Contraception after childbirth: basic methods and features. Modern types of contraceptives for women after childbirth

Doctors never tire of warning young mothers during discharge from the hospital about the need to protect themselves from unwanted pregnancy. Even if a married couple is planning the birth of a second child within a short period of time, they should think about the stress that the mother’s body experiences after childbirth, during lactation, as well as how difficult it will be for a woman to combine pregnancy with feeding and caring for the baby .

It is believed that for one and a half to two months after childbirth, fertilization of the egg cannot occur in the woman’s body, which means pregnancy does not occur. Therefore, many women in labor do not think about contraceptive measures. But it is precisely after two months that re-conception very often occurs, which the woman may not be aware of. long time until he feels the fetus move.

Since after giving birth in female body If strong hormonal changes occur, then during this period it is quite difficult to choose an effective method of contraception. It is advisable to seek advice from an experienced gynecologist. Independent choice of birth control methods may not be reliable enough, even if it never failed the couple before pregnancy.

Most often in after birth period a woman feeds her baby with breast milk, so when choosing a method of contraception, you should definitely take this factor into account so as not to harm the baby and not disrupt the breastfeeding process. The lactation process not only provides the newborn baby with everything necessary for growth and development nutrients, vitamins, microelements, immune bodies and enzymes, but also promotes better recovery maternal body, uterine contraction, normalization of hormonal levels. In addition, the lactation period itself is a kind of protection of the body from repeat pregnancy.

Typically, contraception after childbirth involves a combination of several methods at once, which significantly increases their reliability. Currently known methods of preventing unwanted pregnancy can be divided into several types:

• physiological or natural,
• barrier,
• chemical,
• hormonal,
• intrauterine,
• postcoital (emergency),
• radical.

Let's take a closer look at the various methods of protection, their advantages and disadvantages.

Physiological methods

This group of contraceptive methods includes the following:
Abstinence. The method involves complete abstinence from sexual activity, therefore it is 100% reliable. However, it does not satisfy many couples, so it can only be used for a limited period of time.

Lactational amenorrhea. This method of contraception was created by nature itself to protect a woman who has given birth from re-pregnancy. It is based on the processes that occur in the mother's body after childbirth. Intense production of the hormone prolactin, which is responsible for the reproduction of breast milk, suppresses the production of some other hormones, in particular estrogen, which is responsible for the functioning of the ovaries and the maturation of follicles and, as a result, the possibility of fertilization.

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It is believed that pregnancy cannot occur during lactational amenorrhea, but for this to happen the following conditions must be met:

• the baby should be put to the breast at his first request,
• the interval between daytime feedings should not exceed 2-3 hours, and between night feedings - 5 hours,
• there should be approximately 8-15 feedings throughout the day,
• the child should be fed exclusively with breast milk; supplementary feeding, introduction of additional complementary foods, or replacement of feedings with them are not allowed,
• The method can be used before the onset of the first menstruation,
• six months after birth and during the breastfeeding crisis requires the additional use of other methods of contraception.

The method has a huge number of advantages over other methods of contraception:

• reliability 97% if the above conditions are met,
• simplicity and naturalness,
• useful for the child and, especially, for the mother’s body, as it promotes faster postpartum recovery.

Unfortunately, along with the advantages, this method of contraception also has a number of disadvantages:

• requires strict adherence to feeding regimen and technique,
• in the event of ovulation, the method loses its reliability, which the woman may not know about.
• Doctors recommend using this method of protection in combination with additional methods.

The calendar method is to refuse sexual contacts during periods favorable for conception. The effectiveness of the method does not exceed 50%.

Barrier methods

• Condoms have quite a lot high efficiency. They are easy to use, can be used from the moment intimate relationships are resumed, do not affect the development of the child and the lactation process, and protect against sexually transmitted infections. The disadvantages of this contraceptive method include the need to periodically replenish the supply of contraceptives and follow the technique of their use.
• Diaphragms and special caps. Today, these methods are used quite rarely, although they have a fairly high degree of reliability. The diaphragm is installed deep in the vagina, blocking the path of sperm. The cap covers cervical canal, opening the uterine cavity. This method of contraception cannot be used earlier than 1.5-2 months from the moment of birth, due to the processes occurring in the uterus during this period. Among the advantages this method protection against infections and safety for the baby and maternal lactation can be highlighted. However, it also has disadvantages. This is the need after childbirth to again select the desired size of the cap, install it 20-30 minutes before intimate intercourse and remove it 6-8 hours after. In this case, barrier contraceptives can remain in the vagina for no more than 20 hours, as this can cause infection of the internal genital organs and the development of inflammatory process. In addition, the diaphragm requires special care during operation.

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Chemical methods

Spermicidal creams, gels, tablets and suppositories. The drugs are administered 5-15 minutes before the start of sexual intercourse according to the recommendations of the instructions for the drug. The action begins within a few minutes and lasts for 1-6 hours, depending on the contraceptive.

The reliability of the method with proper use of suppositories, creams and tablets is estimated at 60-95%, and they can be used during breastfeeding, as well as in combination with other contraceptive methods.

The advantages and disadvantages of this method are the same as when using barrier agents.

Hormonal methods

Hormonal drugs are artificially created analogues of hormones produced by the female body. Birth control pills can be made based on:

• one hormone - gestagen,
• two hormones - gestagen in combination with estrogen.

Estrogen pills suppress the maturation of follicles and interfere with the process of ovulation and the attachment of fertilized eggs to the wall of the uterus.

