Contraception

Fertility returns soon after delivery. Be sure to choose the contraception that is right for you.

If you are not breastfeeding, your first period will start about 6 to 8 weeks after delivery. However, you will have released an egg a few weeks earlier than when your period first appears, which means if you are sexually active within this time, you have a chance of getting pregnant.

If you are breastfeeding, when you ovulate and when your first period appears may be delayed, but the timing is unpredictable. Many a baby has been born within a year of their older sibling to parents who assumed breastfeeding was a reliable form of contraception!

There are many choices for (reliable) contraception that can be used after delivery. However, because estrogen-containing contraceptives like the birth control pill increase the chance of developing clots in the leg, the recommendation is that they not be started in the first four to six weeks after delivery. Estrogen may also impact your milk production and while the hormones in the birth control pill won’t affect the quality of the milk, it might affect the production. If you are breastfeeding, it’s probably best to wait until about three months after delivery before starting the oral contraceptive pill to avoid any impact on breast milk production.

Other choices of contraception that don’t contain estrogen and can safely be used starting soon after delivery are the progestin-only pill, condoms and spermicidal foam. IUD’s are also safe to use right after delivery, but we don’t usually insert them until you are six weeks postpartum, as there is a risk it will fall out. If you are certain you would not like any more children, permanent contraception such as a tubal ligation or vasectomy for your partner is also an option.

Choosing Wisely is an excellent guide created by the Society of Obstetricians and Gynecologists that will help you decide what form of contraception is best for you.