Once you grow a baby, deliver that baby, then spend what can feel like 400 hours a day feeding and changing him or her, sex is rarely at the top of your to-do list. But chances are that at some point after you get the all-clear from your healthcare provider, you will, indeed, have sex again. And birth control is a slightly different ballgame now that you’re postpartum.
Here are five stubborn myths about post-baby contraception that won’t go away — and what you need to know instead.
Myth #1: You can’t get pregnant if you’re breastfeeding.
WRONG. You absolutely can get pregnant while nursing, even if your period hasn’t returned yet. You might not get your period for a while, Dr. Stephanie Pierce, an assistant professor of obstetrics and gynecology at Wake Forest Baptist Medical Center, told The Huffington Post, but that does not mean ovulation has not occurred. Up to 10 percent of women will have ovulated without knowing it, Pierce said.
That’s not to say that breastfeeding can’t prevent pregnancy; rather, women should understand that it’s not fail proof and will be more effective if certain criteria are met. Pierce generally gives her patients the following parameters to determine if breastfeeding will likely keep them from getting pregnant again: You should be exclusively breastfeeding, not yet menstruating and nursing on-demand (or at least every three hours or so during the day, and every five to six hours during the night). She also counsels her patients to use breastfeeding as birth control for only the first six months. Beyond that, the likelihood that the body will start to ovulate is higher.
Myth #2: You can’t take hormones if you’re nursing.
Non-hormonal options, like condoms, are always available to postpartum women — as are non-hormonal, long-acting options, like the ParaGard IUD (more on IUDs below). But there are also several hormonal options that could be a good fit, even if you’re nursing.
“Progestin-only methods do not seem to impact breastfeeding,” said Dr. Michelle Moniz, an assistant professor of obstetrics and gynecology with the University of Michigan Health System. Indeed, the American College of Obstetricians and Gynecologists says that progestin-only pills and injections can be used immediately after childbirth, even while breastfeeding. Of course, Moniz emphasized, it’s essential to talk to your healthcare provider about your specific circumstances. Postpartum women do have a slightly higher risk of blood clots, for example. Furthermore, combo pills, which also contain estrogen, may be suitable to start at least 42 days after giving birth, though there’s definitely some evidence they lead to declines in breastmilk.
Myth #3: You’ve got months before you have to get serious about your options.
In fact, the best time to think about postpartum birth control is really while you’re still pregnant, Moniz said. Your healthcare provider should discuss your options with you while you’re still going in for regular prenatal visits, but if he or she doesn’t, you should absolutely should feel empowered to bring it up. Why the rush? Many women are given the go-ahead to have sex again just six weeks after giving birth, so it’s a good idea to know what your options are — and whether you might need a prescription or anything along those lines — at that point, or before.
Myth #4: You have to give your body time to settle.
Your body actually doesn’t necessarily need a long grace period when it comes to starting contraception. “Assuming a woman does not have a contra-indication, or an infection at the time of delivery, she can have her IUD placed immediately,” Moniz explained. It can be done as soon as 10 minutes after expulsion of the placenta, although there is some increased risk of expulsion of the IUD when the device is placed immediately after birth. A lot of women bleed for the first few weeks after giving birth, and, likewise, a lot of women bleed erratically while their bodies adjust to the IUD. “Many folks see that as a benefit… thinking, ‘let’s just overlap those bleeding periods,'” Moniz said.
But IUDs aren’t the only option available to women. Talk to your doctor about when you can start taking birth control pills, but it’s usually something you can start within a matter of weeks. Or if you’re done having kids and are leaning toward sterilization, you can have a postpartum tubal ligation, Pierce said, that is performed at the same time of a C-section or soon after a vaginal delivery. Again, the key is to know that you likely have options almost immediately after birth, so be sure to discuss them with your doctor or midwife while you’re still pregnant if possible.
Myth #5: If you want to get pregnant again — soon — long-acting options aren’t for you.
Long acting reversible contraception options, such as the IUD, “are very easily reversible,” emphasized Pierce, adding that the return to fertility after removal can be immediate. (She cautioned that there may be some issues when it comes to the predicting return to fertility with Depo-Provera, the birth control shot, so definitely discuss it with your care provider first if you’re hoping to get pregnant again relatively soon.)
And just because long-acting options like IUDs can last for years, that doesn’t mean they necessarily have to. It’s perfectly fine to have an IUD in for, say, a year, and then have it removed when you want to start trying. (Keep in mind, however, that there can be an adjustment period.)
“When you have a newborn, you probably don’t want to think about remembering to take a pill every day,” Pierce said, so if you want to consider something like an IUD, you should. “When you [want] to have another child shouldn’t change your contraceptive options,” she said.
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