Hormonal pills for a woman who has given birth to a baby must be selected under the strict supervision of a doctor, otherwise, instead of the expected effect, when using them, you can get a completely unexpected result.

You can start taking birth control pills as early as 6 weeks after giving birth, when the recovery period body. The advantage of such tablets is their safety for the child, the absence negative influence on the quantity and quality of breast milk, as well as the restoration of reproductive functions immediately after stopping taking contraceptives. The disadvantages of birth control pills include reduced effectiveness if simultaneous administration antibacterial and antiepileptic drugs, sedatives, and possible appearance bloody discharge in the middle of the menstrual cycle, which goes away over time.

Another hormonal contraceptive method is the use of injection solutions and subcutaneous implants based on gestogen. You can also start using them no earlier than 1.5-2 months after birth. Injection solutions are administered intramuscularly and provide an effect for 2-3 months. A subcutaneous implant is a capsule containing a hormone that is injected into the forearm and releases it into the body evenly over five years.

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Contraceptives hormonal drugs containing estrogen, a woman can take only after breastfeeding. Despite the almost 100% effectiveness of such drugs, they have a number of contraindications, so they can be prescribed by a doctor after conducting an appropriate examination of the woman. Such drugs cannot be used in the presence of tumors, thromboembolism, certain types of liver diseases, vascular diseases, heart attack and coronary disease hearts.

Emergency methods of contraception

Such methods are used in exceptional cases: after unplanned intimate relations, a broken condom, or a violation of the schedule for taking birth control pills. Postcoital medications contain large dose hormone, so they can interfere with breastfeeding and cause severe bleeding. In addition, the hormone penetrates into mother's milk, affecting its taste and quality.

Intrauterine contraception

The spiral is installed inside the uterus and prevents a fertilized egg from implanting into its wall. It can be installed no earlier than 1.5-2 months after birth, when the uterus has recovered and returned to its previous size. Installation of the spiral provides contraceptive effect for five years, it does not affect lactation and allows as soon as possible restore reproductive function. This method is contraindicated in the presence of internal inflammatory processes.

After the birth of a child, the mother’s body needs time to recover; a woman exhausted from childbirth is not yet ready for new pregnancy. However, ovulation processes are restored very quickly, so the postpartum period is considered especially favorable for the occurrence of a new pregnancy.

A competent approach to contraception issues will reduce this likelihood to a minimum. If the baby is bottle-fed, choose effective remedy easily. It is important for a nursing mother to remember the peculiarities of the lactation period and choose a method of contraception that is safe for the newborn.

When should you start having sex after giving birth?

As soon as the baby is born, the woman begins to bleed, which can last up to 30 days. During this period of time, it is better to completely abstain from sexual activity. There are the following reasons for this:

1. Sometimes during labor activity Perineal ruptures occur. In the first time after childbirth, the vagina has not yet come into normal condition, and sexual contact is unlikely to be enjoyable.
2. The level of estrogen responsible for vaginal lubrication decreases, because main hormone now - prolactin, which is responsible for the production of breast milk. Along with a decrease in estrogen, a woman’s sex drive practically disappears. It is unlikely that anyone will want to have sex if there is no desire, and friction is accompanied by pain.
3. After the placenta is delivered, the uterus is injured and takes more than 4 weeks to heal. If you have sex during this period, an infection may enter the weakened body.

It is impossible to determine exactly when it is possible to renew sex life after childbirth, because a lot depends on individual characteristics body. Doctors believe that if the birth was without complications, you can return to sexual life after 4 weeks. If the birth was difficult, with the formation of tears, you need to wait until they heal, giving up sexual relations for one and a half to two months.

During a visit to the gynecologist, you can find out how the recovery process is going. Based on the results of the examination, the doctor recommends resuming sexual activity or extending abstinence for a certain period.

The importance of contraception during this period

As soon as a woman’s body recovers after childbirth, the spouses resume sexual activity, often forgetting about the need for protection. This often leads to unwanted pregnancy.

Some married couples are sure that it is impossible to get pregnant immediately after childbirth (more details in the article:). Indeed, during lactation hormonal background is changing. However, there is such a thing as lactational amenorrhea: ovulation occurs during lactation. Thus, for a nursing mother, contraception after childbirth is still necessary.

Doctors say that in order for a woman’s body to replenish the supply of important microelements, at least 3 years must pass between births. Studies have shown that if a new conception occurs immediately after the birth of a child, the risk of complications increases by 50%. Late toxicosis, anemia, delayed fetal development are not all the consequences that arise when there is insufficient interval between two pregnancies.

Since pregnancy can occur even before menstruation resumes, it is necessary to use protection from the first sexual intercourse. When choosing a method of birth control for the postpartum period, you should remember that the contraceptive should not affect the quality of breast milk.

Methods of contraception

How to protect yourself after childbirth so as not to get pregnant and harm your baby? It is impossible to answer this question unambiguously, because for some it is easier to take a pill, for others to use a condom, and some prefer natural methods of contraception after childbirth.

Considering that during breastfeeding many contraception are prohibited, before using the tablet, you must carefully study the instructions and consult your doctor. If the child is bottle-fed, the mother can take any medications that prevent pregnancy. Fans of natural methods should remember that hormonal fluctuations reduce their effectiveness, so it is worth choosing a more reliable remedy.

