Contraception after childbirth
Can contraception be used after childbirth? What are the limitations? Marta Zastawny, Doctor of Medicine, a specialist in gynaecology and obstetrics, tells us all about it.
Marta Zastawny, MD:
In my daily practice as a specialist in gynaecology and obstetrics, I know how important it is for my patients to choose the right contraceptive method. The choice of the best way to protect against pregnancy cannot be accidental and must be based on effective, proven and, above all, safe methods for the patient. A particular group seeking help in choosing the right contraceptive method are breastfeeding women, which is related to the fact that not all contraceptives during lactation are allowed and safe for the mother and child.
What are these limitations?
Restrictions apply primarily to hormonal contraceptive methods containing estrogens, which pass into breast milk and may adversely affect the baby and lactation. Then, the solution for these patients is the use of preparations containing only a progestogen hormone, such as single-component contraceptive pills or a subcutaneous implant, which do not affect breastfeeding and the child. The use of this method is possible 4 weeks after childbirth, taking into account the patient’s health condition and establishing no contraindications to its use by the attending physician.
Are there any other alternatives for nursing mothers?
An alternative effective method of contraception after childbirth is a conventional or hormonal IUD, containing a progestogen hormone. IUDs have many advantages: they are highly effective, have a long-lasting effect of several years, can be removed at any time, and do not affect the production or composition of milk and do not influence the further development of the baby.
Of course, we cannot forget about barrier and chemical methods of pregnancy prevention such as condom and spermicides, which can be used by breastfeeding women without any obstacles.
It is often believed that if a woman is breastfeeding she does not need to use contraception;
It is important to note that although breastfeeding reduces the risk of having another pregnancy, relying on this method is uncertain and has a high risk of failure, which may be particularly important for patients who have had a caesarean section and who take time to recover and heal the scar on the uterus after surgery. Too short a period of time between the caesarean section and the next pregnancy can make the uterine strength at the site of the surgical scar insufficient, which during the growth of the uterus during pregnancy or during the contraction activity during labour can lead to dissection or even rupture of the uterus causing dangerous complications.
Therefore, it should be remembered that the choice of the best method of protection against pregnancy should be individual together with the gynaecologist, and it is possible at the first postpartum appointment, taking into account the health factors and the patient’s preferences.