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Contraception and Sex
And when talking about sex, the one thing that can’t be missing is contraception. This may be the furthest thing from your mind after just giving birth, but many unplanned pregnancies happen in the first few months after childbirth, so better to be prepared if you want to delay or avoid another pregnancy.
But when is your period going to return? Well, if you are not breastfeeding, the earliest it can start again is six weeks after birth. Bear in mind though, that you can become pregnant before your periods return because ovulation occurs about two weeks before you get your period! So, you need to start using contraception from 3 weeks or 21 days after birth. Don’t wait until you have your postnatal check or for your period to return because you can get pregnant in the meantime! There are about 14 non-permanent methods of contraception you can choose from:
- Male and female condoms – you can start using them as soon as you want to and they are 98% and respectively 95% effective when used correctly;
- Contraceptive implant – you can choose to have an implant as early as three weeks after birth. This is 99% effective, but does not protect against sexually transmitted diseases. This is a good method to use if you are not planning to have another baby in the near future as it can last for three years;
- Combined pill – you can start using this method from three weeks after birth, but only if you are not breastfeeding. If you are breastfeeding a baby younger than six months old, taking the pill can reduce your flow of milk. Unless you start the pill on day 21 after the birth, and choose to start taking it later, you will need additional contraception for the next seven days. This method is 99% effective at preventing a pregnancy;
- Vaginal ring and contraceptive patch – you can start using any of these two methods from three weeks after birth, but only if you are not breastfeeding. If you are breastfeeding and using these methods, your milk flow may be reduced;
- Progesterone-only pill – this is more than 99% effective and you can start taking it on day 21 after birth and be protected against pregnancy straight away. If you start taking it more than 21 days after birth, you will need additional contraception for the next two days after you have starting taking it;
- Contraceptive injection – you can have one at any time after you have given birth and you will be glad to know that it is safe to have one when you are breastfeeding. However, if you are breastfeeding, it is recommended to wait until six weeks after birth before having one, plus you are less likely to have heavy and irregular bleeding then. This is more than 99% effective and lasts for eight or twelve weeks, depending on the type of injection. If you start injections on or before day 21 after giving birth, you will be immediately protected against becoming pregnant, however if you start after day 21, you will need to use other contraception for the following seven days;
- Intrauterine device (IUD) or intrauterine system (IUS) – these two methods are more than 99% effective and can be fitted four to six weeks after giving birth (sometimes even within 48 hours of giving birth). They’re both safe to use when you are breastfeeding as they won’t affect your milk supply. You’ll need to use another method of contraception from three weeks and until the IUD or IUS are fitted.
- Diaphragm or cap – If used correctly with spermicide, either one of these two methods are 92% – 96% effective at preventing a pregnancy. It is recommended to wait at least six weeks after giving birth before using a diaphragm or a cap, and you might also need a different size.
- Natural family planning – although this can be up to 99% effective if instructions are properly followed, estimates suggest it’s actually only around 75% effective because of mistakes. This method will be even more difficult to follow right after birth, as your fertility signs will be affected, hence harder to keep track of. If you are breastfeeding, the fertility signals used in natural family planning methods are not reliable.
- Breastfeeding – While breastfeeding you will not have a period, so you will be glad to know that you use this method – lactational amenorrhoea – as a form of contraception. This can be up to 98% effective in preventing pregnancy, but only if all the following conditions apply:
- You are fully (or nearly fully) breastfeeding, meaning that baby is having breastmilk only, or little or no formula
- You have complete amenorrhoea (no periods at all)
- Your baby is less than six months old
It will help if you are careful the first few times you have sex – you can explore with your fingers to reassure yourself it won’t hurt. Make time to relax together with your partner and take your time. If you and your partner have any worries, be open and talk about them together.
For more information about contraceptive methods after birth, get in touch with your doctor, health visitor or midwife who will be happy to help.