Birth control pills

A thin layer of mucus covering the cervix protects it from infection. If a woman takes contraceptives after giving birth, the mucus becomes denser and sperm cannot penetrate through it. To increase efficiency you need to follow the rules:

• take contraceptives strictly according to the schedule, without missing a dose;
• start taking it no earlier than 1.5 months after birth;
• take the pills at the same time of day.

Many women prefer birth control pills (more details in the article:). They are divided into 2 groups: those containing synthetic progestogens (affecting the functioning of the ovaries, the production of breast milk) and those containing gestagens and estrogens (affecting the functioning of the ovaries, blocking ovulation). The most popular tablets of the first group include: Mercilon, Charozetta, Fermulen. They have the following advantages:

• side effects practically do not develop;
• the taste of milk and its quantity do not change;
• provide preventive action against inflammation;
• the composition of the blood does not change;
• sexual desire does not decrease;
• The ability to conceive is restored very quickly if you stop taking the pills.

Drugs of the second group, containing gestagens and estrogens, are prohibited if a woman is breastfeeding, as they reduce the quality and quantity of breast milk. When choosing a method of contraception using pills, you should consult a gynecologist. The specialist will tell you which drugs will bring maximum effect and will not affect the quality of breast milk.

Protective injections

If you don't want to drink birth control pills, you can use more modern method contraception - give a protective injection. This method is more than 99% effective. After using injections, reproductive functions are restored for about a year, so injections should be stopped long before planning a pregnancy.

Installation of the spiral

The most rational method of protection after childbirth is intrauterine device. It is absolutely safe during lactation and is 99% effective. The IUD is introduced no earlier than 1.5 months after birth, when the uterus becomes normal sizes. In the presence of “female” diseases, the IUD is contraindicated.

Mirena-type spirals containing progestin are very popular (we recommend reading:). Small amounts of the hormone are released over 12 months and prevent the fertilized egg from attaching to the wall of the uterus.

Barrier contraceptives

As soon as the bleeding stops and the vagina returns to normal size, barrier contraceptives can be used. These highly effective products are absolutely harmless to mother and child.

A condom protects against pregnancy and infectious diseases. Since vaginal dryness or allergies to latex products are noted during the postpartum period, a condom is used with lubricants.

Caps used before birth should be replaced as the size of the vagina and uterus has changed. The gynecologist should select and explain the principle of use. Efficiency in the first 6 months of lactation is 85-97%.

The use of spermicides leads to paralysis and death of sperm. In the absence of lactation, they should be used in tandem with a condom. The effect is from 75 to 94%, duration is from 1 to 6 hours.

Natural contraception

Some women refuse to use contraceptives, preferring natural views protection. These include:

• change in rectal temperature;
• calendar method;
• mucus research.

These methods are ineffective if used until menstruation is completely restored, because until then it is quite difficult to determine the basal temperature and calculate the date of ovulation. In this regard, the effectiveness of natural contraception is no more than 50%.

Many married couples use the method of interrupted sexual intercourse. It involves removing the penis from the vagina before ejaculation and does not require any equipment or preparation. This is a risky method of protection, because even before orgasm, some men secrete a secretion containing sperm, and the sperm that reaches the surface of the genital organs retains the ability to fertilize. So the effectiveness of the method is about 30%.

Not all parents rush to have a second child immediately after the birth of their first child. That is why the issue of contraception after childbirth is most pressing.

In order for the female body to prepare for the next pregnancy, it requires certain time, and for mothers with small children in their arms, it is not always easy to endure a subsequent pregnancy without endangering their own health. Considering all of the above factors, the conclusion about the need to choose a competent contraceptive in the postpartum period suggests itself. Let's try to figure out which contraceptive methods are most suitable for young mothers and do not harm babies.

When should you start having sex after childbirth?

The question of resuming sexual contacts after the birth of a baby concerns not only mothers, but also fathers. It is worth remembering that childbirth is a huge burden for a woman’s body, and even if it proceeded without complications, there is no need to rush into intimate contacts.

Doctors recommend abstaining from sexual activity for 6 weeks after childbirth; if any complications arise during delivery, this period can be extended. You can obtain more complete and reliable information about when you can begin intimate life after childbirth after an examination by a gynecologist, who, based on the examination, will decide on the initiation of sexual activity or temporary abstinence from it.

Is breastfeeding a guarantee against another pregnancy?

I would immediately like to dispel this myth, which young mothers often take as a basis when starting sexual activity. In fact, the hormone, which is produced in the body of a nursing mother, prevents the onset of menstruation and the production of an egg. But there are often cases when menstruation can begin in a woman who is intensively breastfeeding her baby, immediately after the end of postpartum discharge.

Each organism is unique, which is why you should not rely entirely on this method under any circumstances! Even if a woman has established lactation, then, as a rule, menstrual cycle resumes within six months, but if the young mother does not feed the baby, then ovulation can be restored within a month!

It happens that a woman who has recently given birth to a child becomes pregnant even before the first menstrual bleeding appears.

Resumption of sexual relations after childbirth, according to experts, occurs in most women, but, as a rule, about half of them do not even think about using any method of contraception. That is why women who have recently given birth to babies are included in the group high risk unplanned pregnancy.

If you are not planning on having similar babies and carefully monitor your health, many doctors do not recommend getting pregnant again for 2-3 years after the first birth. This is explained by the weakening of the female body, the risk of complications during a second pregnancy, the need to restore the body and other factors. You need to pick up as much as possible suitable method contraception. Only the right method of protection can reliably and effectively protect you.

