Breastfeeding and Birth Control
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It is exhausting, just having had the baby! One thing is for sure: you do not want another one any time soon. This is also best for you and your baby’s health. During breastfeeding several safe and effective birth control methods are available.


Hormonal Methods

  • Birth Control Pills: You might have heard that hormonal birth control pills can affect your milk supply. This is not entirely true. It depends upon the type of hormones present in your pill. There are two types of pills. Mini pills that are progestin only and combination pills that contain both estrogen and progestin. Estrogen pills can reduce your milk supply [1] but progestin only pills do not have any such effect at all [2]. This is the one that would be likely prescribed to you if you are breastfeeding. However, if your doctor thinks combination pill is better for you, they will wait 5 to 6 weeks before they prescribe that to you.
  • IUDs: If you want a long term birth control, your doctor can install an IUD into your uterus. However, it is only done 6 weeks post-partum. There are two types of IUDs, the one that contains copper and the other that contains the hormone progestin. Either one is suitable for nursing mothers. [3]
  •  Implants: An implant is a hormonal birth control method. It comprises of a small stick that is installed under the skin of your upper arm. It contains only progestin so it does not interfere with your milk supply. It can provide protection for up to three years. [4]
  •  Injections: Birth control shots are given every three months. They contain progestin only.
  •  Patches: A birth control patch is peeled and is made to stick on your belly, back, stomach, or butt for a week at a time. The patch contains both hormone estrogen and progesterone just like the combination pill so it may not be the best option for you right after birth. However, it can be prescribed after 6 weeks when your milk supply has established.
  • Vaginal Ring: you place it in your vagina and it is kept there for 3 weeks at a time. This too contains both estrogen and progestin so not a suitable option before 6 weeks post-partum.


Barrier Methods

  • Condoms: Condoms are a safe and easy to use birth control method. If combined with a spermicide, the protection is further increased.
  •  Diaphragm: Your doctor can fit one 6 or more weeks after delivery when you have had enough time to recover from the delivery. If you had a diaphragm before birth, see if it still fits. If not, you may need a new one.
  • Cervical Cap: A cervical cap covers the uterus and bans the entry of sperm into the uterus. If you had one before you gave birth, you make check if it still fits. Most women need a new one due to significant expanding of cervix.


References
[1] https://www.cochrane.org/CD003988/FERTILREG_hormonal-and-nonhormonal-birth-control-
during-breastfeeding
[2] https://my.clevelandclinic.org/health/drugs/15280-contraception-during-breastfeeding
[3] https://healthcare.utah.edu/publicaffairs/news/2017/08/iud-breastfeeding.php
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273969/

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