If you’ve recently welcomed a baby, birth control might be the last thing on your mind. But fertility can return before your first postpartum period, even while you’re breastfeeding. If you’re not ready for another pregnancy, considering your contraceptive options is an important step.
Fortunately, breastfeeding doesn’t mean you have to avoid birth control completely. There are several hormonal and nonhormonal methods that you can use while nursing. The best choice depends on your health, how recently you gave birth, your breastfeeding goals, and your plans for future pregnancies.
Can You Get Pregnant While Breastfeeding?
Breastfeeding can delay the return of ovulation, but it doesn’t guarantee that you won’t become pregnant. Ovulation occurs before your period, which means your fertility can return without an obvious warning. That’s why it’s possible to become pregnant before having your first postpartum period.
Exclusive breastfeeding can sometimes be used as a temporary form of contraception known as the lactational amenorrhea method (LAM). However, this approach is only considered effective when specific criteria are met, including:
- Your baby is younger than 6 months old
- Your menstrual periods have not returned
- You are exclusively or nearly exclusively breastfeeding frequently throughout the day and night
If any of these circumstances change, you’ll need another form of birth control to reliably prevent pregnancy.
Which Birth Control Options Can You Use While Breastfeeding?
Many birth control methods are compatible with breastfeeding. Your options may include both hormonal and nonhormonal contraception.
Progestin-Only Birth Control
Unlike combination birth control, progestin-only methods don’t contain estrogen. Options include:
- Progestin-only birth control pills, sometimes called the “mini-pill”
- The contraceptive implant
- The birth control injection
- Hormonal IUDs
Progestin-only pills can be started after childbirth and may be a convenient option if you prefer an oral contraceptive. However, some types need to be taken within a relatively narrow window each day to remain as effective as possible.
Nonhormonal Birth Control
If you’d rather avoid hormones altogether, there are several options available.
The copper IUD provides long-lasting contraception without releasing hormones. Barrier methods, including condoms, are another option. Diaphragms and cervical caps may also be considered after childbirth, although you may need to be refitted after your body has recovered from pregnancy and delivery.
Can You Take Combination Birth Control While Breastfeeding?
Combination birth control, including certain pills, patches, and vaginal rings, contains both estrogen and progestin. These methods aren’t usually recommended during the first few weeks after childbirth because estrogen can affect milk supply, especially before breastfeeding is well established. There’s also an increased risk of blood clots during the postpartum period, and estrogen-containing contraceptives can further increase that risk.
But that doesn’t necessarily mean you have to avoid combination birth control for as long as you breastfeed. Your doctor will weigh how long it’s been since delivery and your individual health and risk factors to determine whether (and when) an estrogen-containing method might be appropriate.
Can You Get an IUD While Breastfeeding?
Both hormonal and copper IUDs can be options for women who are breastfeeding.
Sometimes, an IUD is placed immediately after a vaginal or cesarean delivery. In other cases, they’re placed during a later visit. Immediate placement is convenient and provides instant contraception, but it also has a greater chance of being expelled from the uterus when compared to one that’s placed later.
Your healthcare provider can help you weigh the timing and potential risks.
Can You Use Natural Family Planning While Breastfeeding?
Fertility awareness-based methods, also called natural family planning, involve tracking signs of fertility to figure out when you’re most likely to become pregnant. Depending on the method, this method might include monitoring cervical mucus, basal body temperature, menstrual cycles, or a combination of signs.
These methods can be used while breastfeeding, but the postpartum period can make fertility more unpredictable, especially before your regular periods return. Cycle-tracking apps that rely on calendar dates could also be less reliable during this season of life. If you’re interested in natural family planning, talk with your healthcare provider about an established fertility awareness method and how to best use it after pregnancy.
How Should You Choose a Birth Control Method After Pregnancy?
The “best” birth control method after pregnancy depends on your unique health history and circumstances. When deciding, consider what works best for your body and your life.
Questions that can help guide your decision include:
- How soon, if ever, would you like another pregnancy?
- Do you want hormonal or nonhormonal contraception?
- Would you prefer something you don’t have to remember every day?
- Are you comfortable with an IUD or implant?
- How important is maintaining your current breastfeeding routine?
- Do you have health conditions that make estrogen inappropriate?
- How do you feel about changes to your menstrual bleeding?
Your previous birth control method may still be a good choice, but pregnancy and breastfeeding can change which factors matter most to you. Your doctor can help you decide if a change is needed.
When Should You Discuss Postpartum Birth Control?
You don’t have to wait until your period returns to start thinking about contraception. In fact, discussing birth control during pregnancy or soon after delivery can give you plenty of time to understand your options before you need them.
Talk with your OB/GYN or healthcare provider about your breastfeeding goals, medical history, future pregnancy plans, and personal preferences. Together, you can choose a birth control method that provides the pregnancy prevention you want while supporting your overall health and wellness.
Schedule your postpartum birth control consultation by contacting us at Atlanta Women’s Obstetrics & Gynecology at (404) 352-3616 today.