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, choosing postpartum contraception. When should you think 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 suits you so that you can live this new stage of your life with peace of mind.

Why is it important to choose postpartum contraception?

When do you become fertile again after childbirth?

From the first few days postpartum, your body slowly begins to recover. And your fertility can return faster than you think! On average, ovulation can resume about 21 days after birth. That's even before your first period returns (also called lochia). However, every woman is unique. And the resumption of ovulation therefore remains very variable from one body to another.

Why are you more fertile after childbirth?

It may seem surprising, but you are more fertile after childbirth. Why? Because the body is in a phase of recovery and hormonal regeneration. Its natural hormonal regulation mechanisms are declining and can thus cause early ovulation.

When to start contraception after childbirth?

Technically speaking, as you will have understood: ovulation can quickly return. And so, you will probably be advised to put in place a contraceptive method as soon as possible, no later than 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 intercourse: there is no need to force yourself to put a contraceptive method back in place. The best time to resume hormonal contraception is the one that suits you best.

What are the postpartum contraception options?

There are many contraceptive options. You probably know some, others not. Let's go through them with you!

Barrier methods

• Male and female condoms

One of the most well-known contraceptive methods is, of course, male condoms (and female condoms: yes, they exist!). Effective, 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

• Estroprogestogens

Estroprogestogen contraception combines estrogen and progestin. They come in the form of:

• pills;
• vaginal rings;
• or patches.

Nevertheless, these estroprogestogen 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 Haute autorité de Santé (HAS), they can be used from 42 days postpartum by women who are not breastfeeding.

For those who are breastfeeding, a minimum of 6 months will be required, as estrogens impact the volume of breast milk produced.

• Progestogens

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

You can therefore opt for this method of contraception from the first few weeks after childbirth. The contraceptive implant, for example, offers long-term protection (up to three years). Injections, on the other hand, will need to be renewed every three months.

Are you asking a thousand questions about what happens after childbirth? Our article How long does postpartum last will interest you!

Intrauterine devices (IUDs)

• Copper IUD

Among the effective contraceptive methods, we also find the copper IUD. 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 C-section). How does it work? This device releases copper ions that are toxic to sperm. This 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 cervical mucus and thins the uterine wall… thus preventing fertilization. It is also inserted from 4 weeks postpartum 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 method (Lactational Amenorrhea Method)?

The LAM method, or Lactational Amenorrhea Method, is a natural contraceptive method for breastfeeding women. It is quite effective because the hormones that produce milk inhibit ovulation for six months postpartum. You can therefore choose this contraceptive method if you are exclusively breastfeeding and your periods have not yet resumed. This method does not work if there is no breastfeeding, of course!

• Ovulation awareness methods

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

• monitoring body temperature;
• analysis of cervical mucus.

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

Permanent contraception methods

• Tubal ligation

Tubal ligation is a surgical sterilization method that blocks the fallopian tubes. This definitively prevents fertilization.

• Electrocoagulation

Another permanent method is electrocoagulation. This destroys the tissues of the fallopian tubes using an electric current, making any new pregnancy impossible.

• Placement of rings / clips

The placement of rings or clips are slightly less invasive but equally permanent contraceptive methods. They involve placing these devices on the fallopian tubes to block them.

How to choose the best contraception for you?

The best method of contraception 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 you to do is to talk to your healthcare professional. They will be best placed to find the method that suits your lifestyle and your future plans. So don't hesitate to ask for a postnatal consultation to discuss it.

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Your most frequently asked questions about postpartum contraception

Can I use postpartum contraception while breastfeeding?

Of course! Using a method of contraception while breastfeeding is entirely possible. But it's important to choose it carefully. Some are particularly recommended for breastfeeding women, as they do not affect the quality or quantity of breast milk.

What methods are recommended during breastfeeding?

Precisely! During breastfeeding, opt for a hormonal contraceptive method that does not interfere with your lactation. This particularly includes progestin-only methods, such as:

• the progestin-only pill;
• the progestin implant;
• both 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 responsibility for the couple's contraception! Just saying...

What are the possible side effects of postpartum contraception?

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

• irregular bleeding;
• headaches;
• mood swings;
• pelvic pain;
• weight gain;
• some breast tenderness;
• irritation/allergic reactions (if using 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 remain 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 available options, you now have the keys to make an informed choice!