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.
I was on the pill or the ring, skipping the placebo week, for almost two decades before going off it to TTC. (I had painful periods so I went on the pill at age 14.)
In between kids, we just used condoms.
Then at my 6 week check up after the last kid, I asked about IUDs and had the Mirena inserted shortly thereafter. Later that year, we realized we were at the family OOP maximum for insurance thanks to birth and complications, so my husband went in and got a vasectomy on Dec 20th or so. I’m leaving my IUD in until it expires, then I’ll probably explore other options, although I desperately want to avoid getting a monthly period so may just stay with an IUD until I have to start thinking about menopause.
Is there even a non-hormonal option that stops your period? Or is it pretty much pill vs IUD vs period? And I’m worried how I’ll even know menopause is starting or is something I have to worry about, if I’m basically ignoring my uterus for all but my yearly checkup.
I have clotting factors and migraines that preclude all forms of hormonal BC. As a result, I ended up abstaining entirely until I was 28 because I didn’t want to risk getting pregnant without a degree and then once I was out of college I just wasn’t in a serious relationship until 28. I tried to get an IUD but apparently my cervix has a crazy hard left turn we discovered trying to insert it so that is off the table, and since I had a scheduled c-section (see clotting factors), it is unlikely my cervix has changed at all. My husband and I used condoms and a sponge (my acne meds strongly recommended two forms of BC). Once I went off the acne meds it was just condoms. Once we started trying, took 2 months to get pregnant, and post baby (5 months) we haven’t bothered because colic + teething + sleep regressions = two very sleepy parents. We will go back to condoms once we get more sleep, but want to space the babies about 2 years apart, so query whether we will need to for very long. Whenever we decide we are having our last kid, I will probably get my tubes tied during the c-section just like my mother did. TBD whether that will be 2 or 3.
My doc refuses to prescribe the pill to anyone over 40. After son was born, I had an IUD until my husband got a vasectomy. I highly recommend the latter. :)
FWIW, I nursed for 2+ years with both my first two kids, and I didn’t start ovulating until at least 16 weeks with both. Nursing baby 3 now and no ovulation yet at 6 months even with her STTN (10-12 hours) since 2 months old!
Did tubal ligation during c-section for baby 3. Husband flat out refused a vasectomy. Sigh.
Can’t multitask today – that should say 16 MONTHS, not weeks.
I had an IUD after my first because we wanted to wait 2-3 years between kids. However, I had a rare experience of excess inflammation in my uterus and as a result had a cancer scare when I had abnormal cells in paps and other tests. Thankfully we took out the IUD and all was resolved. It then took me longer to get pregnant with my second, but I think that was due to other hormonal factors and not from the IUD. After my second child my husband got a vasectomy – we thought about waiting to see if we wanted to have another but my age plus the factors of having trouble getting pregnant before and the added expense of another child helped us to see that our family was complete.
I used a copper IUD initially post-partum, which caused long and bloody periods but was otherwise fine. When my son was 5, I got fed up with the blood and decided to try the pill again, but it was really upsetting my stomach (which in hindsight I think it did pre-baby too, but I never made that connection – I was diagnosed with irritable bowel syndrome back then). So I decided to try a hormonal IUD, which somehow came out of my body without me noticing it in the first week or two after insertion. Luckily I figured this out before I had a chance to accidentally get pregnant. Then instead of trying that again I got the implant. It has the same efficacy and side effect profile as a hormonal IUD, lasts as long, was less painful to have inserted, and cannot fall out. It will be slightly harder to get removed though.
The implant was inserted on the very day the news story broke about how all forms of hormonal BC increase breast cancer risk, which I am not feeling great about, but otherwise so far it has been a good option for me, and one I think more women should be aware of.
How reversible is a vasectomy? We’re 90% sure we’re done after I deliver #2 in a couple of months. But I’m not sure if I’m ready to really say, “this is it.” I just don’t know how I’ll feel in a couple of years, assuming I still have childbearing years ahead of me.
I know it’s still hormonal but I did Nexplanon for three years and found it just right for me. Easy pain free insertion (I had a C-section so was afraid of the pain with an IUD). Nothing to remember.
I don’t tolerate hormonal BC well, so we used condoms between kids. DH had a vasectomy after our youngest was born, and let me tell you, it has been the most freeing thing ever.
These are all fascinating and are introducing me to lots of options I hadn’t previously considered. I was on the pill until age 35, when we started trying for #1. Started trying for (or at least, not avoiding) #2 when #1 was a year old, and used condoms until then. I am now due in a couple of weeks and have no idea what we’ll do afterwards.
Six weeks postpartum, I got the Mirena installed. I had it for a little over a year then had it removed. It made me tired and fat. I am back on The Pill and doing horribly with taking it, which is so interesting because I had been on hormonal BC pills for years before getting pregnant. I wish the Mirena had worked for me. It was so easy.
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.
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 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.