What to Consider When Choosing Birth Control After Having a Baby
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2018 Update: We still think this is a great discussion of birth control after having a baby — but you may also want to check out our more recent roundup of the best birth control options in 2018, over at Corporette.
Choosing birth control before you were a mom was complicated enough . . . but we thought we’d talk about birth control considerations after having a baby. We haven’t talked a lot about birth control here (although a few years ago we had a post over at Corporette about IUDs), so we thought it’d be a great topic to discuss today. What did you consider when choosing birth control after having a baby? Were you concerned about breastfeeding, hoping to get pregnant again soon, or worried about other issues? Are you using the same type that you did before getting pregnant, or did you switch to something else?
What were (or are) your deciding factors? The efficacy of the method? The potential side effects? The length of time that it stays effective? Whether it’s hormonal vs. non-hormonal? Whether or not you’re planning to have another baby soon?
Here are some pros and cons that moms find themselves considering when deciding on birth control after having a baby:
- Breastfeeding: If you breastfeed your baby at least every four hours during the daytime and at least every six hours at night (and you don’t supplement with formula), your body won’t ovulate. (But talk to your doctor and lactation consultant about this — there are a lot of caveats, as described in this Self article.) However, when your baby turns six months old, you’ll start ovulating again. (Psst: here’s our last discussion on crazy hormones while weaning from breastfeeding.)
- Birth control pill: If you’re still breastfeeding/pumping, your doctor will probably tell you to avoid the combination pill because it contains estrogen, instead recommending the progestin-only “mini pill” (which isn’t quite as effective). Last December brought news of a new study (NYT) that confirmed previous studies’ findings that the pill increases breast cancer risk — but that was followed up with articles reminding women that it reduces the risk of other types of cancer (NYT).
- IUD: You may not want to use this method (either the copper IUD or hormonal IUD) if you’re thinking of having a baby within the next few years (although it’s easy to remove, and you can get pregnant right away). Doctors usually recommend waiting six weeks after giving birth to get one. (Here’s an old guest post on Corporette detailing one woman’s experience with an IUD.)
- Permanent birth control:
Essure involves a non-surgical procedure that blocks the fallopian tubes, and it’s 99% effective — but so many women have had problems that it now has an FDA “Black Box” warning. (Of course, many more have had no issues at all.)[Update: Essure will no longer be sold in the U.S. after 2018.] The old standby, tubal ligation, is more than 99% effective as well. Of course, the least painful, safest option for a mom is to have her partner get a vasectomy — and it’s much more effective than a tubal ligation. However (perhaps not surprisingly), the vasectomy rate in the U.S. is about half of the rate of tubal ligations. - None, because babies: Some moms simply take a break from birth control because the only things they’re currently doing in bed are breastfeeding, sleeping, and wishing they were sleeping.
(Not to mention the many other sorts of birth control, including natural family planning, etc. — Planned Parenthood’s website is a great place to research any of them.)
If you’re trying to avoid pregnancy right now, which birth control method are you using? Are you happy with it? What have you used in the past that you’ve had good or bad experiences with, either before or after you became a mom? Have you conceived a “surprise” baby when you were on the pill or using another type of birth control? What’s your advice for other moms on what to consider when choosing birth control after having a baby?
Picture via Stencil.
Since my very first period, my cramps were out-of-control bad so I tried progesterone pills to mellow it out, ortho-tri to regulate my cycle, etc. since I was 13 years old. By the time I was 16 I realized that severe depression is a very real risk for me on heavy hormonal bc pills and I stopped using it. I tried other pills (huge pigment spots on my face, not a good look) and even the depo shot (bled daily for 3 months, no thank you). I used condoms/abstinence the rest of the time in college and then got a copper IUD pre-kids from planned parenthood while I was in grad school. That worked really well until TTC, likely caused a uterine polyp that interfered with #1, used no bc in between #1 and #2 since we were told we were borderline infertile, planned to go on BC again after #2 but before my cycle started (14 months pp, while I was still bf #2) I ended up with #3. Hubby got snipped after #3 and we used nothing for a year. Then, a week after #3’s first birthday I got pregnant with surprise!#4. Sigh. She’s 7 months now and I’m starting to daytime wean because I’m so tired of pumping. Still no period evident, which I’m happy about. I didn’t start ovulating until almost 12 months pp with the other kids either.
