If you've just had a child, you may find it hard to believe, but eventually you are
going to be interested in having sex again. In fact, obstetricians say
-- and scientific studies back them up -- that most American couples
resume having sexual intercourse within several weeks of having a baby.
(It's a fair bet that much of this post-partum sex is at the male
partner's instigation, since the most fervent desire new mothers have
when they get into bed is for only one thing: sleep.) Whether or not
you want more children eventually, you probably don't want them right
away. That means you have to think about contraception.
Gynecologists
say the right time to think about after-baby birth control is while
you're still pregnant. Having a plan in place gives you one less thing
to worry about when you're preoccupied with caring for a newborn. Your
first post-partum checkup, at four to six weeks, is another opportunity
to speak to your doctor about contraception. While you may very well
want to return to a method you were using happily before you got
pregnant, there are some new factors to consider:
Condoms Because they don't need to be fitted and don't
require a prescription, condoms are especially easy for new parents to
use. But because vaginal dryness is common in the weeks after birth --
and even longer for nursing mothers -- you may feel more comfortable
using a lubricated condom or a personal lubricant.
Diaphragms If you were happy with the diaphragm before you
became pregnant, by all means go back to it... but not to the same one
you'd been using prior to pregnancy. You should be re-fitted for a
diaphragm (or fitted for the first time if you've never used one
before) at your four- to six-week postpartum checkup, when the uterus
and cervix have returned to the size they will remain (which is usually
a bit larger than before pregnancy).
Cervical Caps Doctors aren't certain why, but cervical
caps are somewhat less effective in women who've given birth; it may
have to do with a changed cervical shape after delivery. This method
may not be the wisest choice for moms.
Oral Contraceptives Most birth control pills are
combinations of two hormones: estrogen and progestin. Women who are not
breastfeeding can begin or resume taking the Pill at the time of their
first postpartum checkup (sooner may increase the risk of blood clots).
Some doctors prefer to wait in non-nursing women until they've had
their first postpartum period. Most nursing mothers prefer to wait
until their babies are weaned before taking combination pills.
Progestin-only
pills (and other progestin-only contraceptives, such as Norplant
implants or Depo-Provera injections) can be started immediately after
giving birth in non-nursing mothers. There is some controversy over how
safe these methods are for women who are breastfeeding.
IUDS For a variety of reasons -- both legal and medical
-- most doctors will not prescribe IUDs for women who have never had a
child. IUDs got a bad reputation when one model, the Dalkon Shield, was
held responsible for pelvic infections and ectopic pregnancies, but
experts swear the new models are safe and effective. However, once
you've given birth, this contraceptive method becomes newly available
to you. Some physicians will insert an IUD immediately after delivery,
others prefer to wait for six to eight weeks. While not a hindrance to
nursing, the IUD can cause mild uterine cramping during breastfeeding.
Talk to your gynecologist about whether this method would now be right
for you.
Beth Weinhouse is a frequent contributor to Your Baby Today. She specializes in women's and children's health issues and lives in Oxford, Mississippi, with her husband and 6-year-old son.
