Safest Birth Control Options While Breastfeeding

A non-hormonal IUD, most commonly known by the brand name ParaGuard, is a small, T-shaped device that is placed in your uterus by your doctor during an office visit. The IUD releases copper, creating a hostile environment for sperm and causing the lining of the uterus to shed more often, therefore blocking the implantation of a fertilized egg.

The Association of Reproductive Health Professionals (ARHP) offers the following the advantages of a copper IUD:

• Lack of hormones make copper IUDs appropriate for breastfeeding mothers, and women with contraindications to estrogen or progestin.
• Copper IUDs are reversible. Your IUD can be removed and there is a rapid return to fertility after removal.
• Copper IUDs are approved for 10 years of use, although studies have shown them to be effective for up to 20 years.
• Copper IUDs can be used as an off-label emergency contraceptive. They can be inserted up to 5 days after unprotected sex, and reduce the risk of pregnancy by more than 99 percent.

Disadvantages and side effects can include:

• No protection against sexually transmitted diseases (STDs).
• Requires a visit to your doctor’s office for insertion and removal.
• May make your period longer or heavier, and women with heavy or painful periods may not tolerate an IUD.
• Spotting between periods.
• Cramps.
• Pain during sex.
• Some risk of expulsion within the first year.

A new study published in Obstetrics and Gynecology found that women who receive an intrauterine device (IUD) during a Cesarean section were more likely to be using them six months later than women who are told to return to the doctor for contraception six weeks after giving birth.

Many birth control pills contain a combination of progestin and estrogen. While a small amount of these hormones do enter your milk supply, both are safe for your baby. However estrogen can lower milk supply, so breastfeeding moms should not take a combination pill. Progestin-only pills, also called the “mini-pill,” are a safe and effective option. Fully breastfeeding moms can begin taking these pills six weeks after birth; partially breastfeeding moms can begin taking them three weeks after birth.

Progestin-only pills work by preventing ovulation and thickening the cervical mucus and lining of the uterus to prevent sperm from entering. According to the ARHP, less than 1 out of 100 women will get pregnant when using the pill correctly. Although all birth control pills should be taken around the same time every day, progestin-only pills must be taken within the same 3 hour window to be the most effective — this can be challenging for a busy new mom. The ARHP offers the following advantages of progestin-only pills:

• Birth control pills are safe and very effective when used correctly.
• You don’t need to think about birth control every time you have sex.
• Most women can get pregnant quickly again after stopping use.
• Your period may become lighter and less painful.

Disadvantages and side effects can include:

• Spotting between periods.
• Abdominal pain and cramping.
• Bloating or weight gain.
• Headaches.
• No protection against STDs.
• Requires a prescription.
• It’s easy to forget to take the pill at the same time every day, reducing its effectiveness.

The birth control shot, known as Depo-Provera, is an injection of progestin administered by your doctor in your arm, and protects against pregnancy for about three months. If used correctly, the shot is very effective — fewer than 1 out of 100 women will get pregnant when using it.

The first injection takes about seven days to be effective, so use a backup method of birth control during the first week. The shot works the same way progestin-only pills works, by preventing ovulation and thickening the cervical mucus and uterine lining to prevent sperm from entering. The ARHP offers the following advantages of Depo-Provera:

• The shot is safe and very effective.
• You don’t need to remember to take a form of birth control every day.
• You don’t need to think about birth control every time you have sex.
• Your periods may be lighter and less painful.

Disadvantages and side effects can include:

• No protection against STDs.
• Requires a visit to your doctor every 12 weeks for a shot.
• If you wish to go off the shots and become pregnant, it may take up to a year from your last injection.
• Some women experience irregular bleeding, especially during the first 6 to 12 months of use.
• Some women experience bone thinning when on the shot.

Non-hormonal barrier methods include diaphragms, male and female condoms, contraceptive sponges, cervical caps, and spermicidal gel. These methods block sperm from entering the uterus and reaching an egg.

Barrier methods are not as effective as IUDs and progestin-only birth control pills and shots. According to the ARHP, the effectiveness of these methods is greatly enhanced when both partners understand and discuss how to use them.

According to the ARHP, exclusive breastfeeding can be an effective form of birth control — fewer than 1 out of 100 women who exclusively breastfeed will get pregnant within the first six months. However, lactational amenorrhea is only effective if specific guidelines are strictly followed, which can be extremely tough for most nursing moms.

When you are breastfeeding, your body has increased levels of the hormone prolactin, which prevents ovulation. For this method to work, a breastfeeding mom must meet all of the following criteria:

• Only nurse your baby from the breast (no pumping or supplemental formula).
• Breastfeed your baby every four hours during the day.
• Breastfeed your baby every six hours at night.
• Your period hasn’t returned post birth.

Disadvantages include:

• This method only works for about six months. After six months, you’ll need to use another form of birth control.
• Some women find it difficult to exclusively breastfeed their baby.
• Does not protect against STDs.

Talk to your doctor before using breastfeeding as a form of birth control, and consider using a non-hormonal backup to be safe.