Birth Control After Baby
Sure, you just had a child, or will have one imminently. And, yeah, sex is probably the last thing on your mind. But eventually, you (and definitely your partner) will want to jump back in that sack. What you may not want, at least not right away? Another bambino. Whatever your family-expansion timeline, there's a contraceptive that will offer you peace of mind -- for as long as you need it. Get ready to meet your new favorite form of birth control.
"Call us crazy, but we want to get pregnant again within a year."
Consider this: A barrier method, such as condoms or a diaphragm
Cost: About $1 each for condoms; $15 to $75 for a diaphragm. (Prices provided by Planned Parenthood.)
New-mom perks: Barrier methods give you fairly reliable protection without a commitment -- use 'em when you want, toss 'em when you're ready to try again. Both methods have about an 85 percent success rate with typical use (aka when used by real people in real life), according to the Centers for Disease Control and Prevention in Atlanta. Plus, they protect against sexually transmitted diseases. You'll need to wait until six weeks postpartum to see the doc for a diaphragm fitting. "Childbirth can permanently change the size and shape of your vagina and cervix," says Rebecca Allen, M.D., an ob-gyn at Women & Infants Hospital in Providence. OBs suggest you say no to nookie till your six-week postpartum visit anyway, but if the moment strikes before then, make sure your guy wears a glove!
Good to know: Condoms may feel different to you postpartum because vaginal tissue can be supersensitive. "After my second child, they really hurt me," says Kara-Noel Lawson, a mom of four in Trabuco Canyon, California. Finding the most comfortable condom for you may take trial and error -- get a big ol' variety box! And pick up a bottle of lubricant while you're at it.
They're probably not for you if: You don't like interrupting the moment to rummage in your night table. In the post-baby phase, quickies are often the norm. No one can blame you for wanting to make every second count.
"We're definitely waiting a year. After that, we'll see."
Consider this: A hormonal method, including the Pill, the patch, or the ring. They all provide a combination of estrogen and progestin, which suppress ovulation, prevent implantation, or do both; they differ in how they deliver the hormones. Another option is the progestin-only mini pill.
Cost: $15 to $50 a month for pills; $15 to $80 a month for the patch; $15 to $80 a month for the ring
New-mom perks: Each hormonal method boasts a 92 percent success rate with typical use -- used perfectly, 99 percent. The patch and the ring serve up another boon: One less thing to remember. The patch, which delivers hormones through the skin, stays put for seven days; the ring, which you insert into the vagina like a diaphragm, remains in place for three weeks. "I found the ring very easy," says Elaine Barber, of Ogden, Illinois. "I just set an alarm on my cell phone to ping me when it was time for a new one." Combo methods can ease vaginal dryness, a common issue for nursing moms, because they stimulate the vaginal lining. If you're breastfeeding, the mini pill won't decrease your milk supply (there's evidence that contraceptives containing estrogen may, Dr. Allen says). Fertility is restored as soon as you stop using any of these options.
Good to know: You have to wait at least four weeks after delivery to begin the combo methods because postpartum women have an increased risk of blood clots, which estrogen may heighten, says Mary Jane Minkin, M.D., a clinical professor of ob-gyn at Yale University in New Haven, Connecticut. For the best protection, take the Pill during the same daily three-hour window.
They're probably not for you if: You're worried about forgetting to take -- or change -- them. "After my second baby, I went on the Pill," says Barber. "But with two little ones, I seemed to miss a lot of doses. We switched back to condoms."
More Next-Baby Plans
"I need a solid handle on parenting first... gimme a few years!"
Consider this: Implanon, a flexible plastic rod (about 4 centimeters long and 2 millimeters wide) that's infused with progestin and inserted under the skin of your upper arm
Cost: $300 to $900 every three years
New-mom perks: You can use this method while you're nursing (it won't decrease your supply), and you'll free up brain space because there's nothing you have to remember. It's 97 to 99 percent effective, and lasts for three years. You're Fertile Myrtle as soon as you have it removed.
Good to know: Implanon may cause unpredictable spotting, Dr. Minkin says. Because it is progestin-only, it doesn't provide the same cycle control as methods containing estrogen, she adds. Breakthrough bleeding usually diminishes over time.
It's probably not for you if: You'll be seriously PO'd by spotting.
"We'll talk when this munchkin's in preschool."
Consider this: An IUD. The Mirena releases progestin into the uterus via a plastic device; the copper-based ParaGard is hormone-free. Both interfere with sperm's ability to reach the egg by thickening cervical mucus and altering the uterine lining.
Cost: $500 to $1,000. That may seem pricey, but protection lasts for years.
New-mom perks: Once your OB inserts your IUD, you can cross a surprise pregnancy off your worry list: Mirena works for five years, ParaGard (safe to use while nursing) for 12, and they're both more than 99 percent effective. Struck by baby pangs? Have it removed and get busy! Good to know An IUD can be inserted four to six weeks post-birth, possibly sooner. The progestin in Mirena can cause irregular bleeding for months after insertion; after that, periods become lighter or nonexistent. Nicci Micco, a mom of two in Burlington, Vermont, didn't see an improvement for nearly eight months. "I spent a small fortune on 'light' tampons," she says. As for ParaGard, you have a regular period, but it can be heavier and crampier.
They may not be for you if: You don't like the idea of a foreign object in your uterus. Since doctors can't foresee how you'll respond to either period-wise, make sure that's a variable you're prepared for.
"The shop is closed!"
You're 100 percent confident your family is the perfect size? It might be time to consider a permanent form of contraception. The old standbys, vasectomy (a procedure for men that blocks the tubes that carry sperm) and tubal ligation (an intervention that involves cutting and tying a woman's fallopian tubes), are still around, but you've also got two effective nonsurgical options to consider: Essure and Adiana. Both can be done in your doctor's office under local anesthesia, and they work basically the same way: Your physician inserts a small device into each fallopian tube (a coil for Essure; a silicone insert for Adiana). Over the next three months, scar tissue forms around them, blocking the tube. "These devices are by definition safer than other types of tubal sterilization," Dr. Allen says. "There are no incisions, nor is work performed inside the abdomen." Always a good thing.
Originally published in the June 2012 issue of American Baby magazine.
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