I have a copper IUD again, and since I’m 40 it should last until menopause. Because there’s no way I need #5. Moral of the story: if the vasectomy happens, continue to get him tested until it comes back “zero live sperm” from a FERTILITY LAB. The urologist did a quick check in his office, said there were zero, accused me of whoring around (not in so many words) and then we got a second opinion. A count of 2 million is technically infertile, but not infertile enough.
Ugh, birth control. Fun times. I am almost 40 and have been on the pill since I was 17… Eek. So the news of the new study kind of freaked me out. My ob/gyn says it’s fine for me to stay on the pill, however (when I asked before that big study). I wish I had known I was going to have a C-section when I had my son years ago, because I would have asked them to do a tubal ligation as well, grrr. I was so out of it at the time that I didn’t think about it in the moment, and maybe they wouldn’t have anyway. I’m not crazy about the IUD option (my ob/gyn says they’re a great option for me though), and my reasons for staying on the pill for now is that my periods are totally scheduled, I don’t have side effects on the one I use, and … I love what it does for my skin. Yes, that’s a shallow reason. I’m not sure if my husband would agree to a vasectomy or not, but maybe he would if I remind him about my two-day labor… two-day back labor.
Abstinence so far. 100% effective, but often dissatisfying.
But now I’m starting to think about dating again (how’s that for noncommital?) and wondering what I should use. I am more concerned about STDs from new partners, so I guess condoms are the way to go. But I’d like a less in-the-moment option just in case; I really don’t want to be a single working mom of an infant ever again. Hormonal BC completely changed my taste in men (I went from liking normal, geeky, smart guys to wanting to take care of whiny emo guys and hey voila, ex husband!), so I’d like to avoid that until/unless I find a long-term partner.
I’m thinking of an IUD but I don’t really understand the “strings” issue. Are they really strings or stiffer than strings? And do I need to do anything with them? Will *I* feel them all the time? Because that’s a no for me.
I had a tubal ligation during c-section. I was almost 41, and had 2 complicated pregnancies. Clearly the right decision for me.
Prebaby – I used the ring, which was amazing. I loved it. I had tried various pills but they all made me nuts.
Postbaby – I was advised against the ring because I was breastfeeding, and all my health care providers and my friends raved about the IUD. I got it but I’m not a huge fan. My husband can feel the string, my periods are unpredictable and although they are much lighter, they last WAY longer than they used to be (from 5 days to 10+ days). Plus I’ve been advised against using the DivaCup with the IUD because apparently the suction can dislodge it, so that just makes the whole experience less pleasant. I was also pretty uncomfortable for the first few weeks after it was inserted (though the actual insertion was nothing at all). After the next baby, I’m not sure what I’ll do.
I had a very bad reaction to hormonal birth control when I first went on it right after becoming sexually active, so condoms were my only method of birth control from age 20 to age 34 – never had an accident. Once we started trying, I became pregnant immediately at age 34 so clearly no fertility issues and the condoms were doing their job for many years. The long term plan is for husband to get snipped but we’re using condoms until we’re 100% sure we’re one and done (95% sure now). My husband and I both kind of like using condoms – he lasts longer and there’s no mess – and they’ve been very reliable for us so I’ve never really considered an IUD or trying hormonal BC again.
Pre-child, I took the pill and didn’t seem to have many side effects. When I went back on it post-baby, I didn’t tolerate it nearly as well, it gave me horrible mood swings, and decided to go off of it. Got a Mirena after that. I’m due to replace it this year, but I’m not sure I want to. The first few years with it, my cycle was light to non- existent and now it lasts for a week. I’ve had a much harder time losing weight too. I’m moodier too. I don’t know if these age related or IUD related, but taking out the IUD may provide some answers Our family is complete and DH has said he’s fine with getting the snip. Having him actually get that scheduled may take some time. At the same time, I feel kinda bad asking him to take a permanent step if I decide to go back to an IUD for cycle control or something.
