This means no more than four hours between feeds during the day and six at night between feeds. Occasionally using formula milk or expressing milk may not create the same hormonal protection that comes from nursing a baby directly. This is because the hormone prolactin, which stimulates the production of breast milk, has a suppressing effect on the ovaries.
Relying on breastfeeding for birth control – known as the Lactational Amenorrhea Method (LAM) – can provide 98% protection while:
- The baby is under six months old
- You have no signs of periods returning
- You can stick to using breast milk only – no other liquids.
You are fertile about two weeks before your periods return. As you can’t know when it will return, relying on breastfeeding as a sole method of contraception may not be enough.
Tips for resuming sex after childbirth
- Most women wait at least six weeks – but everyone is different, so don’t feel pressured.
- You may have a reduced sex drive and feel disinterested, but don’t worry – try to maintain closeness in other ways such as cuddling and kissing.
- Keep a sense of humour.
- Lack of sleep and general fatigue can make sex seem a chore, but this is completely natural. Speak to your partner and foster an understanding of how you feel.
- Speak to your partner or a healthcare professional if you feel concerned about any physical or psychological aspect of resuming sex.
- Vaginal dryness, and pain from the perineal wound, is common so water-based lubricants can help ease discomfort during sex.
- Fear of getting pregnant soon after giving birth can be a powerful antidote to sex, so it’s worth thinking about contraception.
- Take your time. Resuming a sexual relationship after giving birth is a gradual process.