Figuring out which birth control option is best for a woman is a tough choice without having to worry about recovering post-giving birth. Throw pregnancy into the mix and there's a whole slew of questions -- hopefully most of which we can answer. Pregnancy not only changes a woman physically, but it can alter her chemical balance as well. In addition to worrying about whatever hormones are flying around in there, a pregnant woman has a newborn baby who's dependent on her.
If she chooses to breastfeed, that means that everything she's ingesting, the baby is also ingesting. Obviously, this rules out certain types of birth control temporarily. Luckily, there are options for immediate post-pregnancy as well as long-term post-pregnancy, each with their own pros and cons. It's so important to find the right type of birth control for mom personally since she's the one who it will affect and the last thing she wants after giving birth is to be in even more discomfort. Thanks to today's advanced medical research and studies, we've come a long way in terms of both medications as well as IUD options. There is, without a doubt, a birth control that will be the perfect fit for mom and her lifestyle needs.
20 IUD: The Ninety-Nine Percent Effective And Easiest
With all the talk of the Pill for so many years, the IUD has a surprising statistical fact regarding effectiveness. Studies have shown that an IUD is over 99% effective, which makes it just the slightest bit more effective than the Pill. The margin of error for this specific type of birth control has less to do with your lifestyle and more about what's required to make it so effective: absolutely nothing but an empty uterus.
The IUD works so well because there's no need to remember to take pills on time, no need to set a timer so that they're taken at the same time each day (which is necessary for Progestin-only pills), and there's no risk of forgetting to take an IUD...Because there's nothing to take orally.
The IUD works by sitting in the base of your uterus, just above the cervix, and continuously releases just the right amount of hormones to thicken uterine lining and prevent pregnancy. In some cases, such as Mirena, the amount of hormone found in an IUD is roughly 10% less than that of the Pill. All IUDs except the copper-based ones (we'll talk about that later) release a progestin-based hormone, therefore not only are hormone levels less due to no estrogen, but they're acting remotely in the uterus as opposed to being run through the bloodstream through ingestion. Considering those odds, an IUD is a reliable form of birth control with unbeatable effectiveness.
19 Either IUD Right Away, Or Wait Weeks
The chance of becoming pregnant again shortly after giving birth is a very certain reality, which is why birth control should definitely be considered if you're not down for having more kids immediately.
IUDs are a great option for immediate birth control because they can be inserted up to two days, precisely 48 hours, post-birth.
It's often easier to insert them after a woman has given birth which is a definite pro in the way of having something inserted where another thing just came out. Unfortunately, if an IUD isn't inserted within 48 hours, new moms are encouraged to wait a full four weeks to come back and get one inserted. If birth control isn't the first thing on your mind -- granted the pain from labor reinforced that -- then waiting three weeks to start the Pill if you're not a fan of IUDs won't be as long a wait as it seems. If you're not breastfeeding, the next option is for you. After three weeks, as long as you're not at risk blood clots or any other medical conditions, you can begin a combination pill that will help prevent pregnancy. If you do decide to breastfeed, a full six weeks is the suggested wait time before beginning an oral birth control pill.
18 Mini Pill For Mini Hormones: Safe For Breastfeeding
The progestin-only pill, which is often referred to as the "mini-pill", is a great option for those who chose to breastfeed and don't want an IUD. The pill isn't really "mini", it just doesn't contain estrogen like combination pills do, therefore it's a smaller dose. There are good and bad aspects of being on the mini pill. For starters, it's much less forgiving than the combination pills, meaning it absolutely needs to be taken at the same exact time every day. Since many women already find the regular pill hard enough to take consistently, this can definitely be a downside. The mini pill prevents ovulation and thickens the uterine lining like most do, but the effect of the progestin-only pill only lasts 24 hours...Meaning it needs to be taken routinely every single day for a full 28 days to prevent pregnancy.
If timing is your thing and you keep your life running routinely to the second, then this is a viable birth control option that has been approved by the FDA to be safe for moms who are breastfeeding.
Very little progestin has been traced down to the babies of moms who are taking progestin-only pills, therefore it's a safe birth control method to consider post-pregnancy.
17 Estro Versus Progestin
There's often confusion when it comes to combination pills versus progestin-only, or "mini-pills". The difference is the presence, or lack thereof, of one hormone: Estrogen. Combination pills contain a balance of progestin and estrogen to help prevent pregnancy. Because of this, both pills are otherwise known as "estrogen" and "non-estrogen" pills.