Choosing a method of contraception after childbirth

Of course, the ideal choice would be the selection postpartum contraception even before the baby is born. If for some reason you were unable to do this, you can get necessary information from a doctor in the maternity ward, immediately after birth. A specialist will tell you about the pros and cons of a particular method and recommend what is right for you. When choosing a contraceptive method, you should not rely on the advice of friends or acquaintances; remember that only a doctor can give you the right advice!

If you are breastfeeding, be sure to indicate this in a conversation with your gynecologist, since not all methods of contraception are compatible with breastfeeding; some pills can affect lactation or block it altogether.

A woman who does not breastfeed her baby for any reason, you should start taking contraceptives immediately from the moment you begin an intimate relationship. If there are no contraindications to a particular method, then a woman is free to choose the method of contraception that is most convenient and comfortable for her, but only after consultation with a doctor.

Regarding nursing mothers, then everything is a little more complicated: the frequency of feeding the baby and the time that has passed since delivery must be taken into account. When choosing a contraceptive for women whose children are breastfed, the main thing is that the method of contraception does not have a negative impact on either the baby’s health or the process of milk production.

If the child is completely breastfed, then oral contraceptives are not recommended for six months. If feedings are irregular or early complementary feeding is introduced, then the woman must contact a gynecologist no later than a month after giving birth, so that the specialist can select and prescribe the correct drug.

There is one more important rule, which women should not forget: different methods protections have varying degrees effectiveness, some involve restrictions in use, and not all contraceptives can be used in the first weeks after the birth of a child.

A woman who has recently given birth to a child should be psychologically prepared in advance to the fact that now contraception should be approached especially carefully, and in order to increase the degree of protection against unwanted pregnancy, it is often necessary to combine certain methods, achieving the highest possible protection and reliability.

It is also worth remembering the so-called “safety net” if for some reason you doubt the effectiveness of the product you have chosen. Only a competent gynecologist can tell you how to correctly combine protective equipment and what to do if the reliability of protection decreases, who should be visited as early as possible after the start of sexual activity after childbirth.

What methods of contraception after childbirth are the most effective, and how to make the right choice?

Of course, the 100% method of preventing an unwanted pregnancy is sexual abstinence or, in other words, abstinence. But, often, for many couples this method of contraception is not suitable even for short period time, so they are looking alternative method with a high degree of protection.

1. Lactational amenorrhea method - What is it? In order to understand how this method of contraception works, let's understand its mechanisms. So, having given birth to a child, a special hormone is produced in the body of a young mother - prolactin, which is responsible for lactation and at the same time suppresses ovulation. It is lactational amenorrhea that causes the absence of menstruation in women in the first months, when a young mother is actively breastfeeding her baby.

In this case, prolactin provides a contraceptive effect. It is worth noting that the level of the hormone in a woman’s body decreases significantly if the time between feeding the baby is more than 4 hours, and, consequently, the contraceptive effect is reduced.

Putting a baby to the breast immediately after delivery is one of the most well-known methods natural protection mother from subsequent unwanted pregnancy. In addition, breastfeeding promotes rapid recovery female genital organs after childbirth.

The lactational amenorrhea method involves constantly feeding the baby throughout the day, that is, both day and night, at intervals of no more than 3-4 hours. This method is considered most effective when a young mother feeds her baby on demand (15 to 20 times a day). However, expressing milk is not considered feeding, and the degree of protection this method is significantly reduced.

This method of protection can be used for six months if all the above rules are observed, however, even it does not provide a 100% guarantee and there is a risk of getting pregnant even if you feed the baby correctly and on time.

The advantages of this method are undeniable: it is very easy to use, has no contraindications, and has a positive effect on recovery process mother's body after childbirth (contraction of the uterus, reduces the risk postpartum hemorrhage etc.), and, of course, this method of contraception is very beneficial for the health of the baby who has already been born.

Despite many advantages, this method also has certain disadvantages. The lactational amenorrhea method will not protect you from sexually transmitted diseases, it is not suitable for working women and requires strict feeding of the child on demand, and this method of protection can only be used for 6 months (if the woman’s menstruation has not returned earlier).

2. Oral contraceptives. There are several options for oral contraceptives, some contain only progestins and are called “mili-pili”. These tablets contain synthetic hormones, due to which the viscosity of the cervical mucosa is reduced, and the sperm is not able to enter the uterine cavity. Thus, the embryo does not implant.

Women can use such drugs as early as 6 weeks after delivery, and non-breastfeeding mothers can take these tablets a month after childbirth or from the moment menstrual bleeding begins. At correct intake of the drug in combination with breastfeeding, this method of contraception provides a guarantee of about 98%.

Separately, it is worth noting that taking these oral contraceptives does not affect the quantity and quality of breast milk of a nursing woman.

And, of course, it’s worth saying a few words about the disadvantages of these drugs. In the first cycles of treatment, discharge similar to menstrual discharge may be observed. This is due to the body’s adaptation to the drug and should not be a cause for concern. If your periods have stopped or something has bothered you since taking the pills, you should immediately visit a gynecologist.

The peculiarity of taking oral contraceptives is that they must be taken constantly, without skipping, at a certain time. They are not recommended to be combined with certain drugs; you can get more detailed information about this from the instructions for the drug or from the doctor who prescribed the medicine.

The ability to conceive, as a rule, returns to normal immediately after stopping the drug, so if you decide to continue taking oral contraceptives after stopping breastfeeding, then you better choose combined contraceptives. They begin to be taken from the moment menstruation begins after breastfeeding is stopped. The effectiveness of these pills is close to 100%, that is, if taken correctly, it is almost impossible to get pregnant.

