Post-birth contraception

You can have the contraceptive implant immediately after having your baby. It can be inserted in the hospital before you home.

The implant is a tiny, bendy rod, about the size of a matchstick that is inserted under the skin of your upper arm.

The implant steadily releases a hormone called progestogen into your bloodstream, which prevents the release of an egg each month (ovulation).

It also thickens the cervical mucus which makes it more difficult for sperm to move through the cervix and thins the lining of the womb, so a fertilised egg is less likely to implant itself.

It's more than 99% effective. Fewer than 1 woman in 1,000 who have the implant as contraception for 3 years will get pregnant.

Advantages 

• Suitable if you are breastfeeding.
• Can start immediately after birth. 
• Lasts for 3 years. 
• It can reduce your menstrual flow or stop your periods altogether. 
• Does not contain oestrogen (safer for some people).
• Removed at any time and fertility returns to normal quickly.
• It may reduce period pain.

Disadvantages 

• Possible irregular periods or no periods. 
• Bruising, tenderness, swelling around implant after it is inserted.
• You are not protected against sexually transmitted infections (STI’s) 
• Migration of implant (it moves from its position). 
• You may have some side effects such as breast-tenderness, acne, low mood, headaches. These should clear up after a period of use.

The hormonal IUD can be fitted either in the first 48 hours after delivery, or 4-6 weeks later. This will be discussed by your healthcare professional before you give birth and can be planned for the time of your delivery. It can also be inserted at the time of a planned caesarean section.

The hormonal intrauterine system (LNG-IUD) (sometimes known as a Mirena/Levosert/kyleena) is a little, t-shaped device that is placed in your uterus (womb).

It releases a small amount of hormone, called progestogen, which prevents sperm from getting through the cervix into the uterus and meeting up with an egg. It can last up to 5 years or more.

It is more than 99% effective. That means fewer than 1 out of 100 people who use an IUD will get pregnant each year.

Advantages 

• Suitable for breastfeeding women.
• Lasts at least 5 years.
• It can reduce your menstrual flow or stop your periods. 
• It can reduce heavy or painful periods.
• Can be inserted before you leave hospital.
• Does not contain oestrogen (safer for some people). 
• Removed at any time and fertility returns to normal quickly.
• It is not affected by other medications.

Disadvantages 

• Possible irregular periods or no periods. 
• Small risk of infection after insertion.
• You are not protected against STIs. 
• You may have some side effects such as breast-tenderness, acne, headaches, low-mood these should clear up after a short time.
• There is a small risk your body may expel the IUD. 
• Some women can develop small fluid-filled cysts on ovaries, this is uncommon, and these usually disappear without treatment.

The copper IUD can be fitted either in the first 48 hours after delivery or 4-6 weeks later. This will be discussed by your midwife or doctor before you give birth and can be planned for the time of your delivery. It can also be inserted at the time of a planned caesarean section.

The copper IUD is a t-shaped device that is placed in your uterus (womb) which releases copper. It can last either 5 or 10 years based on the device fitted. 

The copper alters cervical mucus, which makes it more difficult for sperm to reach an egg and survive. It can also stop a fertilised egg from being able to implant itself. 

It is more than 99% effective. That means fewer than 1 out of 100 people who use a copper iUD will get pregnant each year.

Advantages:

• Suitable for breastfeeding women
• Lasts at least 5 or 10 years; once in place you do not need to think about contraception. 
• It can reduce your menstrual flow or stop your periods. 
• It can reduce heavy or painful periods.
• Can be inserted before you leave hospital.
• Does not contain oestrogen (safer for some people). 
• Removed at any time fertility returns to normal quickly.
• There are no hormonal side effects such as acne, headaches, or breast tenderness.
• Not affected by medications 

Disadvantages:

• Your periods could be heavier longer or more painful in the first 3-6 months after it is put in. 
• Small risk of infection after insertion.
• You are not protected against STIs. 
• There is a small risk your body may expel the IUD

You can use the contraceptive injection immediately after having your baby. It can be given in the hospital before going home.

The contraceptive injection contains a hormone called progestogen, which releases a hormone into your bloodstream to prevent a release of an egg each month (ovulation).

The injection is normally administered into your buttock.

It also thickens your cervical mucus, which makes it difficult for sperm to move through the cervix and thins the lining of the womb, so a fertilised egg is less likely to implant itself.

If used correctly, the contraceptive injection is 99% effective. This means than 1 woman in 100 who use the injection will become pregnant in a year.

Advantages:

• Suitable for breastfeeding women
• Each injection lasts for 13 weeks.
• It can reduce your menstrual flow or stop your periods. 
• It can reduce heavy or painful periods & help PMS symptoms for some women. 
• Can be given before you leave hospital.
• Does not contain oestrogen (safer for some people). 
• It is not affected by other medication.
• You do not need to remember to take a pill every day.

Disadvantages:

• In real world use about 6 women in 100 become pregnant in a year because people forget to get their next injection (94% effective).
• Your periods may change & become irregular, heavier, shorter, light or stop altogether.
• It does not protect you against sexually transmitted infections (STI’s)
• There can be a delay in 1 year before your periods return or you become pregnant.
• Possible weight increase. 
• Side effects like headaches, acne, hair loss, mood symptoms.