The combination of both hormones works together to prevent ovulation, which means if no egg is released, there's no baby to be conceived. In addition to this, they also thicken the mucus lining of the uterus and keep hormone levels from becoming a roller coaster which can be beneficial post-birth. One of the major benefits of combination pills is their forgiveness as far as people who are naturally forgetful; a few hours won't make too much of a difference in effectiveness with both hormones working together. Once a day is missed, and for each day thereafter, the effectiveness of the combination pill steadily decreases. The mini-pill is progestin-only which makes it very similar to an IUD except it's taken orally.
There is no forgiveness with this pill and while it's breastfeeding mom-friendly, it needs to be taken on time, every single day.
Both pills are a good option depending on your needs as a new mom, neither option is any worse than the other; it's all dependent on you, your body, and your lifestyle.
16 The Hormone-Free, 10 Year Copper Baby Stopper
Contrary to popular belief, not all birth controls need to be pumped with hormones to be effective. The copper IUD is known for its long-term effectiveness and ability to completely prevent pregnancy without the use of any hormones whatsoever. The non-hormonal IUD is called Paragard, and its effectiveness is over 99% in preventing pregnancy. We know you have questions at this point: Is it safe to have copper in such a vulnerable place? What does it do to prevent pregnancy with no hormones? How long does it last? Why doesn't it rust? Okay, maybe that last one isn't a common question unless you're paranoid, but they're all reasonable.
Paragard has been referred to as "super effective birth control" because not only does it work without hormones, but it can be used as an emergency contraceptive as well.
If you take a close look at Paragard (before it's inserted, of course) the t-shaped IUD has a thin roll of copper around the base. This copper produces a reaction that's toxic to sperm and eggs, completely eliminating the chance for any pregnancy at all. There are serious pros and cons that go with this IUD, though. With the lack of hormones, it won't put you at risk for blood clots or other hormone-based complications and can be used while breastfeeding. It also has a life of ten years which is unheard of among hormone-based IUDs. The con of using Paragard is that you may encounter longer, heavier periods after insertion, along with stronger or more frequent cramps. These symptoms should subside after six months, however, it may not be conducive to people who already suffer from painful menstrual cycles. There are a lot of things to consider with this one, mainly whether six months of irregular periods are worth ten years of protection against pregnancy -- which may be just the thing to make it your first choice.
15 Hormones And Nursing Don't Mix
It should go without saying that whatever you take in orally can be passed onto your baby through breastfeeding, but it's worth noting in the facts you should know before considering a birth control method post-pregnancy. There are certain pills that are safe to take shortly after and some that aren't.
For the most part, combination pills should be avoided for at least six weeks after giving birth because of their high concentration of hormones: both estrogen and progestin. Estrogen has been shown to suppress milk production, which is obviously an issue if you're planning on nursing.
While there's no immediate proven risk of combination pills having an effect on nursing babies, the effects, in the long run, are not documented and many doctors will caution against it. Progestin-only pills are a slightly safer bet when it comes to nursing and taking birth control since the amount of hormone you take is much, much less significant and therefore less of a risk as far as breastfeeding is concerned.
14 Everything Has Risks
All birth control comes with risks since it's not something that is naturally occurring in the human body. These are risks that you should be aware of especially post-pregnancy when your body is at its most vulnerable and still recovering. The risks with IUDs are low, but they're still something to be aware of. Within a month of having an IUD inserted, rejection is a risk: your body may naturally try to expel the IUD because it senses that it doesn't belong there and it may begin to slip out. Included in expulsion risks is embedment, where your IUD may migrate and/or become embedded in the uterine wall. The largest study ever done involving both hormone-based IUDs and copper IUDs found that, by the one-year mark of the study, 93% of progestin-based IUD users still had their IUD, and only 1% suffered from expulsion, and 1.4% suffered from a perforation. Copper-based IUD users showed 87% retained the IUD, while 1.2% suffered expulsion, and 1.1% suffered perforation out of 1,000 monitored IUDs. With those odds, it's easy to see why IUDs have serious risks, but they are not common.
Women choosing IUDs post-pregnancy or while breastfeeding may have an increased risk, but the pill also comes with its own set of risks too. Nutrient deficiency can often arise as one because in order to metabolize the extra hormones, the body needs extra vitamins.
This can obviously pose a significant risk for women who have just given birth but is easily corrected. The pill may also worsen candida, which puts women at risk for increased yeast infections -- another thing that's particularly uncomfortable post-pregnancy. In addition to these, the pill can cause excess moodiness, anxiety, and depression due to the increase in hormones. Physical risks include an increased cancer risk, as well as an increased risk for blood clots, especially if both are common in family history.
