The main points
- The contraceptive choices you have depend on your needs and whether or not you are breastfeeding
- If you are not breastfeeding, you can choose any type of contraception
- Using an effective method of contraception such as a contraceptive implant or intrauterine device (IUD) will help in preventing an unplanned pregnancy
Contraception after you have a baby
After having a baby, using an effective method of contraception such as a contraceptive implant or intrauterine device (IUD) will help in preventing an unplanned pregnancy. The contraceptive options you have will depend on your individual needs and whether or not you are currently breastfeeding.
When deciding which contraceptive method is suitable for you, it is important to know:
- what each method involves
- how the method works
- how reliable the method is
- when you can start using it
- when it will start to work
It is important to remember that no contraceptive method is 100% effective and some methods are more effective than others.
Recommended options if you are currently breastfeeding:
The contraceptive implant
The contraceptive implant (sold as Implanon NXT®) is a small hormonal rod (4cm long, 2 mm wide) inserted under the skin of the arm (usually on the inner side of the arm, at the top) and can be inserted straight after you have had your baby. It is more than 99.9% effective in preventing pregnancy and is immediately effective when inserted in the first 5 days of your menstrual cycle.
Only a very small amount of the dose is passed on to your baby through breastfeeding and it does not affect the amount of milk you produce. It is easy to remove if you are having problems or if you want to have another baby. After removal, the chances of getting pregnant will quickly return to normal.
Intra Uterine Device (IUD)
These devices, which are fitted into the uterus (womb) by a trained doctor, are small, plastic and T shaped with a nylon string at the end. There are two types – a copper IUD and a hormonal IUD. Both types last for 5 to 10 years.
Both the copper and hormonal IUD (sold as Mirena®) can be inserted after having a baby, but you will need to wait at least four weeks from the time your baby was born.
They start working quickly and are at least 99% effective. Usually, both types are easy to remove if you are having problems or if you want to have another baby. After removal, the chances of getting pregnant will quickly return to normal.
The contraceptive injection
If you decide to use the contraceptive injection (sold as Depo-Provera®), you may be advised to wait six weeks from the time your baby was born. However, it can be started straight after giving birth.
Only a very small amount of the dose is passed on to your baby through breastfeeding and it does not affect the amount of milk you produce.
The contraceptive injection is 94-99.8% effective. If you stop using Depo-Provera® it may take some time for the chance of getting pregnant to return to normal.
The mini pill
The mini pill can be started straight after you have had your baby and is 91-99.7% effective in preventing pregnancy. However the timing of taking a tablet is very strict which can be difficult with a young baby.
The combined pill and vaginal ring
These methods contain oestrogen and cannot be used until your baby is at least 6 weeks old. These methods are 91-99.7% effective.
You can use male and female condoms as soon as you start having sex again. Condoms are 79-98% effective in preventing pregnancy.
As well as helping to prevent pregnancy, condoms provide the best available protection from sexually transmissible infections (STIs).
The Caya® diaphragm
The Caya® diaphragm cannot be used until your baby is at least 6 weeks old. The Caya® diaphragm can be bought without a prescription from the pharmacist. It is important that a doctor or nurse checks that the diaphragm is a good fit for you. The Caya® diaphragm is 82-86% effective in preventing pregnancy.
Breastfeeding to avoid pregnancy
If you are considering using breastfeeding as a method of contraception, you should speak with a doctor or nurse beforehand.
Breastfeeding is 98% effective in preventing pregnancy, but only if:
- you have not had a period since your baby was born and
- your baby is less than six months old and
- you are only breastfeeding, meaning your baby is not having any other food or drink.
Once your periods return or you start giving your baby other food or drink and you do not want to become pregnant, you will need to use another method of contraception.
Natural family planning
Natural family planning involves monitoring a range of bio-physical changes that happen during your menstrual cycle, letting you know when to avoid having sex to lessen your chance of becoming pregnant.
It is 76-99.5% effective, depending on how well you use it and the monitoring method you choose.
You will need to learn natural family planning from a specialist who may recommend using more than one method at the same time. It can be difficult to use this method when breastfeeding.
Sterilisation is a permanent surgical method of contraception that is more than 99% effective in preventing pregnancy.
Women can choose to have a tubal ligation or tubal occlusion and men can have a vasectomy. These methods involve relatively minor surgical procedures.
Tubal occlusion and tubal ligation are best performed at least three months after you have had your baby. However, it is often recommended that you wait a little longer, as caring for a young baby can be stressful and it may not be the best time to make a permanent decision.
Emergency contraception (EC)
Emergency contraception reduces the risk of pregnancy after unprotected vaginal sex with a male partner. EC should be taken as soon as possible, preferably within 24 hours, after unprotected sex. There are 3 types of emergency contraception available in Australia.
Emergency contraception containing levonorgestrel is available under many brand names.
These are safe to use while breastfeeding and can be purchased from a pharmacist without a prescription.
Ulipristal,(brand name EllaOne®) is not recommended if you are breastfeeding. It is only available with a doctor’s prescription.
The copper IUD (see above under Intra Uterine Device) is the most effective method of emergency contraception. It must be inserted within 5 days of unprotected sex.
Recommended options if you are not currently breastfeeding:
If you are not currently breastfeeding, you can choose any type of contraception.
You can start using the Pill or vaginal ring six weeks after you have had your baby.
The contraceptive injection (sold as Depo-Provera®), can be started straight after your baby has been born.
For all other methods, the recommended starting time is the same as for breastfeeding women.