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Postpartum Birth Control

By Doula Jen

…because you CAN’T rely on the temporary menopause brought on by breastfeeding.  Why?  Menstruation is the AFTERMATH of ovulation.  The egg comes first.  So, even if you have yet to see a period post-birth, you can’t be sure that an egg has yet to drop.

So, let’s talk about some of the more common options:

Combination Hormonal Contraceptive:

Contains both estrogen and progesterone and includes many brands of the pill, injections, the patch, and the ring.

Pros:  Highly effective compared to barrier methods, convenience in case of the shot and patch.

Cons:  Estrogen-containing contraceptives are not recommended for breastfeeding moms and almost always lower the milk supply.  Beyond hormonal changes to the breastfeeding situation, many women feel uncomfortable with the other hormonal side-effects common with the pill including moodiness, fatigue, and breast tenderness.  

Progesterone Only Contraceptive:

No estrogen here.

Pros:  Same as the combo but with reduced risk to milk supply.

Cons:  There are still some incidents of damage to milk supply and it is not recommended for use until 6 weeks or so postpartum (you’re not supposed to have sex until then anyway).  Also, both pills leave a considerable room for error as the mother in question (who is exhausted) must remember to take the pill or schedule the shot.


A small U-shaped device, made of either plastic or copper (which has sperm fighting properties). This is secured in the uterus and can be left in for up to 12 years.

Pros:  Extremely effective and long lasting.  Generally safe and comes in hormonal and non-hormonal varieties.  Most effective on women who have already been pregnant and given birth.

Cons:  You need a health-care professional to place the device; the procedure is costly and often not covered by insurance.  Often leads to heavier and sometimes irregular periods.  Small risk of infection and slightly elevated risk of ectopic pregnancy in cases of contraception failure.


Vasectomy or female sterilization. 

Pros:  About as effective as it comes and the peace of mind can make romantic relations more fun.

Cons:  Involves major surgery and while reversal of a vasectomy in particular is becoming more common, it is expensive and not guaranteed.  You’d better be certain that you’ll have no regrets!

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This old school multi-use barrier method is still fairly popular today.

Pros:  Fairly effective when used in combination with spermicide.  Not very noticeable for a barrier method; feels quite like using nothing at all.  Reusable (cost-effective, enviro-friendly).

Cons:  Room for error.  Can be an afterthought when foreplay happens spontaneously.  Risk of infection or toxic shock when not washed properly or when left in for too long.  Must be left in for at least 6 hours after sex which may be a nuisance for some.

Male Condom:

Often the first birth control experience, it might not be the sweetest option for parents in a committed relationship.

Pros:  Fairly effective when used correctly, every time, and with spermicide.  Somewhat affordable.  Portable.  

Cons:  Room for error.  Can ruin the mood/take you out of the moment.  Lessens sensations for some and often diminishes the feeling of intimacy.  If you can’t locate one in the heat of the moment, what do you do?  And that leads us to…


Otherwise known as “pulling out.”  You’d better know what you’re doing!

Pros:  Can be a very effective way of preventing pregnancy while preserving the intimacy–as effective as a barrier method when done correctly every time.  

Cons:  Interruption of connection upon one partner’s orgasm.  HUGE room for error if the man is not extremely skilled at predicting and controlling ejaculation.  Some have it down to a science…a MUST if you are going to use this method!  

Fertility-Awareness Based Methods:

Also Natural Family Planning (NFP) or The Rhythm Method.

Pros:  A great way to get to know your reproductive system!  You may be become more in-tune with your body and furthermore the world around you.  Can get you in touch with when you CAN get pregnant for when you’re ready to try to conceive again.  No barriers, hormones, or devices needed.

Cons:  Really only reliable for women with reliable cycles and strong ovulation symptoms.  Otherwise, less effective than any other method.  When done most diligently, involves charting and checking and all sorts of things that tend to make sex seem more clinical and less lovely.  Also, guess what?  The “danger-zone” time of the month is when the woman is biologically most inclined to want sex!  That’s kind of a bummer and can make you feel OUT of sync with the bio rhythms.  If this method appeals to you, you might want to consider combining it with a barrier or withdrawal when in the “danger zone.”  


These of course are just a few options.  The sponge and cervical cap are valid, however less effective for women who have already had children than–say–the diaphragm.  The female condom is hard to use correctly.  Spermicide alone isn’t very effective.  This brief list gives you a starting point from which to fully research and choose the method (or combination of methods) that’s right for you.

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