13 Everything Has Side Effects
Another thing to consider is the side effects of each birth control. Every medication has side effects and birth control can't be singled out for having them, it's just the way things go. Birth control pills are first up! Common side effects (all of which should begin to level out after three to six months, if they don't then you should see your doctor) include headaches or migraines, increased blood pressure, weight gain from water retention, random mood changes until your body levels out, nausea associated with cramping or irregular bleeding, and breast tenderness since birth control mimics and "tricks" your body into thinking it's pregnant. The side effects associated with an IUD consist of pain when the IUD is inserted which may last several seconds before subsiding, cramping and/or backaches shortly after insertion, irregular spotting, irregular periods until your body becomes used to the IUD, and if Paragard is your choice, heavier periods and severe cramps may accompany it.
None of these are things you'd be jumping for joy over but in the long run, but they cut down on stress and are a minor inconvenience compared to the risk of becoming pregnant again immediately.
12 Timing Is Everything
The importance of taking a progestin-only pill can't be stressed enough. Doctors recommend setting an alarm specifically for taking your birth control pill since many people do forget. We're all human and sometimes it can't be helped. After having a baby, your life may be even more chaotic which is why it's so important to give serious thought to which birth control is the best for you and your lifestyle. If you're absolutely certain you can stick to a schedule, then a progestin-only mini-pill may be the right course of action for you. If you want to be on birth control as quickly as possible and don't want to be bothered with needing to set a pill reminder every day, an IUD is something to consider. And lastly, if birth control isn't your main concern and you're more preoccupied with your new life as a mom and can wait a few weeks, then an eventual combination pill is definitely the way to go. All personal choices, as always, should be left up to you and you alone based on what you need.
But if mom isn't ready to become pregnant again right after the birth, she should make sure to think about what's best for her in advance and have everything she needs prescribed to her when she needs it.
11 Things To Consider
A major thing to consider if you've never been on birth control or just don't know much about it is what it does and doesn't protect against. Obviously, both the pill and the IUD protect against pregnancy given they're being taken correctly/are working efficiently. However, the protection against everything else stops there. Birth control will not protect against STDs or any types of infections. The hormones present in the pill and hormone-based IUDs only helps to thicken uterine lining and help to prevent the release of an egg, something STDs and infections have absolutely nothing to do with. IUDs and the pill are meant to prevent pregnancy and nothing else, including infection. Both birth controls may have side effects that contribute to infections, though, and those complications while rare should still be discussed with your doctor if you're prone to them. Infections such as UTIs will not be affected by birth control and there has been no substantial, proven evidence that birth controls can cause them, either. If mom and/or her partner need to protect against any type of pre-existing infection, they need a physical barrier that just can't be provided by any IUD or pill.
10 What Goes Into You Body, Goes To Your Baby
Breastfeeding is essential for many moms. It's seen as an important bonding experience with the newborn, and has many health benefits for the baby. But it has consequences for parents, especially if mom isn't ready to be pregnant again right away. We've established the fact that the pill, especially combination pills with both estrogen and progestin, should only be considered with at least a six-week waiting period post-pregnancy. What we haven't covered is why and what effect the pills have on breastfeeding and more importantly, your newborn baby. The six-week mark is considered a safe enough waiting time period because by then, your body should be fairly well-established as far as producing milk goes and there should be a definitive feeding pattern.
As far as your newborn, by six weeks he or she should have no issues metabolizing any hormones that do end up in breast milk.
It's nothing new that every human body is different and as such, every woman reacts differently to new birth controls. The safest thing you can do for you and your baby is to have an in-depth conversation with your doctor about which birth control is right for you depending on your body chemistry.
9 The IUD-ea Is Simple
There's a lot of mystery surrounding the IUD because while it's not a new form of birth control, it's becoming more mainstream for women who are not and haven't been pregnant. One of the most common questions is "how does it work?" We're going to give you the straight facts behind the idea of the IUD, how it's inserted, and what it does. The IUD is placed up inside the uterus through the cervix by a trained doctor in a procedure that's relatively simple and quick. It's been said that pain levels vary; if you haven't had kids before and the cervix has remained a constant size then initial pain may be more severe, while if you have had kids, the cervix has already been stressed and can handle an IUD insertion much easier without the need for dilation. The IUDs vary in size with Mirena being the most popular in recent years as a hormone-based IUD. ParaGard, the only copper IUD on the market, has no hormones but works immediately upon placement.
