Contraception after having a baby

Reviewed by Dr Neel Patel

For new mums, contraception may be at the bottom of the to-do list, but it's important to think about it. 

It’s possible to get pregnant as soon as three weeks after you’ve given birth, even before your periods return, so if you’re sexually active after having your baby, you should be using contraception – unless you’re keen to get pregnant again!

Contraception methods for new mothers aren’t any different to what you may have used in the past, but – depending on the type, and whether you’re breastfeeding – you might need to wait to use it.

When can you start contraception after giving birth?

Contraception should be a consideration soon after or even before you give birth. This is because it’s possible to get pregnant again about 21 days after you’ve had your baby. Even if you’re breastfeeding and your periods haven’t come back yet. 

Even if it’s not on your mind, it’s normal for midwives and hospital staff to ask you about your contraception plans soon after you’ve had your baby. You’ll normally talk about it while you’re in hospital after giving birth, and once again at your postnatal check, six to eight weeks later.

You can bring up the topic of contraception at any time with your midwife, health visitor, or GP – even while you’re still pregnant.

Fertility after birth

You can get pregnant again in as little as 21 days after giving birth. Although the time it takes for fertility to return will be different for everyone, if you’re having unprotected sex you’ll need to consider contraception. 

What kind of contraception can I use straight after birth?

There are a few types of contraception that are completely safe to use straight after you’ve given birth – provided you don’t have any specific medical risks.

It’s safe for new parents (breastfeeding or not) to use any of the following:

• The contraceptive implant

This is a small piece of flexible plastic fitted under the skin of your upper arm that releases a synthetic version of progesterone.

• The contraceptive injection

This is an injection of synthetic progesterone given every eight to 13 weeks.

• The Intrauterine contraception (IUC)- the copper coil (IUD) or hormone coil (IUS)

This is a small T-shaped device, with or without hormones, that sits inside your womb. It can be inserted at the time of giving birth, and lasts for 3-5 years depending on the type.

A coil can be fitted immediately after birth. If it's not inserted within 48 hours you need to wait for four weeks to have it put in.

• The progestogen-only pill

This is a contraceptive pill (also known as the mini pill) that is taken orally every day.

• Male and female condoms

When can I start taking contraceptive pills after giving birth?

The progesterone only pill (POP or mini pill) can be started straight after giving birth. Lots of women use the combined pill for their contraception, and may be keen to restart it after they’ve had their baby.

The combined pill contains synthetic versions of oestrogen and progesterone. It can be taken by new mums but not directly after birth. The same goes for the vaginal ring and the contraceptive patch, which are two other forms of combined contraception.

• If you’re not breastfeeding, you can usually start combined contraception three weeks after giving birth (provided there is no medical risk)
• If you're breastfeeding, you’ll need to wait at least six weeks to use combined contraception

Can I use a diaphragm or cap after giving birth?

You can use a diaphragm or cap for contraception from six weeks after giving birth. If you've used one before, please don't start using it again before you've had a check up: you may actually need a different size now.

Emergency contraception after birth

If you have unprotected sex and you don’t want to get pregnant, you can use emergency contraception, even if you’re breastfeeding. There are two morning after pills available - Levonorgestrel and ellaOne. Either of these can be taken if you are formula feeding your baby, if you’re breastfeeding there are a few things to consider. 

You can also have the IUD copper coil fitted as a form of emergency contraception – however this can normally only be fitted from four weeks after you’ve given birth. 

The best option for breastfeeding mums is the morning after pill Levonorgestrel. However, you should avoid breastfeeding for at least 8 hours after taking Levonorgestrel. You should use a breast pump to keep up your supply up, but your baby shouldn’t drink any of your expressed milk for 8 hours following the tablet. 

The morning after pill, ellaOne is an effective form of emergency contraception, but we don’t know how safe it is for breastfed babies. It’s recommended that new breastfeeding parents who take ellaOne for emergency contraception should not breastfeed their baby for one week after taking it.  You can still pump to maintain your supply but your expressed milk should be thrown away. You’ll need to take this into consideration when choosing an appropriate form of emergency contraception. 

Breastfeeding as contraception

It’s possible to get pregnant after birth even if you’re breastfeeding and your periods haven’t come back yet.