Combined drugs are similar in their method of administration and the ability of the body to restore conception after their withdrawal to drugs containing progestins.

It is worth noting long-acting progestogens. These drugs long acting, which are administered to breastfeeding women after 6 weeks after birth and to non-breastfeeding women after 4 weeks. They provide very high protection against unwanted pregnancy, also do not affect lactation and breast milk, do not have a negative impact on the health of women and children.

These drugs are prescribed and administered only by a doctor; after their administration, they must be used for 14 days additional methods protection.

3. Intrauterine devices. If a woman does not experience any complications during childbirth, this method of contraception can be introduced immediately. Otherwise, an IUD can be placed six weeks after birth. The protection efficiency is about 98%, which is quite a high figure.

Today, many women prefer intrauterine devices as a reliable and effective remedy against unwanted pregnancy. It is worth noting that those women who have an intrauterine device installed need to visit a gynecologist at least once every six months. This method of contraception can provide effective protection for a period of 5 to 7 years, after which the contraceptive is removed or replaced.

The disadvantages of this type of contraception are that after installation of the IUD, pain in the lower abdomen may occur when feeding the baby. Menstruation in the first months after installing this contraceptive may be more heavy and painful than before. Sometimes the spiral may fall out, so a woman should carefully monitor its location. The advantage of the IUD is that the contraceptive effect occurs immediately after its installation.

The installation of this method of contraception is not recommended for women who have diseases of the female genital organs or are sexually active with several sexual partners.

4. Barrier methods of contraception. The most popular barrier method of preventing unwanted pregnancy is the condom. You can start using it immediately from the moment you resume sexual activity. According to statistics, a condom provides a guarantee of about 90%, and when used correctly, reliability increases to 97%. This method of contraception is easy to use and accessible to everyone. It does not affect lactation, and, importantly, protects partners from various sexually transmitted infections.

The disadvantages of a condom are that it can slip off, break, and at the same time the risk of pregnancy increases significantly. That is why you should strictly follow the instructions for using a condom.

4-5 weeks after birth, you can use a cap (diaphragm) as protection against unwanted pregnancy; it is suitable only when the female genital organs have returned to their usual size. The effectiveness of this barrier method directly depends on the correctness of its application. During breastfeeding, the effectiveness of protection is about 90%. The advantages of the method are that it does not affect milk production and can protect against some infections.

A gynecologist should select a cap for a woman and teach her how to use it correctly; after the baby is born, the size of the cap may change, so consultation with a specialist is also necessary here. It is better to use caps as a method of contraception in conjunction with spermicides, which we will discuss below.

Spermicides are various creams, suppositories, tablets, ointments that disrupt sperm motility or lead to their death. Application this tool contraception should be combined with some other method.

5. Sterilization. It is an irreversible method of contraception, after which pregnancy is impossible. When carrying out sterilization, women undergo tubal ligation, and men undergo ligation of the vas deferens.

The decision to sterilize must be thoughtful and informed. In Russia, sterilization is carried out for women at least 35 years old or those who already have two children. It is worth noting that the legislation does not say anything about male sterilization, and it is worth noting separately that this operation in men does not affect potency.

6. Natural methods to help prevent pregnancy. They can be used if a woman knows how to calculate fertile and “safe” days. Typically this is done by measuring basal temperature and constructing an appropriate graph to determine ovulation.

This method is not suitable for a woman after childbirth, because the menstrual cycle has not yet formed, and nursing mothers should not rely on it at all. You can also use special ovulation tests to calculate days when pregnancy is unlikely. This method cannot be called the most effective and is best used in combination with another means of protection.

Many couples resort to another method of preventing unwanted pregnancy - interrupted sexual intercourse. This method not only does not give high degree protection, but also interferes with the normal course of sexual intercourse of a couple, which often causes quarrels, disagreements, and irritability among spouses. And many scientists claim that interrupted sexual intercourse has a negative impact on men’s health.

So, in this article we looked at the most common methods of contraception after childbirth. Currently, there are a great many ways to protect yourself from unwanted pregnancy after childbirth, and, as we have found, many of them are harmless to the baby and do not affect the breastfeeding process.

Which one should you choose? It's up to you to decide! The main thing is that before deciding on choosing a method of contraception, you need to consult a gynecologist who will give you true advice, will select the appropriate contraceptive and help you make a decision.

Let your intimate life bring only joy!

Answer

A miracle happened. The baby you've been waiting for for nine long months has finally arrived. Now you, parents, are completely immersed in caring for him. At first, both of you are terribly tired, night feedings are exhausting, and you can’t even think about resuming sexual relations. Yes and overweight appeared, the figure is not the same as before pregnancy. No, you need to wait a little, especially since the doctor recommends not having sex for the first 4-6 weeks... But nature takes its toll, and your sexual relations will soon resume. Contraception is probably the last thing on your mind right now. Is it worth taking care of her at all, isn’t breastfeeding enough?

It’s worth it if you want to avoid an unplanned pregnancy in the first months after giving birth, because, contrary to popular belief, this is not so uncommon. Studies have shown that in women who breastfeed, menstruation resumes on average after 2-6 months, depending on the intensity of feeding, and in non-breastfeeding women - 4-6 weeks after birth. If you do not have lactation or breastfeed irregularly, then ovulation, and therefore the ability to conceive, can resume as early as 25, and on average 45 days after birth. And since ovulation occurs 14 days before your period, you may already be fertile without knowing it.

