Contraception Confusion: What's Right for You?

As a new mom, you're dealing with sleep deprivation and learning to care for a newborn, so birth control may not be on your mind. But fertility can return as quickly as two weeks after delivery, particularly if you're not breastfeeding. Discuss the options with your partner and doctor during pregnancy, or after childbirth, before diaper duty takes over. Our mom-friendly guide will make it easy.

Because the cervix is stretched during labor, some of your favorite barrier methods of birth control will need to be refitted after childbirth. Your tissues are healing, and devices that work by keeping spermicide near the cervix for an extended period may cause irritation. So it's probably best to wait to have sex until you've discussed all available methods with your ob-gyn at your six-week postpartum checkup.

• How it works: A sheath made from latex, synthetic materials, or natural membranes covers the penis, preventing sperm from entering the vagina.
• Advantages: Condoms (except for those made from natural membranes) are the most effective method for preventing sexually transmitted diseases (STDs).
• Risks: Two percent of women will become pregnant in the first year of use, if condoms are used perfectly; but people make mistakes when using them, so the typical failure rate is 15 percent.
• Postpartum issues: Lubricated condoms may help alleviate bothersome vaginal dryness.

• How it works: A polyurethane sheath is inserted into the vagina. Flexible rings hold it in place inside and outside the vagina.
• Advantages: Female condoms protect against contracting STDs and can be inserted up to eight hours before sex.
• Risks: Vaginal irritation or allergic reactions. Twenty-one percent of women will get pregnant during the first year of typical use; with perfect use, the failure rate is 5 percent.
• Postpartum issues: Doesn't need to be refitted after childbirth.

• How it works: Spermicides come in jellies, films, creams, foams, and suppositories. They all contain nonoxynol-9, a chemical that destroys the sperm-cell membrane.
• Advantages: Offers lubrication to counteract vaginal dryness.
• Risks: Irritation, allergic reactions, urinary tract infections. Some research indicates that frequent spermicide use may create microscopic lesions that make it easier for the human immunodeficiency virus (HIV) to enter tissue. Twenty-nine percent of women will get pregnant during the first year of typical use; with perfect use, the failure rate is 18 percent.
• Postpartum issues: Possible irritation following childbirth.

• How it works: A prescribed, reusable dome-shaped rubber cup is filled with spermicide and inserted into the vagina to cover the cervix. It provides protection for at least six hours, and must be left in place at least six hours after intercourse.
• Advantages: Some studies show use lowers cancer risk.
• Risks: Irritation, allergic reactions to spermicide, urinary tract infections, and toxic shock syndrome -- a rare but serious bacterial infection -- may occur if a diaphragm is worn for more than 24 hours. Six percent failure with perfect use in the first year; 16 percent for typical use. Replace after one or two years.
• Postpartum issues: Must be refitted by your gynecologist.