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Planning Your Family: Postpartum Contraception Options

Congratulations! You just had a baby. They exited your body in a manner closer to brutal than graceful - pulled out by a doc, or pushed out by your own muscles. Now is time for you to recover and regain your ability to sleep on your stomach or just tie your own shoes. In some cruel twist of fate, the immediate period after birth is prime time for baby-making, as far as your uterus is concerned. As I hope you know, but someone in your health class probably failed to tell you, it's totally possible to get pregnant before your period returns. (That's because you ovulate before your period.)

Clue

So here you sit: in some form of mesh underwear with a gigantic pad shoved between your legs. In a few weeks, you're due for a postpartum appointment where your doctor will (hopefully) clear you to resume sex. And if you're like me, the thought of getting pregnant again is *terrifying* when you're only six weeks into having a tiny human keep you up at all hours.

What's a girl to do? Back in the day, not much. Before the launch of "The Pill", or hormonal contraceptive in pill form, women didn't have very many reliable options for preventing pregnancy. But this is 2018! And we have some pretty awesome, revolutionary ways to manage fertility. (I won't even go into all the medical conditions that are treated with hormonal contraceptives here, just pregnancy prevention.) Buckle in - this is going to be informative - and my mom is going to be so embarrassed if she reads this.

Pull and Pray

Just what it sounds like. Unreliable at best, not recommended for those who want to prevent creating another human. Probably why I exist.

Barrier methods

These have been around five-ever. Once only lambskin was an option - now we have latex condoms that are pretty decent at both preventing pregnancy and protecting against STIs. Not perfect, prone to user error, but better than nothing.

Diaphragms

My OB won't even prescribe these anymore because they're so ineffective. Pass.

NFP Methods

Basically a more educated form of pull-and-pray. Tracking your cycle or symptoms that indicate fertility, and abstaining or adding a barrier method on fertile days. Taking Charge of Your Fertility is the Bible of NFP.

NFP for Millenials

I can say this as a millennial. We love apps. Not appetizers, applications. There are several companies partnering highly sophisticated algorithms with monitoring systems that sync to an app on your phone or tablet. Daysy is probably the most well-known, since it's actually a certified medical device in the EU. You can even get HSA or FSA reimbursement for this bad boy. Apparently these have excellent accuracy, but definitely won't protect against STIs. Pope-approved.

Daysy

IUD

Hormonal or non-hormonal, these nifty inventions hang out in your uterus and prevent implantation. They're highly effective and easy to use, and provide long term contraception. An excellent choice for people who don't want to have children for several years. Definitely not Pope-approved.

Joy Ho/NPR

The Pill

Comes in a million different varieties, but all are hormonal. They prevent ovulation or implantation. Take it every day at the same time - that second part is key and is where most people mess up. Can have interactions with other meds. Lots of potential side effects, but many use it with no issue.

The Ring

A ring that stays in your vagina and you only have to change once a month. Unless you actually forget to put it in, you won't run into user error here. Keep it in your fridge when it's not in your vagina.

The Implant

A matchstick-sized rod that is inserted under your skin, in your upper arm. Slowly secretes hormones into your bloodstream. Immune to user error, but users have to check it for breakage or migration. Provides several years of protection. Makes you feel like a bionic woman in an Orwellian YA novel.

Is this working for me?

Every method has pros and cons, and what works for your friend or sister might not work well for you at all. Consider what's most important to you - ease of use? STI protection? - and discuss with your medical provider. It’s never too early to start discussing contraceptive options with your OB-GYN. In fact, ask them specifically about “Same Day Long Acting Reversible Contraception” - see if they’re on-board! This option cuts out extra visits to the doctor, making it more convenient for new moms. You've got a baby in your arms, and you should be enjoying them instead of worrying about your fertility.

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