The great thing about IUDs is that they give you the flexibility to live your life without setting a timer to remember pills and since most IUDs last three to five years (or up to ten for ParaGard), there's no need to constantly get renewed prescriptions and worry about an influx of hormones that may affect your body more so than just the progestin found in hormonal IUDs.
8 A Bit Of A Chemistry Lesson
The types of combination pills we have today are as follows: monophasic, biphasic, and triphasic.
These three types of pills differ based on how long hormones hang around in your system during a full four-week cycle.
With most pill packs, the fourth week is almost always placebos to simulate a period and keep levels balanced for as normal a cycle as possible. These birth control types, or phasic birth control as they're referred to, each prevent pregnancy in a different way. Monophasic birth controls have equal levels of both estrogen and progestin to keep hormone levels balanced every month, such as with Lo Loestrin FE, which only contains 10 micrograms of estrogen as opposed to the 30-35 that most of them have. This is commonly the first birth control most people are introduced to since it's low-dose and lessens side effects. Biphasic birth control, as you may have guessed already, fluctuates in hormone dosage halfway through the pill pack. Estrogen levels remain the same, but progestin is increased towards the end such as with Mircette and Necon. Triphasic birth control has the most hormonal fluctuations in a pack, with hormone levels that increase in both estrogen and progestin each week of the pack until the fourth placebo pill week. This is found in birth controls such as Ortho-Tri-Cyclen. Neither pills are less effective than the other and what's right for you simply depends on your body's natural organic chemistry during your cycle; your doctor will most likely prescribe a low-dose monophasic birth control simply because it keeps hormones level for 28 days and has fewer side effects.
7 When Does It Work: The Pill
Tah-dah, the 28-day combination pill! Gone are the days of having a clunky plastic box with a set of pills in it that make it super obvious that you're on birth control. Newer pills are given to you in a super thin pouch that'll easily fit in your pocketbook or discreetly slid next to your toothbrush in the bathroom, and the pills are small enough to swallow, no problem. Some pills even have the option of being chewed (with a delightful mint flavor) because either way, they're being absorbed into the bloodstream.
While being intimate is probably not the first thing on your mind immediately after having a baby, it's good to know when birth control officially begins working just in case. To put your mind at ease, we have the answer to that. Birth controls pills must be started on the first Sunday of the week that you get them, and begin working seven days from that point.
So essentially you need to wait one week after beginning your pill pack for the hormones to be effective working to prevent pregnancy.
Of course, this changes according to whether or not you've decided to breastfeed as well. There has been no confirmed evidence that hormones from combination pills affect a newborn through his mother's milk, however, most doctors will caution you to wait at least six weeks before starting a new birth control method unless it's a progestin-only pill. Therefore you'd need to take the full six weeks into account and then add a week to that: So seven weeks in full.
6 When Does It Work: The IUD
The quickest-working immediate birth control is the ParaGard IUD since it works immediately upon placement as a spermicide. This makes it a great emergency contraception as well since it is additionally toxic to any eggs that are at risk of being fertilized. It's also a great option for use during nursing since there are no hormones involved whatsoever. Hormonal IUDs have an interesting timeline, since they work based on your menstrual cycle.
If you have the IUD inserted within seven days of your last menstrual cycle, they begin working almost immediately. If the IUD is inserted long after that, you need to wait at least a week for it to become effective.
The method of inserting an IUD within 48 hours post-birth is slightly different from insertion on a non-dilated cervix, but chances of expulsion are increased due to this -- however, the initial average percentage of expulsion on a non-dilated cervix is only 2-3% to begin with. Obviously being pregnant affects your cycle as well and a doctor will be able to best tell you exactly when your birth control is doing you a solid. The IUD is definitely the answer to the question: how can I be protected as soon as possible after birth?
5 Compared To Birth, IUD Is Nothing To Be Afraid Of
Ah, the most common question: Is birth control painful? This seems completely idiotic compared to the pain associated with giving birth, but it's something to consider if you're choosing an IUD and not having it inserted until after your cervix is no longer dilated. Surprisingly, an IUD can be inserted within ten minutes post-birth even with an elevated risk of expulsion, because the CDC and ACOG got together and decided it was still beneficial to new moms to have it placed as early as possible. This is stellar news as far as pain goes, because, uh, it's not a cakewalk to get an IUD inserted.
After pregnancy, your cervix is dilated so there's not only more room for your doctor to use for the insertion process, but there won't be such a tight space hugging a tiny piece of hormonal plastic.
