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Navigating Postpartum Birth Control while Breastfeeding

Birth control might not be the first thing on your mind in the whirlwind of new parenthood and breastfeeding, but it’s important! Preventing pregnancy for the first 12-18 months after delivery improves bonding with your baby, promotes your physical recovery, and reduces the risk of complications in your next pregnancy. You may be concerned that birth control could negatively impact breastfeeding, but fortunately there are some great options that won’t interfere with your nursing or pumping journey.

1. **The Mini Pill:** First up, we have the mini pill, also known as the progestin-only pill. These pills contain only progestin (no estrogen), making them a breastfeeding-friendly option. There is a low dose, generic version that must be taken at the same time everyday (taking even just 3 hours late can render the pill ineffective), and a brand name option called Slynd that has a 24 hour missed pill window.

2. **Depo-Provera Shot:** If you’re not into taking a daily pill, the Depo-Provera shot might be a good option. It’s a progestin-based injection that lasts for three months, providing effective contraception without interfering with breastfeeding.

3. **Intrauterine Devices (IUDs):** IUDs are a fantastic long-term solution for postpartum birth control. Both copper and hormonal IUDs are breastfeeding-friendly. The copper IUD is hormone-free and approved to prevent pregnancy for up to 10 years, while the hormonal IUD releases a small amount of progestin and is approved for 5-7 years depending on which type you choose. You should wait to have your IUD placed until 6-9 weeks postpartum, as this time frame provides the lowest risk of expulsion of the device or uterine perforation.

4. **Implants:** The birth control implant is another option you might want to consider. It’s a small rod called Nexplanon that is inserted into your arm and releases progestin. It’s effective for up to three years and, you guessed it, breastfeeding-friendly!

5. **Barrier Methods:** Don’t forget about trusty old barrier methods like condoms or diaphragms. They’re hormone-free and don’t interfere with breastfeeding.

6. **Spermicides:** Although less effective than the aforementioned options, with perfect use spermicides can be 82% effective at preventing pregnancy. Phexxi is a birth control gel that lowers the vaginal pH to immobilize sperm, preventing them from meeting the egg. Phexxi is 92% effective if you use it every time with intercourse.

7. **Lactational Amenorrhea:** If you have not gotten your period back and your baby is getting all calories from breastmilk (no supplements or formula), you are unlikely to ovulate during the first 6 months after delivery. Once your baby begins solid foods in addition to breastmilk, you should no longer rely on this method, even if you have not yet started getting a period.

Postpartum life can be overwhelming, and these breastfeeding-friendly birth control options give you the freedom to focus on your baby while staying in control of your reproductive journey. No two women are the same, and what works for one may not work for another. Talk with your provider about your priorities and preferences, so you can find the method that works best for you.

Find more information about postpartum birth control methods here: https://www.acog.org/womens-health/faqs/postpartum-birth-control

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Durant Medical Center
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