Here’s What You Need to Know About Postpartum Birth Control

You read all the books, scrolled into the wee hours of the night, asked your doctor all the questions, but nothing could truly prepare you for the moment your baby entered the world. The euphoric rush of seeing your little one hoisted into the air, placed on your chest, your skin meeting for the first time. But then what?

Along with the joys of welcoming your little one into the world, comes a slew of individualized postpartum choices and challenges. The last thing you should have to worry about is figuring out your birth control plan…where do you even begin?!

So, we’re here to lend a hand. We spoke with two OBGYNs about: things to know while navigating postpartum, birth control planning and why an intrauterine device (IUD) may be a good option to consider, and what to discuss with your doctor to ensure you’re choosing an appropriate birth control option that may work for you. Here’s what they had to say.

You can get pregnant while breastfeeding

You’re probably already aware that breastfeeding can offer a range of health benefits for both you and your baby. If you’re planning to breastfeed, you may also have heard that you can’t get pregnant during this time but…that’s not exactly true.

“Although some women believe it’s not possible to get pregnant while breastfeeding, the reality is, it’s just less likely – but still possible,” explains Jessica Shepherd, MD, MBA, gynecologist, and women’s health expert.

While the likelihood of becoming pregnant may be lower during the time you’re breastfeeding, there is no way to predict when your body will start ovulating again and it usually occurs 2 weeks before your menstruation starts, this means that you can get pregnant even if you have not yet had a period. There are many factors that can influence when your body starts ovulating after childbirth. The hormone associated with breastfeeding, called prolactin, plays a role in when you resume ovulation. And while your prolactin levels can fluctuate for a variety of reasons, it’s often associated with frequency and duration of breastfeeding, suckling and pumping. As these decline – prolactin, too, is likely to decline, which sends a signal to your body to start ovulating again. Most women begin their period about six months postpartum, a sign that ovulation has resumed, according to the American College of Obstetricians and Gynecologists (ACOG) but research shows that you can get pregnant earlier than 6 weeks after giving birth and though uncommon, it is possible to get pregnant even before you start having your period again.  

Seven in 10 pregnancies in the first year postpartum are unplanned

While getting intimate with your partner after giving birth may be the last thing on your mind, the day could arrive before you know it. Unless you’re ready to have another baby, having a contraception plan in place to avoid an unplanned pregnancy will make getting cozy in the sheets a lot less stressful.

In fact, one study found that 7 out of 10 pregnancies that occur within one year of giving birth were unplanned.

“Most times it is due to a lack of understanding on how quickly ovulation returns and also being so involved with a newborn, that birth control isn’t top of mind,” says Dr. Shepherd.

But that doesn’t mean you cannot be proactive and effectively family plan. 

“The best way to address a birth control plan is to do so during pregnancy,” advises Maria Sophocles, MD, gynecologist and women’s health advocate. She says to consider your postpartum family planning in your second trimester, a time when women typically have the most energy to prepare.

An IUD may be a low-maintenance option that can be inserted right away

In the haze of postpartum and caring for a newborn, remembering to stay on top of your birth control can be overwhelming. An IUD provides no daily routine as a pill-free, low-maintenance birth control option. Instead, you will have to check for the threads once a month on your own.

The Mirena IUD is a hormone-releasing IUD that prevents pregnancy for up to 8 years and can be inserted right after birth or at your 6-week check-up and is one of the most effective, reversible forms of birth control available.

The risk of perforation is increased with insertion after delivery if Mirena is inserted while you are breastfeeding, or if you have recently given birth. The risk of expulsion is increased with insertion after delivery.

Mirena is a small flexible plastic T-shaped system that slowly releases a progestin hormone. Two thin threads are also attached to the lower end of Mirena, however, unlike a tampon string, the threads do not extend outside your body. At insertion, your healthcare provider will first examine your pelvis to find the exact position of your uterus. They will then clean your vagina and cervix with an antiseptic solution and slide a slim plastic tube containing Mirena through the cervix into your uterus. Your healthcare provider will then remove the plastic tube and leave Mirena in your uterus. Following placement, your healthcare provider will then cut the threads to the right length.

You may experience pain, bleeding or dizziness during and after placement. If your symptoms do not pass within 30 minutes after placement, Mirena may not have been placed correctly. Your healthcare provider will examine you to see if Mirena needs to be removed or replaced.

The Mirena IUD is also reversible—which means, if you want to stop using it, you can have it removed by your healthcare provider if plans change.

Mirena may not be right for everyone so it’s important to talk to your healthcare provider to see if it is a good option for you. Things will get busy once the baby comes, so have a conversation with your provider about your postpartum plans.

INDICATION FOR MIRENA

Mirena^®️ (levonorgestrel-releasing intrauterine system) is a hormone-releasing IUD that prevents pregnancy for up to 8 years. Mirena also treats heavy periods for up to 5 years in women who choose intrauterine contraception.

IMPORTANT SAFETY INFORMATION

If you have a pelvic or genital infection, get infections easily, or have certain cancers, don’t use Mirena. Less than 1% of users get a serious pelvic infection called pelvic inflammatory disease (PID).

If you have persistent pelvic or stomach pain, or excessive bleeding after placement, tell your healthcare provider (HCP). If Mirena comes out, call your HCP and avoid intercourse or use non-hormonal back-up birth control (such as condoms or spermicide). Mirena may go into or through the wall of the uterus and cause other problems.

Pregnancy while using Mirena is uncommon but can be life threatening and may result in loss of pregnancy or fertility.

Ovarian cysts may occur but usually disappear.

Bleeding and spotting may increase in the first 3 to 6 months and remain irregular. Periods over time usually become shorter, lighter, or may stop.

Mirena does not protect against HIV or STIs.

Only you and your HCP can decide if Mirena is right for you. Mirena is available by prescription only.

For important risk and use information about Mirena, please see the accompanying Full Prescribing Information.

Visit Mirena.com to learn more.

Dr. Sophocles does not provide paid consultation services to Bayer and is not being compensated for this information. Dr. Shepherd has provided paid consultation services to Bayer in the past but is not being compensated for this information.

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