However, we have good news for anyone who has had a baby: Chances are, your pain will still be significantly less on insertion than someone who hasn't had one simply because the cervix is a tad stretchy. To speak to this aspect, everyone in the world feels pain differently and there's no scientific evidence to prove a definitive pain scale. All we've got are personal testimonies (which you absolutely should not read beforehand) and the facts on how an IUD is inserted and where it sits. All hail the mothers of the world who made it through labor pain -- an IUD insertion should be easy for you compared to that.
4 Set The Alarm, It's Progestin Time
It's time to set the record straight on the mini-pill. Progestin-only pills, or POPs for sure -- we like the cuteness of it, too -- have one job: Thicken the cervical mucus and thin out the uterus lining. This works in tandem to prevent pregnancy by decreasing the chance of sperm making their way into the uterus (imagine trying to wade your way through a melted marshmallow) while preventing an egg from attaching to the uterine wall (like rock climbing on a sheet of thin ice). The two working together is highly successful and have a success rate of 87-99.7% which is less than an IUD but keep in mind, this is only because they need to be taken at the same time, every single day.
The success rate, when taken correctly, is close to 100%.
When that statistic is broken down, it's estimated that for every 100 women, between two and nine of them will become pregnant but again, this is mostly due to an incorrectly taken pill pack. Human error is by far the biggest cause of birth control failing. If mom isn't 100% confident that she can take her pill perfectly, or if she's not able to compensate for these errors with other forms of birth control, she needs a different option.
3 Family History Is A Risk Factor
There is one risk that comes with almost all birth controls and one that's worth mentioning since your risk goes up based on family history or contributing factors. All hormonal birth controls can add to the risk of blood clots. The risk is generally low but the increased estrogen can lead to deep-vein thrombosis (DVT) or a clot in the lungs, which can lead to more serious trouble later on.
The risk of that is lower with modern birth controls that contain much lower doses of estrogen, but if you have a family history of heart problems and blood clots, it's something to be wary of.
You may potentially want to consider other birth control options with no estrogen. Combination pills and the patch are at the top of the list when it comes to estrogen, however, chances of blood clots increase within the first six weeks after giving birth. This is so, so important to be aware of when considering a birth control post-pregnancy since you can talk to your doctor about birth control options with either no estrogen and no desogestrel (another form of progestin). It's better to be safe than sorry!
2 The Long-Term Timeline: Moms Need A Plan
How long will birth controls last? It may seem overwhelming initially when you have all of these options in front of you and to make that decision a bit easier, factoring in how long you want your birth control to last may be something to consider. Birth control pills will last as long as you keep taking them which can be however long you want to go baby-free after your last one. There are pros and cons to this.
Taking your own birth control orally can boost the control you have in your own life to decide when you're ready to have another child if you want to which is a good feeling for many women.
However, because you're fully in control of your own preventative method, it's important to stick to a schedule and make sure you take the right pills every day and be sure to renew your subscription every month, three months, or six months depending on your plan. If you want a long-term method of birth control, an IUD is a great option that will last for years. The pro is longevity, the con is that when you are ready to have kids again, you absolutely need to go back to your doctor to have the IUD taken out. It's not a procedure you can or should do at home and should always be handled by a medical professional who is trained to do so.
1 Doing It All Over Again
Let's say something happens and you realize that your birth control isn't the reason you're not getting your period. Whether you've missed a dose, become sick shortly after taking your pill, or may have taken another medication or supplement that decreases effectiveness, it's become a reality. These things happen and it's nothing to immediately stress out or panic over, but of course, birth control should be stopped immediately upon confirmation of a baby. This is easy to do with birth control pills, as it's also easier to become pregnant when taking them as opposed to an IUD, and there is no definitive evidence that has shown birth control has done any harm to a developing baby. If you have an IUD and become pregnant it can cause significant complications. If you have a feeling that you are pregnant you should make an appointment with your doctor ASAP to conduct an in-office pregnancy test because they're more reliable than at-home tests. It's so important to do this especially if you've had a positive test at home because IUDs increase the risk for an ectopic pregnancy -- which means the egg has been fertilized outside of the uterus and instead is stuck in the fallopian tubes. It's a dangerous situation that almost always ends with a loss of pregnancy and with the threat of potential damage to reproductive organs, needs to be taken seriously and acted on quickly. The good news is that this is very rare and is exactly why annual and six-month visits to your OBGYN are important!
References: Parents.com, Webmd.com, healthywomen.org, babycenter.com, fitpregnancy.com, upmc.com, bedsider.org, verywell.com, kff.org, askdrsears.com, plannedparenthood.org, medscape.com, bedsider.org, mayoclinic.org, prjktruby.com, babycenter.com, nhs.uk, zocdoc.com, birthcontrolbuzz.com