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Most women prefer to wait a few months, or years, before getting pregnant again. So it is super important to know this: you can get pregnant after delivery even if you haven't had your first period yet. Why? Because the first period occurs more or less two weeks after the first ovulation, and since we do not know when that first ovulation will occur, we cannot be sure that we are just ovulating when we have sexual intercourse.
So, this means that we have to use contraception from the first moment we decide to have penetrative sex again. Even during breastfeeding.
I tell you what contraceptive measures you can use postpartum:
1- MELA (method of lactation and amenorrhea): LAM is a totally natural contraceptive method that the body has. If you are exclusively breastfeeding your baby (only drink milk from your breast and directly from your breast, without bottles) your body protects you from not getting pregnant again. This method has a proven efficacy of 98-99% provided that the following premises are met:
- Your baby is less than 6 months old and only takes milk from your breast.
- Breastfeed every 6 hours or less at night and every 4 hours or less during the day.
- You have not had your period yet after delivery (amenorrhea).
By complying with these three previous points, you are as protected from pregnancy as if you were using another non-natural contraceptive method.
2- Preservative: We all know this barrier method, let's not forget that it is one of the safest and with the fewest side effects. Besides being the only one that protects us against sexually transmitted diseases.
3- Hormonal contraceptives: what we all know as "the pill", although it also exists in the form of injections as well as pills. The normal "pills", which are taken by women who do not breastfeed, are made up of mainly two hormones: estrogens + progesterone. Well, during breastfeeding it is recommended to use contraceptives that do not contain estrogens, or that carry them in very low amounts. The reason is that estrogens can cause milk production to decrease, so it is best to use progesterone-only contraception (commonly known as a “mini-pill”). Your doctor can prescribe them, and you can choose to take them in pill form, quarterly injection, or subcutaneous implant. It is totally safe for the baby and for lactation. Like any medication, it has side effects for you, of which your doctor must inform you and you must weigh when deciding to use it or not. The contraceptive efficacy of the progesterone pill is equal to that of the combined pill (98%).
4- IUD (intrauterine device): it is a plastic device that the gynecologist or midwife places in the uterus and secretes small doses of progesterone. You must wait between 6-8 weeks postpartum to be able to use it. There are also non-hormonal IUDs, which simply work by creating a hostile environment in the uterus (reaction to a foreign body) that prevents sperm from fertilizing the egg or, if it does, prevents implantation of the egg. Both are 98-99% efficient.
5- Diaphragm: it is a silicone cup that is placed in the vagina and covers the cervix during sexual intercourse, preventing access to sperm. It is recommended to always use together with a spermicide to increase its effectiveness. It is a barrier method just like the condom, with the advantage that you put it on when you decide before or during sexual intercourse.
6- Definitive methods: vasectomy or tubal ligation.
My advice is that you decide based on whether you want to have more children soon, your state of health and, above all, with which you feel most comfortable and secure. The most effective method is one with which you feel confident enough to always use it with determination.
You can read more articles similar to Contraceptives during breastfeeding, in the category of On-site breastfeeding.