Life goes on after you’ve had a baby. Here are few things to think about.
There are lots of choices for birth control postpartum. We talk about birth control choices in three tiers. Tier 1 choices are most effective, while Tier 3 choice are least effective.
- Tier 1
- Intrauterine Devices (Mirena, Skyla, Kyleena, Liletta, ParaGard)
- Implant (Nexplanon)
- Sterilization (female and male)
- Tier 2
- Combined oral contraceptive pills (OCPs – “The Pill”)
- Birth control vaginal ring (NuvaRing)
- Birth control patch (Xulane)
- The shot (Depo-Provera)
- Minipills (norethindrone-only pill)
- Tier 3
- Withdrawal method
- Fertility awareness-based methods or natural family planning (NFP)
When picking a birth control method, ask these questions:
- How well does the method work?
- Can I use it while breastfeeding?
- Will it affect my ability to breastfeed?
- How soon can I start it?
- How well do other women like it?
This chart answers these questions for you:
Notice that aside from male sterilization methods, the hormonal IUDs are associated with the highest efficacy and highest patient satisfaction. This high rate of patient satisfaction reflects a low rate of complications and side effects. The Tier 1 methods in general are the best choices, with the lowest rates of unintended pregnancies, highest continuation rates, highest patient satisfaction rates, and lowest side-effect rates.
None of the Tier 1 methods interfere with breastfeeding. Though the IUDs and implant can be started immediately after delivery, most hospitals in the United States don’t offer this choice; most women still get them in the office at 4-6 weeks after delivery.
There is a myth that combination birth control pills can’t be used with breastfeeding because either they will diminish milk volume or because the hormones will pass through the breast milk and affect the baby. Neither of these things are true. However, because the systemic hormones in the Pill, Patch, and Ring can increase your risk of blood clots, they shouldn’t be started immediately postpartum.
For more information and pros and cons of each method, read here for more.