advice

family planning:
a guide to postnatal contraception

If you’ve just had a baby, you and your partner are probably so exhausted that sex seems like ancient history. Once you’re in the swing of things though, things soon change. Planning ahead can save the stress when they do.


your fertility after birth

Incredible as it seems, your body can be ready to conceive again just three weeks after giving birth. Many of us assume that we’re not fertile until we start having periods again – but as ovulation occurs about two weeks before you actually have a period, there’s no way of knowing whether those little eggs are being released again. Because of this, even if you’re not planning to have sex for a while longer, it’s worth looking into what types of postnatal contraception are available.

pregnancy and breastfeeding

Cleverly, breastfeeding can act as a contraceptive. This natural method of birth control is called Lactational Amenorrhoea Method (LAM). However (and it’s a big however), you must be breastfeeding your baby on demand, 24/7, and not giving any formula or solid food at all – not even a dummy. LAM only works if your baby is under six months old and your periods haven’t returned. It’s unclear whether expressing milk has any effect.

If you stick to these conditions, it’s estimated that LAM is 98% effective as a postnatal contraception.

short-term contraception


  • condoms – the postnatal contraception of choice for many couples. Convenient, easy to buy, and 94-98% effective
  • diaphragm – you’ll need to wait until six weeks after the birth to be fitted with a new diaphragm as your cervix will change shape
  • natural method – this can be tricky to establish after birth, as your cycle takes time to settle down. Speak with your GP or family planning service for advice

the contraceptive pill


  • combined pill – you can start taking the pill just three weeks after having your baby. However, it can’t be used if you’re breastfeeding
  • mini pill – the progesterone-only pill can be used if you’re breastfeeding. However, to be 99% effective you have to take it at the same time each day
  • emergency contraception – most GP surgeries can supply this, and you can buy it over the counter. If you’re breastfeeding, let your doctor or pharmacist know: Levonelle is safe for lactating mums, but prescription-only EllaOne isn’t

long-term contraception


  • coil (IUD) – can be fitted six weeks after giving birth. It lasts for three to eight years and is 98-99% effective
  • IUS – can also be fitted six weeks after giving birth. It remains in place for five years, and is 99% effective
  • the implant – can last up to five years. It can be inserted from three weeks after birth and is 98% effective
  • the injection – can be given five days after the birth (or six weeks if you are breastfeeding). It typically lasts for two to three months

sterilisation

There is, of course, also the option of sterilisation. If either you or your partner wants to be sterilised, take time to think about it carefully – it’s very hard to reverse the process. If after a while it still seems like a good option for your family, speak to your GP.