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A Mom's Guide to Birth Control

Best if: You don't want to get pregnant tomorrow; You're thinking "maybe baby"; You've found your perfect family size

How they work: These popular pills contain estrogen and progestin, which prevent ovulation and thicken cervical mucus so sperm can't reach your uterus. You take an active pill for 21 days and get your period the following week; if you go with Yaz, you pop an active pill daily for 24 days, which gives you a shorter, lighter period.

Perks: No fumbling for protection during steamy moments. Some brands ease PMS symptoms (Milder cramps! Fewer zits!) and make the monthly blues more bearable. Combo pills can also reduce your risk of ovarian, endometrial, and colon cancer.

Drawbacks: You have to remember to take the pill at the same time every day. Also, some pills have PMS-like side effects, such as acne, bloating, and moodiness, so it may take some trial and error for you and your doctor to find the type that's best for you. All varieties can raise your risk of life-threatening blood clots, though the odds are small if you don't have other risk factors (like a smoking habit, a family history of blood clots, or migraines with auras -- in that case, your ob-gyn may not recommend the pill at all). Yaz (and its cousin Yasmin) are off-limits for women who have ever had kidney, liver, or adrenal disease.

Fertility returns 1 to 2 months after discontinuing the pill.

Best if: You don't want to get pregnant tomorrow; You're thinking "maybe baby"; You've found your perfect family size

How they work: First there was Seasonale and its spin-off Seasonique, combo pills you take for three months, making your period a four-times-a-year event. Newer on the scene is Lybrel, which eliminates your period altogether, since you take an active pill every day.

Perks: Extended pills can provide major relief for women who experience intense cramps, heavy bleeding, and other severe menstrual symptoms.

Drawbacks: Many women experience break-through bleeding during the first few months, but it tapers off with time. Extended pills have the same health risks as traditional combo pills.

Fertility returns 2 to 3 months after discontinuing the pill.

Best if: You're breastfeeding

How it works: This progestin-only pill works by thickening cervical mucus to prevent fertilization and reducing ovulation. You take an active pill for 28 days, so you receive a continuous flow of hormones.

Perks: The mini pill is an ideal choice for breastfeeding moms who are concerned about estrogen's possible effect on milk production. Your period may get lighter or disappear.

Drawbacks: You need to take it at the same time every day within a two- to three-hour window or you risk getting pregnant. The mini pill causes more irregular bleeding than combo pills do, but it usually tapers off within a few months.

Fertility returns 1 to 2 months after going off the pill.

Best if: You don't want to get pregnant tomorrow; You're thinking "maybe baby"; You've found your perfect family size

How it works: Once a week for three weeks, stick the beige patch on your upper back or arm, lower abs, or butt, where it releases a continuous flow of estrogen and progestin into your bloodstream. You go patch-free for week four so you can get your period.

Perks: You can slap it on once a week and forget about it.

Drawbacks: The patch may cause minor skin irritation, but only about 3 percent of women quit because of it. The risk of blood clots may be higher than that of some birth control pills. Studies found an increased rate of unintended pregnancies in women who weigh 198 pounds or more.

Fertility returns 1 to 2 months post-removal.

Best if: You're breastfeeding; You don't want to get pregnant tomorrow; You've found your perfect family size

How it works: Your doctor inserts a flexible matchstick-size rod under the skin of your upper arm, where it secretes progestin for three years.

Perks: A convenient, low-maintenance option if you want to space out your pregnancies for several years or if you've completed your family. Because it contains progestin only, it may be a good choice for nursing moms (once your baby is 6 months old). It's also discreet: The implant is usually invisible beneath your skin.

Drawbacks: A doctor has to insert and remove the implant, and the procedure carries a small risk of complications (and you may scar). Your periods may be irregular, and obese women might need to replace it every two years.

Fertility returns 1 to 3 months post-removal.

Best if: You're breastfeeding; You don't want to get pregnant tomorrow; You've found your perfect family size

How it works: You've got two options: The ParaGard copper IUD and Mirena, a hormone-based IUD. Both are small T-shaped devices your doctor inserts inside your uterus. ParaGard releases copper, which inhibits sperm movement and implantation, while Mirena secretes progestin. ParaGard lasts for 10 years, Mirena for five.

Perks: It's super convenient, which may be why IUDs are the top choice of contraception in the world. Mirena may decrease your flow (while ParaGard may increase it).

Drawbacks: You could have break-through bleeding in the first few months. IUDs aren't recommended for women with a history of ectopic pregnancy or who have pelvic inflammatory disease.

Fertility returns 2 months post-removal.

Best if: You're breastfeeding; You don't want to get pregnant tomorrow

How it works: You get a shot of progestin in your butt or arm once every three months; you or your doctor can do it.

Perks: You only have to deal with it four times a year.

Drawbacks: Depo-Provera isn't a popular choice for several reasons: It can cause heavy break-through bleeding and weight gain, and may even increase your risk of osteoporosis if you use it for more than two years.

Fertility returns 9 to 12 months after your last shot.

Best if: You don't want to get pregnant tomorrow; You're thinking "maybe baby"; You've found your perfect family size

How it works: You insert this hormone-laced flexible ring in your vagina once a month and leave it there for three weeks, where it releases progestin and very low-dose estrogen directly into the vaginal walls. Remove it to get your period during week four, then insert a new ring.

Perks: Insertion is a cinch. In fact, it's effective even when it's not precisely positioned. Most women can't feel the ring, though there's a small chance your partner may notice it during sex.

Drawbacks: It can cost twice as much as the pill, and it comes with the same blood-clot risk as combination pills.

Fertility returns 1 to 2 months post-removal.

Best if: You're breastfeeding; You're thinking "maybe baby"

How it works: A diaphragm fits over your cervix to prevent sperm from traveling to your uterus; you have to use spermicidal cream or jelly with it each time you have sex. You can leave it in for six hours after lovemaking.

Perks: It's hormone-free and doesn't necessarily interrupt sex, since it can be inserted up to six hours beforehand.

Drawbacks: Using a diaphragm can be messy and high-maintenance; plus, spermicide may irritate sensitive vaginal tissue. You need to be fitted by a doctor and possibly refitted periodically, especially after giving birth vaginally.

Fertility returns immediately.

Best if: You're breastfeeding; You're thinking "maybe baby"

How it works: You know the deal: It creates a physical barrier between you and your partner's sperm.

Perks: Doesn't require taking hormones, seeing your doctor, or a lot of fuss. Plus, it's safe for breastfeeding moms.

Drawbacks: Lack of spontaneity.

Fertility returns immediately.

Copyright © 2008. Used with permission from the May 2008 issue of Parents magazine.

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