Contraceptive choices after you've had a baby

Contraception may be the last thing on your mind when you've just had a baby, but it's something you need to think about if you want to delay or avoid another pregnancy.

Many unplanned pregnancies happen in the first few months after childbirth, so even if you’re not interested in sex at the moment, it's better to be prepared.

Your Guide to Contraceptive Choices – After a Baby (PDF)

You can have sex as soon as you and your partner both want to. Having a baby causes many physical and emotional changes for both partners and it may take some time before you feel comfortable or ready to have sex.

 

Everyone is different, so don't feel pressured or worry that you're not normal if you don’t feel ready to have sex. It can help to talk to your partner or a healthcare professional such as a nurse, doctor or health visitor about any concerns you have.

The earliest your periods can return is five to six weeks after the birth if you're not breastfeeding. Breastfeeding usually delays the return of your periods. You're more likely to start having them once you breastfeed less often and feeds are shorter, but in some women they may return earlier.

You can become pregnant before your periods return because ovulation (releasing an egg) occurs about two weeks before you get your period.

You need to start using contraception from three weeks (21 days) after the birth. Don’t wait for your periods to return or until you have your postnatal check before you use contraception as you could get pregnant again before then.

 

If you're fully breastfeeding you can choose to rely on this for contraception (see Will breastfeeding act as a contraceptive?).

You don’t need to use any contraception in the first three weeks (21 days) after the birth as it's not possible to become pregnant in this time.

 

These methods can be used or started any time after the birth:

From three weeks after the birth if you're not breastfeeding and have no other medical risks, or from six weeks if you're breastfeeding or have certain conditions or risks, you can use:

From four weeks after the birth you can use:

The IUD and IUS can also be inserted within 48 hours after vaginal or caesarean birth.

From six weeks after the birth you can use:

This depends on what you and your partner prefer, your medical history, any problems you had in your pregnancy and if you're breastfeeding.

Long-acting reversible contraceptives (LARC) are the most effective methods at preventing pregnancy. You don’t need to remember to take or use them.

  • Contraceptive implant – lasts for up to three years. Can be taken out earlier. 
  • IUD – lasts for five to 10 years depending on type. Can be taken out earlier. 
  • IUS – lasts for three to five years depending on type. Can be taken out earlier.
  • Contraceptive injection (Depo-Provera or Sayana Press) – lasts for 13 weeks.

Other methods rely on you remembering to take or use them. These are all effective methods if used according to instructions. But you have to use and think about them regularly or each time you have sex. If they're not used according to instructions every time they're less effective.

If you’re breastfeeding then it’s recommended that you wait until the baby is six weeks old before starting the combined pill, the contraceptive vaginal ring or the contraceptive patch. These methods contain the hormone estrogen which may affect your milk production starting.

 

If you used a diaphragm or cap before you became pregnant, check with your doctor or contraception clinic to make sure it still fits – your cervix and vagina change shape during pregnancy and birth.

 

Natural family planning can be more difficult to learn and use just after you've had a baby. If you used this method before your pregnancy, ask your natural family planning teacher for advice.

An implant, IUS or IUD can be taken out at any time you choose and your normal fertility will return quickly.

 

If you use the injection, your fertility may not return for several months after your last injection has worn off. It can sometimes take up to one year for your periods and fertility to get back to normal. So if you want to get pregnant sooner, this may not be the best method to choose.

 

You can stop taking or using other methods whenever you choose to and your normal fertility will return quickly.

 

Natural family planning can help you with planning a pregnancy as well as avoiding one.

 

Waiting at least one year after giving birth before getting pregnant again can help you have a healthier pregnancy and birth, reducing the risk of an early birth, a very small baby or a stillbirth. If you do get pregnant earlier, don’t worry – ask for advice from your doctor, nurse or midwife.

If you're absolutely sure you don't want any more children you may wish to consider female sterilisation (tubal occlusion) or male sterilisation (vasectomy). These are permanent methods of contraception. It's not usually recommended for men or women to be sterilised at the time of childbirth, as you need time to be sure that you don't want any more children.

 

There's some evidence to show that women who are sterilised at the time of the birth, or just after, are more likely to regret this decision later. The failure rate of female sterilisation may also be higher when it's done at this time.

Breastfeeding is also known as lactation. It can help to delay when you start ovulating (releasing an egg) and having periods after the birth. This is known as lactational amenorrhoea (LAM) and it can be used as a contraceptive method. LAM can be up to 98 per cent effective in preventing pregnancy for up to six months after the birth. All of the following conditions must apply:

  • You're fully, or nearly fully, breastfeeding. This means you're only giving your baby breast milk, or you are infrequently giving other liquids in addition to your breast milk.
  • Your baby is less than six months old.
  • You haven't had you first period since the birth.

The risk of pregnancy increases if any of these conditions apply:

  • You start breastfeeding less often.
  • There are long intervals between feeds – both day and night. 
  • You stop night feeds. 
  • You use supplement feeding.
  • Your periods return.

Once your baby is over six months old the risk of getting pregnant increases, so even if you don’t have periods and are fully or nearly fully breastfeeding, you should use another contraceptive method.

 

If you're using a hormonal method of contraception a small amount of hormone will enter the milk, but no research has shown that this'll harm your baby.

 

It’s advised that you wait until the baby is six weeks old before starting the combined pill, the contraceptive vaginal ring or the contraceptive patch. These methods contain the hormone estrogen which may affect your milk production starting.

 

Using the IUD doesn't affect your milk, and copper from it doesn't get into the milk.

 

If it's more than 21 days since the birth and you have sex without using a contraceptive method, or you think your contraception might have failed, you can use emergency contraception. It's not possible to get pregnant earlier than 21 days (three weeks) after the birth.

  • You can use an emergency pill from 21 days.
  • You can use the emergency IUD from 28 days.

If you're breastfeeding and use an emergency pill containing ulipristal acetate (known as ellaOne) you should avoid breastfeeding for one week after taking it. During this week you should express and discard your breast milk.

 

If you use the emergency IUD or an emergency pill containing levonorgestrel you can continue to breastfeed.

You can find out more about contraception from a midwife, nurse or doctor in hospital or at a birth centre, or from your midwife or health visitor at home. You and your partner can also visit your general practice or a contraception or sexual health clinic.

 

Visit our help and advice pages for more information about all methods of contraception. 

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This website can only give you general information about contraception. The information is based on evidence-guided research from the World Health Organization and The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists. All methods of contraception come with a Patient Information Leaflet which provides detailed information about the method.

Remember – contact your doctor, practice nurse or a contraception clinic if you're worried or unsure about anything.

INFORMATION LAST UPDATED DECEMBER 2016. Next planned review December 2018.