I want to put in a plug for FAM/NFP, which I am currently using (and is not to be confused with the old “rhythm method”). With perfect use the efficacy rate is in the high 90s; with typical use, it’s in the 80s, which is comparable with many forms of contraception. It takes a little bit of daily effort/action, especially postpartum, but it has zero side effects, and it’s been fascinating to understand and track my fertility. So, if you’re feeling a little bit crunchy, I recommend it.
One thing that surprised me was that having a kid changed my hormones, so things that I used to tolerate well no longer were worth the awful side effects. It was very surprising and confusing after being on BC with no issue for a decade, to all of a sudden be at a loss about what I could take. In the end DH got a snip and as of a month ago, I’m not longer on BC. Yay! I think!
Pre kid:
the pill- slight nausea, no big deal
the shot – totally great, no period
implanon – totally great, no period
Post kid:
implanon – nonstop bleeding for months and months
the shot – became an enraged harpy
the patch – extreme breast tenderness and morning-sickness level nausea
Yeah… body chemistry is weird.
I’m on my third Mirena – the first for four years before TTC #1 (pregnant first cycle after removal), the second from 10 weeks postpartum to 12 months postpartum when we TTC #2 (pregnant first cycle after removal), and now the third that was inserted 10 weeks after delivering baby #2. Given how quickly we were able to conceive both times, I’m incredibly confident in the Mirena’s birth control capabilities! I had no adverse effects at any point with Mirena and will likely stick with one until I’m sure that I’m sure we are done having kids.
Mirena was terrible for me, but was easy enough to get out and replace it. I LOVE love love Paragard – had it before TTC, have it now. I haven’t experienced the higher flow a lot of people have, also no increase in cramps. It has been awesome! My feeling with IUD is that if one doesn’t work for you, it’s not a big hassle to try another. YMMV, I guess. I wish I had gone with an IUD 20 years ago.
I am sensitive to all types of hormonal BC, and was hoping Mirena would have a small enough amount that I could tolerate it, but – nope. Highly recommend Paragard (copper) for those with similar issues. As an aside, my husband is more comfortable with the Paragard, too – something is different about the strings.
I was on the pill until we started TTC when I was 27. That took over a year. Then I got the Mirena 8 weeks after giving birth to my son. I was really scared of the insertion pain, but maybe because I got it so soon after giving birth (or because I was still mildly traumatized from the pain of giving birth), I honestly barely felt a thing! I’ve had no complications.
Important side note though – because it took so long for us to conceive, and then I was pregnant after, my DH and I completely and totally forgot about birth control the first time we had sex after I gave birth! Thankfully nothing happened, but I had a mild panic attack right at the mere thought that I could be pregnant again so soon!
I am on my third copper IUD; I had one before kids and then placed again six weeks after each kid. I love it. Periods are long and heavy but it doesn’t interfere with nursing, doesn’t seriously raise my risks of anything and doesn’t require any action. Plan to do copper IUDs in between and after kids until we’re very certain we’re done; then DH will get snipped.
Between 1st and 2nd kids, I used the breastfeeding method. Fortunately it worked out. We were fine having kids close together but in the end, I didn’t start ovulating again until my 1st had forgotten my b**bs even existed (haha, but really – I didn’t get my period until 4 months after I weaned her). I got my first PP period when older daughter was about 14 months old, and got pregnant with #2 when oldest was 18 months. After #2 the dr convinced me to try Mirena, which I HATED. Spotting + discomfort for both my husband and me during gardening. I went back to Ortho Tri Cyclen which worked well for me before kids and also works fine now. I have another medicine that I take daily so I don’t have trouble remember to take the pill.
I have migraines and hormonal birth control cut the frequency in half. (From 1 every six-nine months to 1 every year-18 months. Also had a couple of aura-only/pain free migraines while on the pill.)
I had two migraines in the first six weeks after giving birth. None on the mini-pill (which I took for two years — longer than my daughter nursed).
I’ll take hormonal pills as long as they’ll give’em to me.