Consequently, pregnancy can occur even before the first menstruation appears, so in order to start using contraception, you should not wait for the restoration of the menstrual cycle, the start of complementary feeding and a reduction in the frequency of breastfeeding.

According to surveys, two-thirds of Russian women resume sexual relations within a month after childbirth, and within 4-6 months - almost all (98%). At the same time, doctors are greatly alarmed by the fact that after giving birth, 20-40% of sexually active Russian women do not use any methods of contraception. Meanwhile, the probability of pregnancy in the absence of reliable contraception in nursing mothers 6-8 months after birth reaches 10%, and in non-breastfeeding mothers - 50-60%. Thus, women who have recently given birth in Russia should be considered a high-risk group for unplanned pregnancy.

And pregnancy during this period is generally extremely undesirable. Doctors believe that the minimum interval between births should be about 3 years. Why? Despite the fact that organ involution reproductive system(returning them to their previous state) ends 4-6 weeks after birth, full recovery the body takes at least 1.5-2 years. Breastfeeding also places a significant burden on a woman’s body. But after this, a woman still needs to replenish her supply of important microelements, such as iron, calcium, etc. As studies have shown, when pregnancy occurs earlier than 2 years after birth, the risk of developing pregnancy complications doubles (preeclampsia, anemia, intrauterine growth retardation), childbirth and the postpartum period.

Thus, we inevitably come to the conclusion that in the postpartum period and for 2 years after childbirth, a woman needs effective, reliable and safe contraception.

Choosing a contraceptive method after childbirth

Ideally, you should get advice and choose a suitable method of contraception after childbirth during pregnancy. If you don’t have time before giving birth, consult a doctor at the maternity hospital. If you still cannot decide on a contraceptive method or you have doubts and questions, then before resuming sexual relations (even while breastfeeding), you should definitely seek advice from a gynecologist, for example, an antenatal clinic or a family planning and reproduction center. The purpose of this article is to give general idea about contraceptive methods during the postpartum period and how these methods are combined and how compatible they are with breastfeeding, however, you should only determine which of these methods is right for you in consultation with your doctor.

A non-breastfeeding woman should start using contraceptives from the moment she resumes sexual relations. Moreover, if not special contraindications, she can choose any of the modern arsenal of contraceptives.

The method of contraception for a nursing woman depends on the feeding regimen and the time elapsed after childbirth. In addition, the contraceptive should not adversely affect the child’s health or milk secretion. If you are exclusively breastfeeding, the start of contraception can be delayed by 6 months. If feeding is infrequent or early start complementary feeding (all this is typical for residents of developed countries), the method of contraception should be selected during a mandatory postpartum visit to the doctor no later than 6 weeks after birth.

One more thing important note: the various methods of contraception, which will be discussed below, have different effectiveness, some of them involve serious limitations in use, and not all can be used in the first weeks after childbirth. Tune in advance to the fact that in this important and responsible period of your life, when you next pregnancy in any case, it is better to wait; different methods of contraception will often have to be combined, either by increasing the effectiveness of a method that is ideal for you, but not reliable enough, or by “hedging your bets” in circumstances where the effectiveness of a reliable method for some reason is reduced. And in determining the need and principles of combination various methods, as well as in selecting the most suitable remedy for your couple, again only a doctor will help.

Methods of contraception after childbirth

Abstinence

Abstinence (sexual abstinence) has 100% contraceptive effectiveness, but most couples are not satisfied with this method even for a short time.

Lactational amenorrhea method (LAM)

Mechanism of action and characteristics. After childbirth, a woman’s body produces the hormone prolactin, which stimulates milk production by the mammary glands and at the same time suppresses ovulation, resulting in lactational amenorrhea (absence of menstruation during breastfeeding). This effect of prolactin on a woman’s body determines the contraceptive effect of breastfeeding. Each act of breastfeeding stimulates the secretion of prolactin, but if the break between feedings is too long (more than 3-4 hours), the level of prolactin gradually drops. Breastfeeding started immediately after birth is effective method natural contraception and at the same time provides the child with the most good nutrition. In addition, sucking stimulates the production of oxytocin, a hormone that promotes not only the contraction of the muscles of the areola of the mammary gland (due to which milk is released from the nipples), but also the contraction of the uterus, which leads to speedy recovery its size and shape after childbirth.

MLA involves exclusive or near-exclusive breastfeeding, both during the day and at night. The effectiveness of MLA is maximum if feeding does not occur according to a schedule, but at the child’s first request (even at night), sometimes several times an hour, on average from 12 to 20 times a day, of which 2-4 times at night. The break between feedings should not exceed 4 hours during the day and 6 at night. In this case, each time it is necessary to give the baby the breast, and not express milk. The contraceptive effectiveness of MLA remains at an acceptable level if the share of complementary feeding is no more than 15%.

Terms of application. The first 6 months after childbirth proper feeding chest.

Efficiency. 98%.

Advantages

• Easy to use.
• Gives a contraceptive effect immediately from the start of use.
• Does not affect sexual intercourse.
• Promotes uterine contractions, reducing the risk postpartum complications(bleeding) and leading to a speedy recovery of the body.
• Does not require medical supervision.
• Beneficial for the child (breastfeeding provides him with the most adequate nutrition, promotes the development of immunity, and reduces the risk of infection).

Flaws

• Requires strict adherence to the above breastfeeding rules.
• Not suitable for working women.
• Short-term use (6 months).
• Does not protect against sexually transmitted diseases.