Having said this, this is uncommon and studies have shown that exclusive breastfeeding prevents pregnancy in 98% of cases. Not having periods due to breast feeding is called "lactational amenorrhoea" and can be used as a method of contraception. It is only reliable if:

• You’re breastfeeding exclusively, meaning your baby doesn't get anything other than breastmilk
• Your baby is less than six months old 
• Your periods haven’t started again

If you start breastfeeding less often, or if there are very long intervals between feeds, you stop night feeds or you are giving your baby other liquids, breastfeeding is not a form of contraception.

When do periods start after birth?

Everyone’s body is different, so it’s hard to say when your periods will start again after you’ve given birth. Your period could return as soon as 5 to 6 weeks after birth. This may be the case if you’re bottle feeding or combining breastfeeding and bottle feeding.

If you’re exclusively breastfeeding your baby, your periods may take longer to return. You might not get your period again until you completely stop breastfeeding, stop breastfeeding at night or introduce your baby to solid food at around 6 months. 

After having a baby your periods may change too, they could be:

• Irregular - the length of your periods and the time in between may be longer
• Painful - periods cramps may be more or less painful than you’re used to
• Heavier - you may notice clots of blood in your period. If your periods are heavier or you notice blood clots you should speak to your GP.

How long after giving birth can you have sex?

You can have sex again whenever you’re ready! However, your body will need time to recover, and you might feel sore for a while, so it’s important not to rush yourself.

When you’re ready to try, using a lubricant can be really helpful as it can reduce discomfort and friction. Remember too that sex doesn’t always have to be penetrative – oral sex and intimate touching can be a good way to ease yourself back into sex.

If you have any concerns about your sex life after having a baby, talk to your midwife or health visitor. It can also be helpful to communicate with your partner about what you’re feeling.

How soon after giving birth can you get pregnant?

Sex may be the last thing on your mind after you’ve had a baby, you’ll most likely be tired and sore. However you’re feeling about sex, it’s a good idea to think about contraception and your options if you don’t want to get pregnant again. Even if your periods haven’t started again or you’re breastfeeding, you can get pregnant in as little as three weeks after birth. 

You can speak to your midwife or GP any time about contraception after the birth of your baby, you’ll also have a six week postnatal check where you can talk through your contraception options. If you’re having sex in the meantime you’ll need to use condoms. 

What are permanent methods of contraception?

Sterilisation is a permanent method of contraception, which is more than 99% effective in preventing pregnancy. It may be an option for you if you are certain you don't want any more children or if  being pregnant again would be dangerous for your health.

Sterilisation for women is a procedure that blocks the fallopian tubes, so an egg cannot travel to the womb to be fertilised by sperm. Sterilisation for men known as vasectomy is when the tubes that carry sperm are cut or sealed to stop sperm being released when men ejaculate.

Once the procedure has been confirmed as successful you won’t need to think about contraception again, however sterilisation does not protect you against STIs. 

Conclusion

After the birth of your baby, sex and contraception might be at the bottom of your list. But as you adjust to your new routine and feel like becoming intimate with your partner, you’ll want to explore your contraception options after birth. If you were taking a contraceptive pill before you became pregnant you may want to use these again or perhaps you’d like to explore another option. 

For more information about contraception, visit our advice hub. You can also browse contraceptives available from Online Doctor at our online clinic.

References

https://www.nhs.uk/conditions/contraception/when-contraception-after-baby/
https://www.fpa.org.uk/sites/default/files/contraception-after-having-baby-your-guide.pdf
https://www.nhs.uk/conditions/contraception/contraceptive-implant/
https://www.nhs.uk/conditions/contraception/contraceptive-injection/
https://www.nhs.uk/conditions/contraception/iud-coil/
https://www.nhs.uk/conditions/contraception/ius-intrauterine-system/
https://www.nhs.uk/conditions/baby/support-and-services/sex-and-contraception-after-birth/
https://www.nhs.uk/conditions/contraception/emergency-contraception/  
https://www.health.harvard.edu/blog/can-breastfeeding-really-prevent-pregnancy-202203022697
https://patient.info/sexual-health/contraception-methods/contraception-after-having-a-baby
https://www.nhs.uk/common-health-questions/pregnancy/when-will-my-periods-start-again-after-pregnancy/ 
https://patient.info/sexual-health/sterilisation