For the best part of a year now, you haven’t had to worry about such things as contraception – but now the subject returns.
If you are breastfeeding, the choices of contraceptive methods are different to what they were previously.
Post delivery sexual intercourse should be avoided until after the bleeding has stopped, and then can be resumed as normal.
Your period may not return for some time. The range of time that you have amenorrhea (no periods) varies greatly with some women having their first period within the first couple of months and others not for more than six months. Below is a summary of the contraception methods that may be used if you are breastfeeding.
LAM Lactational Amenorrhea Method. This is actually a very successful method of contraception and is very underutilised in the first six months of the baby’s life. As long as:
• The mother is exclusively breastfeeding – both day and night, with no supplemental feedings and very little pacifier use,
• The baby is less than six months old
• There have been no periods – in which case there is 98% protection against a pregnancy
It is important to understand that as soon as there is a decline in breastfeeding or the baby starts having supplemental feeds or feeding less often, the contraceptive protection decreases and other methods should be considered. If you are interested in this method of contraception, there is a very good article on the Australian Breastfeeding Association website. Otherwise, speak to Angela for more information.
1. The Mini Pill
The mini pill is a contraceptive that contains only progestogen, a synthetic version of the hormone progesterone. It is more than 99% effective but MUST taken at the same time each day.
Implanon is the commonly used implant in Australia. It lasts for three years. It is a small thin flexible tube, containing progestogen, which is slowly released. It is usually inserted by your GP and has a 99% effectiveness rate.
3. Intrauterine Devices
IUDs. Mirena and Multi Load IUDs may be inserted at your postnatal visit if you have had a vaginal birth and at six months post partum of you have had a caesarean.
Women who experience painful or heavy periods often use the Mirena IUD. Progesterone is slowly released, which assists in reduction of the bleeding. It is a very effective form of contraception and can be used for up to five years before a replacement is needed. Fertility will not be affected, and it may be used during breastfeeding.
4. Barrier methods
The most common barrier method is the use of condoms, they are easy to use, contain no hormones and if used properly offer 98% effectiveness as a contraceptive. Female condoms are also available but tend not to be as popular or as easy to use as regular condoms.
Diaphragms are soft circular domes made of rubber or silicone that fit over your cervix. If you were using a diaphragm before pregnancy, you will need to have a new one fitted, as your body will have changed. Diaphragms are up to 95% effective if used correctly and with a spermicide.
There are injectable forms of progesterone, which can provide contraception for 12 weeks. Depo Provera is probably the most commonly used in Australia. A small amount of progesterone will reach your baby but is not believed to be harmful. This method offers 99% effectiveness and is given by you GP. If you wish to get pregnant again fairly soon after stopping contraception, this may not be the method for you, as it often takes several months for your fertility to return to normal.
6. Emergency Contraception.
If you have had unprotected sex and believe that you may be fertile again then you can get the “morning after” pill from your GP, or pharmacist or the Accident and Emergency Department of your local hospital.
Do not be surprised if, during orgasm your milk leaks or sprays out. This is due to the Oxytocin release. To minimise this happening, you may like to feed the baby or express beforehand. You may also find the need to use a lubricant, such as KY jelly, as the hormones of breastfeeding often cause vaginal dryness.
By Angela Smith
Midwife & Lactation Consultant