If you have just had a baby, you can use the progestogen-only pills immediately if you wish. Your healthcare team can give you a supply of pills before leaving the hospital. 

This method suits women who want to take pills but cannot have oestrogen. The pills are taken every day and contain one hormone. 

There are two kinds of progestogen-only pill:

• The traditional ones that thicken cervical mucus and stop sperm reaching the egg.
• The newer ones that keep the ovaries from releasing an egg (ovulation).

If taken correctly, it can be more than 99% effective. This means that fewer than 1 in 100 women who use the progestogen-only pill as contraception will get pregnant in a year.

Advantages:

• It is suitable for breastfeeding women.
• You can start immediately after birth. 
• It is safe for women who cannot have oestrogen.
• It can reduce your menstrual flow or stop your periods altogether. 
• You take the pill everyday; no break between packs.
• You can take the POP even if over 35 & smoke.

Disadvantages: 

• You must take the POP at the same time everyday.
• If you are sick (vomit) or have severe diarrhoea, the POP may not work. 
• You may have irregular bleeding. 
• You are not protected against STIs.
• Typical use of POP is 91% the way it is taken in real life by women. 
• You may have some side effects such as breast-tenderness or spotty skin. These should clear up after a period of use.

If you are sure your family is complete, sterilisation can be done at the time of caesarean section. You should think of this a permanent method.

If you are considering this option, you need to discuss as early as possible in your pregnancy with your healthcare team. So, they can assess whether this would be a suitable method for you and to become part of your birth plan. 

Female sterilisation is a procedure to permanently prevent pregnancy. The fallopian tubes are blocked or sealed to prevent eggs reaching the sperm and becoming fertilised. Eggs will still be released from the ovaries as normal, but they will be absorbed naturally into the woman's body.

It is more than 99% effective. That means fewer than 1 out of 200 people who have female sterilisation will get pregnant each year.

Advantages:

• Suitable for breastfeeding women.
• Permanent method if family complete.
• Does not affect your hormone levels.

Disadvantages:

• Sterilisation reversal is not available on NHS & can be difficult.  
• Success rates vary, depending on factors like age and method that was used. 
• Does not protect you from STIs.
• Small risk of complications, infection, damage to other organs.
• If pregnancy occurs after sterilisation, it is likely to be an ectopic pregnancy.

Lactational Amenorrhea Method (LAM) involves breastfeeding when all the criteria are met below.

We are aware that some mothers may be concerned about starting contraception in the first 6 weeks after the birth of their baby and the aim of this information is to help you make the decision that is right for you.

Exclusive breastfeeding means that the baby is only having their mother’s own breastmilk, no supplements with formula milk, donor milk, or any water or solid foods.

When a mother is exclusively breastfeeding her baby and the baby is feeding frequently, the levels of the hormone prolactin will stay high enough to stop ovulation from happening.

If you are breast feeding your baby, the available evidence indicates that progestogen-only methods of contraception (Intra-uterine hormonal coil, Implant, Injection, and pill) have no adverse effects on lactation, infant growth, or development.

Women who breastfeed and experience a bleed in the first 6 months after childbirth have been shown to have a higher risk of pregnancy.

If used correctly, lactational amenorrhea method is 99% effective. This means that 2 women in 100 who use breast-feeding will become pregnant in a year. 

Therefore, for breastfeeding to be used as an effective contraceptive method it is recommended that all three of these criteria are met.

• Exclusive breastfeeding day and night. 
• No long intervals between feeds. This means no more than 4 hours during day or 6 hours at night.
• No periods or bleeds.
• Baby less than 6 months old.

If you breastfeed you should wait until 6 weeks after the birth of your baby before starting to use any method of combined hormonal contraception.

If breastfeeding reduces or other LAM criteria is no longer being fulfilled as above, please speak to your GP, or local sexual and reproductive healthcare services to move onto another contraceptive method of your choice. 

A condom is a sheath-shaped barrier device used during sexual intercourse to reduce the probability of pregnancy or a sexually transmitted infection. 

There are two types of condoms:                                                    

Male condom

A male condom, also called an external condom is worn on the penis. Male condoms are a “barrier” method of contraception. They are designed to prevent pregnancy by stopping sperm from meeting an egg.

Make sure the penis does not touch your partners genital area before you have put on a condom – semen can come out of the penis before full ejaculation (you have come).

There are latex and non-latex condoms available.

Male Condoms are 98% effective at preventing pregnancy. This means that 2 out of 100 women using male condoms as contraception will become pregnant in a year.

Female condom

A female condom, also called an internal condom is worn inside the vagina. Female condoms are “barrier” methods of contraception worn inside the vagina. They prevent pregnancy by stopping sperm meeting an egg.

A female condom can be put into the vagina before sex, but make sure the penis does not come into contact with the vagina before the condom has been put in. Semen can still come out of the penis even before full ejaculation (you have come). 

Female condoms are 95% effective. This means that 5 out of 100 women using female condoms as contraception will become pregnant in a year.