Most healthcare providers will give the green light to resume sexual activity at your six week postpartum check-up. It is important to remember that you can become pregnant again once sexual activity resumes. Studies have shown that getting pregnant too soon after childbirth can have serious health implications for both mom and baby.
Proper family planning and adequate child spacing reduces the risk of premature birth, birth defects, stillbirth, neonatal death, maternal anemia, bleeding during and after pregnancy and maternal death. Ideally, pregnancies should be spaced a minimum of 18 months to 3 years (or more) apart.
Did you know that breastfeeding can help protect against pregnancy and is considered natural birth control? It's true, exclusive breastfeeding is approximately 98-99% effective in preventing pregnancy in the first 6 months after childbirth. This is known as the lactational amenorrhea method (LAM) and is due to the suppression of hormones that are necessary for ovulation. LAM is widely accepted around the world as a natural family planning method. In order for LAM to be effective, three very important criteria MUST be met. These include (listed in order of importance):
Menstruation has not resumed. The Academy of Breastfeeding Medicine defines menses return as "any bleeding that occurs after 56 days postpartum that is perceived by the patient as a menses, or any two consecutive days of bleeding."1
- Breastfeeding is exclusive or almost exclusive.
- Baby is less than 6 months old. (Complimentary foods are usually begun around this time with a gradual reduction in breastfeeding frequency. Ovulation usually resumes by 6 months after childbirth.)
Be advised that you can get pregnant before menstruation resumes since ovulation occurs before
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menstruation. If you are not exclusively breastfeeding and do not meet the criteria for LAM, be sure to use some form of contraception to prevent an unplanned pregnancy. It is best to choose a contraceptive that protects breastfeeding such as barrier methods (condoms, diaphragm, spermicides) or intrauterine devices (IUDs). Copper IUDs (Copper T380A) have no known effect on breastfeeding while progestin IUDs (Mirena and levonorgestrel) may have minimal effects.
Hormonal birth control products if used while breastfeeding can negatively affect your milk supply. If you choose hormonal contraception, ask your doctor about progesterone-only birth control products. To reduce the risk of negative effects on your breastmilk, it is advised that progesterone-only pills are begun after 6 weeks postpartum and once milk supply is well established. Estrogen-containing contraceptives should be avoided during lactation since these tend to decrease your milk supply.
To reduce your risk of pregnancy during the postpartum period, discuss your contraception options at your follow-up appointment with your healthcare provider.
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1. The Academy of Breastfeeding Medicine (2005). Clinical Protocol Number #13: Contraception during Breastfeeding
Conde-Agudelo, A. & Belizán, J.(2000) Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ; 321(7271): 1255–1259.
Conde-Agudelo, A., Rosas-Bermúdez, A., Kafury-Goeta, AC. (2006) Birth Spacing and Risk of Adverse Perinatal Outcomes: A Meta-analysis. JAMA;295(15):1809-1823.
USAID. Birthspacing: Call To Action
Author : Diba Tillery RN, BSN, IBCLC, CPST