Postpartum contraception: what contraception after childbirth?

Welcoming a newborn is one of life’s most beautiful adventures. But it also comes with many challenges! Among them is choosing postpartum contraception. When should you start thinking about it? What are the options that respect your body, especially if you are breastfeeding? In this article, we explain how to choose the contraception that is right for you, so you can experience this new stage of your life with peace of mind.

Why is it important to choose postpartum contraception?

When does fertility return after childbirth?

From the very first days after giving birth, your body begins to gently recover. And your fertility can return faster than you might think! On average, ovulation can resume about 21 days after birth. That is even before your first period (also known as the return of fertility). However, every woman is unique. Therefore, the resumption of ovulation remains highly variable from one body to another.

Why are you more fertile after childbirth?

It might seem surprising, but be aware that you are more fertile after giving birth. Why? Because the body is in a phase of recovery and hormonal regeneration. Its natural hormonal regulation mechanisms are lower and can thus trigger early ovulation.

When should you start contraception after childbirth?

Technically speaking, as you will have understood: ovulation can return quickly. Therefore, it is undoubtedly recommended that you put a contraceptive method in place as soon as possible, at the latest three weeks after childbirth. The idea is to avoid any risk of pregnancy, especially if you are not exclusively breastfeeding your baby (we will come back to this). However, if you do not feel ready to resume sexual activity, there is no point in forcing yourself to put a contraceptive method back in place. The best time to restart hormonal contraception is the one that suits you best.

What are the postpartum contraception options?

There are a huge number of contraceptive options. You are undoubtedly familiar with some, and others not. We’ll walk you through them!

Barrier methods

• Male and female condoms

One of the best-known contraceptive methods is, of course, male (and female: yes, they exist!) condoms. Effective and hormone-free, you can use them immediately after childbirth, whether you are breastfeeding or not. Their advantage: they also protect you against sexually transmitted infections (STIs).

• Diaphragm, cervical cap, and spermicides

The diaphragm and cervical cap are inserted into the vagina before sexual intercourse. They cover the cervix and thus prevent sperm from entering. They are often combined with a spermicide for greater effectiveness. However, it is recommended to wait 6 weeks postpartum before using these contraceptive methods.

Hormonal methods

• Combined hormonal contraceptives

Combined hormonal contraceptives combine estrogen and progestin. They come in the form of:

• pills;
• vaginal rings;
• or patches.

Nevertheless, these combined contraceptive methods are not recommended before 6 weeks postpartum, or even 12 weeks in case of thromboembolic risk. This is because they increase the risk factor for blood clots, which is already high after childbirth. According to the French National Authority for Health (HAS), they can be used from 42 days postpartum by women who are not breastfeeding.

For those who are breastfeeding, you must wait at least 6 months, as estrogens impact the volume of breast milk produced.

• Progestin-only methods

Progestin-only contraceptives (such as the progestin-only pill, the implant, or injections) are generally recommended postpartum, even if breastfeeding. They are not a risk factor for blood clots or thromboembolic risk. And they do not affect milk production.

You can therefore opt for this contraceptive method from the very first weeks after your delivery. The contraceptive implant, for example, offers long-term protection (up to three years). Injections, on the other hand, must be renewed every three months.

Do you have a thousand questions about what happens after childbirth? Our article How long does the postpartum period last will interest you!

Intrauterine devices (IUDs)

• Copper IUD

Among the effective means of contraception, there is also the copper IUD. As a hormone-free method, you can make an appointment with your midwife to have one inserted from the 4th week postpartum (unless you had a cesarean section). How does it work? This device releases copper ions that are toxic to sperm. And thus prevents fertilization. It can remain in place for 5 to 10 years.

• Levonorgestrel IUD

The hormonal IUD (levonorgestrel) releases a small amount of progestin directly into the uterus. This thickens the cervical mucus and thins the lining of the uterus… and thus prevents fertilization. It is also inserted from 4 weeks after childbirth and remains effective for 5 years.

An attractive advantage: it reduces menstrual bleeding. This makes it an interesting option for women who suffer from very heavy periods.

Natural postpartum contraception methods

• What is the LAM (Lactational Amenorrhea Method)?

The LAM method, or lactational amenorrhea method, is a natural means of contraception for breastfeeding women. It is quite effective because the hormones that produce milk inhibit ovulation for six months postpartum. You can therefore make this contraceptive choice if you are exclusively breastfeeding and your period has not yet returned. A method that does not work if you are not breastfeeding, of course!

• Fertility awareness methods

There are also different methods for observing the various signs of ovulation such as:

• tracking body temperature;
• analyzing cervical mucus.

However, they remain less reliable postpartum, as your cycles are likely to be irregular for some time.

Permanent contraception methods

• Tubal ligation

Tubal ligation is a surgical sterilization method that blocks the fallopian tubes. And thus permanently prevents fertilization.

• Electrocoagulation

Another permanent method: electrocoagulation. This destroys the tissues of the fallopian tubes using electric current and thus makes any new pregnancy impossible.

• Insertion of rings / clips

The insertion of rings or clips is a slightly less invasive but equally permanent method of contraception. They consist of placing these devices on the tubes to block them.

How to choose the best contraception for you?

The best contraceptive method for you depends on many factors: what are your personal needs? What is your health status? Are you breastfeeding your baby? In short, what we advise above all is to talk about it with your healthcare professional. They will be best placed to find the method that matches your lifestyle and your future plans. So do not hesitate to ask for a postnatal consultation to discuss it.

Pssst… Moral Boost, our postpartum dietary supplement, can support you during this period to sustain your vitality and reduce daily fatigue.

Your most frequent questions about postpartum contraception

Can I use postpartum contraception while breastfeeding?

Of course! Using a contraceptive method while breastfeeding is perfectly possible. But it is important to choose it carefully. Some are particularly recommended for breastfeeding women, as they affect neither the quality nor the quantity of breast milk.

Which methods are recommended while breastfeeding?

Exactly! During breastfeeding, opt for a hormonal contraceptive method that does not interfere with your lactation. And in particular, progestin-only methods, such as:

• the progestin-only pill;
• the progestin implant;
• the two types of intrauterine devices (IUDs).

Finally, let's not forget male and female condoms, which are also safe options that have no impact on breastfeeding. And yes, because good news: your partner can also take care of the couple's contraception! Just saying...

What are the possible side effects of postpartum contraceptives?

Depending on the type of contraception chosen, you might experience some side effects such as:

• irregular bleeding;
• headaches;
• mood swings;
• pelvic pain;
• weight gain;
• breast tenderness;
• irritation/allergic reactions (if condoms).

Not all the time, and not all at once, we reassure you! However, if this is the case and you feel like you are "suffering" from your contraception, talk to a healthcare professional. Do not stay in pain; other solutions will undoubtedly suit you better.

In short, as you will have understood: choosing the ideal postpartum contraception is an important decision, to be made according to your needs and lifestyle. With all the options available, you now have the keys to make an informed choice!