Hormonal methods

ORAL CONTRACEPTIVES (OK)

OCs containing only progestins (“mini-pills”)

The tablets contain progestins - synthetic hormones, the contraceptive effect of which is to reduce the amount and increase the viscosity of cervical mucus (which prevents the passage of sperm into the uterus), change the structure of the mucous membrane of the uterine body (this prevents embryo implantation) and suppress ovulation.

Start of use. Breastfeeding women can start taking pills 5-6 weeks after birth, non-breastfeeding women - from the 4th week after birth or with the onset of menstruation.

Efficiency. 98% when taking pills correctly and regularly in combination with breastfeeding.

Advantages. They do not have a negative effect on the quantity, quality of milk and duration of lactation.

Flaws. In the first 2-3 cycles of use, intermenstrual bleeding is often observed, which is a consequence of the body’s adaptation to the drug. Some women may experience menstrual irregularities, including amenorrhea.

Features of application. OK prescribed by the doctor. They must be taken daily, without breaks, strictly at the same time. Violation of the time of taking or skipping pills, as well as the simultaneous use of certain antibiotics, anticonvulsants and sleeping pills, vomiting or diarrhea reduce the contraceptive effect. The ability to conceive is usually restored immediately after stopping the drug. After stopping feeding, you should switch to combined OCs, which are more effective.

Combined OK

They contain the hormones gestagen and estrogens, which suppress the growth and maturation of follicles and ovulation, as well as preventing implantation.

Start of use. After stopping breastfeeding, combined OCs are started to be taken with the resumption of menstruation. If you have not breastfed at all, you can use this type of contraception from the 4th week after birth.

Efficiency. When taken correctly and regularly, the effectiveness approaches 100%.

Advantages. After stopping taking the pills, the ability to conceive is quickly restored.

Flaws. It is not advisable to use during breastfeeding (estrogens reduce milk secretion and the duration of lactation).

Features of application. Similar to the use of OCs containing only progestins.

PROGESTAGENS, LONG-ACTING

Highly effective long-acting products. These include, for example, injectable drug"Depo-Provera" and subcutaneous implant "Norplant".

Start of use. The first administration of the drug to nursing women is no earlier than 6 weeks after birth, to non-breastfeeding women - from the 4th week after birth.

Efficiency. 99%.

Advantages. Do not affect the quantity and quality of milk, the duration of lactation, do not have harmful influence per child. One injection of Depo-Provera provides contraception for 12 weeks. "Norplant" provides protection against unwanted pregnancy for a period of 5 years. Removal of the implant is possible at any time.

Flaws. The disadvantages of OCs containing only progestins are similar (frequent intermenstrual bleeding and the onset of amenorrhea).

Features of application. Prescribed and administered by a doctor. In the first 2 weeks after administration, additional contraceptives should be used. It is necessary to strictly observe the intervals between administration of the drug. “Norplant” must be removed after 5 years, since after this period the effectiveness of the method sharply decreases. After discontinuation of the drug, restoration of a regular menstrual cycle and the ability to conceive usually occurs within 4-6 months.

Intrauterine contraceptives (spirals)

Start of use. In case of uncomplicated labor and no contraindications, an intrauterine device (IUD) can be inserted immediately after birth. This does not significantly increase the risk infectious complications, bleeding or perforation of the uterus. Optimal time introduction - 6 weeks after birth, which reduces the incidence of IUD loss.

Efficiency. 98%.

Advantages. Compatible with breastfeeding. Provides protection from pregnancy for up to 5 years. Gives a contraceptive effect immediately after administration. The IUD can be removed at any time. Restoring the ability to conceive after removal of the IUD occurs very quickly.

Flaws. Sometimes it causes discomfort in the lower abdomen resulting from contractions of the uterus during breastfeeding. For some women, in the first months after insertion of an IUD, menstruation may be heavier and more painful than usual. Sometimes the IUD comes out.

Features of application. The IUD is inserted by a doctor. Not recommended for women who have had inflammatory diseases uterus and appendages, both before pregnancy and in the postpartum period; as well as women who have multiple sexual partners, since in this case the risk of inflammatory diseases increases.

Barrier methods of contraception

CONDOM

Start of use. When resuming sexual activity after childbirth.

Efficiency. On average 86%, but with correct use And good quality reaches 97%.

Advantages. The method is easily accessible and easy to use, and does not affect lactation or the health of the child. IN to a large extent protects against sexually transmitted infections.

Flaws. At misuse the condom may slip off or break. Use is associated with sexual intercourse.

Features of application. You should not combine the use of a condom with the use of fatty lubricants, which can cause the condom to rupture. Use a neutral lubricant with spermicide.

DIAPHRAGM (CAP)

Start of use. Not earlier than 4-5 weeks after birth - until the cervix and vagina shrink to normal sizes.

Efficiency. Depends on correct application. During breastfeeding, it increases to 85-97% due to a decrease in the ability to conceive at this time.

Advantages. Does not affect lactation and baby's health. Provides partial protection against some sexually transmitted infections.

Flaws. Use is associated with sexual intercourse.

Features of application. Select a diaphragm for a woman and teach her how to use this method of contraception medical worker. After giving birth, you need to clarify the size of the cap; it may have changed. Used together with spermicides. The diaphragm should be removed no earlier than 6 hours after sexual intercourse and no later than 24 hours after its insertion.

SPERMICIDES

This method of chemical contraception is local use creams, tablets, suppositories, gels containing spermicides - substances that destroy cell membrane spermatozoa and leading to their death or impaired motility.

Start of use. When resuming sexual activity after childbirth. While breastfeeding, they can be used independently; in the absence of lactation, they should be combined with other means of contraception, in particular with a condom.

Efficiency. At correct use 75-94%. The contraceptive effect occurs a few minutes after administration and lasts from 1 to 6 hours depending on the type of drug.

Advantages. In addition to those described for the condom, it provides additional lubrication.

Sterilization

Sterilization is a method of irreversible contraception in which operationally ligation or clamping of the fallopian tubes (in women) or ligation of the vas deferens (in men) is performed.

FEMALE STERILIZATION

Start of use. Performed immediately after uncomplicated childbirth local anesthesia laparoscopic approach or by minilaparotomy, as well as during surgery caesarean section.

Efficiency. 100%

Advantages. The effect occurs immediately after the operation.

Flaws. Irreversibility. Low likelihood of postoperative complications.

Features of application. The method is acceptable only for those who are absolutely sure that they do not want to have more children. The decision to use the method should not be made under pressure from circumstances or emotional stress.

MALE STERILIZATION (VASECTOMY)

Under local anesthesia, a small incision is made in the scrotum and the vas deferens are ligated (similarly fallopian tubes). Sexual desire, erection and ejaculation are not disturbed in any way, only the ejaculate does not contain sperm.

Efficiency. 100% if you follow the rule: you should use a condom for the first 3 months after surgery. The effectiveness of vasectomy can be confirmed by the absence of sperm in the ejaculate, detected using a spermogram.

Disadvantages and application features. Similar to female sterilization.

Natural Family Planning Methods

Based on abstinence from sexual intercourse on days favorable for conception.

Start of use. Only after establishing a regular menstrual cycle.

Efficiency. No more than 50% if all rules are followed.

Advantages. No side effects. Spouses bear joint responsibility.

Flaws. To determine favorable and unfavorable days the couple requires special training by medical staff, careful record keeping, self-control and self-discipline. It is not recommended immediately after childbirth, as it is difficult to determine the timing of ovulation and first menstruation.

Every young mother, after the birth of her little angel, thought about contraception after childbirth. This question becomes key when choosing a means to prevent unwanted pregnancy, and it should be approached with special care. In order not to harm yourself and your child, you need to study different variants and choose the right one for yourself. It is necessary to take precautions after childbirth with extreme caution.

Is it possible to get pregnant after childbirth? Yes, yes and yes again. Protection after childbirth, with or without breastfeeding, is required every time, since obstetricians and gynecologists unanimously insist that there is still a small chance of getting pregnant.

After such stress, a woman is forced to take care of her body with even more attention than ever before in her life, because now she is responsible not only for herself, but also for another person who is completely dependent on her.

Before resuming sexual activity, you need to consult a doctor and find out when you can indulge in impulses of passion again. This question is among the key ones, and most often, it is asked during interesting situation. Thus, future parents will be able to roughly plan their future intimate relationship.

IN to a greater extent it depends on how exactly the process of bringing a baby into the world will take place. And, if the birth of the baby passed without complications, the mother feels great, and the father is already crossing out the days on the calendar, experts recommend restoring intimate relationships 6 weeks from the moment of delivery. But remember, each person is different, and the period of abstinence may vary.

When is a mommy able to get pregnant?

Restoring the functions of the ovaries and uterus is strictly individual. You can only roughly calculate when the egg will be ready for fertilization. On average, the egg is released between 40 and 90 days after delivery, but it happens that this process occurs much earlier.

Two lines on the test while you are still breastfeeding your first toddler is a surprise. Often a woman during this period does not even suspect fertilization.

The logic is this: if there is no menstruation, then this is good and it means that my body is not ready yet. This is how children of the same age are born.

Such cases are not uncommon and, unfortunately, often end in termination at the request of the mother or medical indications. Doctors say that most happen due to the ignorance and negligence of the girls themselves. If they knew how and with what to protect themselves after giving birth to a nursing mother, excessive stress and medical intervention could be avoided.

The World Health Organization recommends using contraceptives 21 days after leaving hospital. Of course, the likelihood of conceiving again within 40 days after resolution is extremely low. But it exists and it is better to “play it safe” than to allow an undesirable development of events.

Conception during lactation

Many are sure that fertilization during lactation is impossible. And there is part of the truth in this, but there are also a lot of pitfalls and conventions for those who decide to use feeding as the only method of protection.

Lactation can be used to protect yourself with the following caveats:

• It is effective only for six months, then ovulation is restored regardless of whether you breastfeed or not.
• If you give your baby breasts according to each request every 2 or three hours.
• If you wake up at least three times a night and let him eat.
• If the little one feeds only on your milk and you do not give additional water or nutritional formula.

However, even if you follow all the rules, this will not protect you 100 percent from re-fertilization. It is important to at least combine this method with the method of coitus interruptus.

How to distinguish menstruation from lochia

The body is able to reaccept the egg before menstruation during the first cycle after resolution. The danger is that no one can accurately calculate when a new menstruation will occur and when ovulation will occur. It is difficult not only to determine when the egg left the ovaries, but also to understand when menstruation began, because lochia comes out of the vagina within 6-8 weeks.

Lochia is part of the baby's place, lubricant and blood that leaves the mother's body over a long time.

This is similar to how the cycle manifests itself on the last day: light spotting that may not occur continuously and stop for almost a day. Over time, they become lighter, since there is practically no blood left in the uterus. During the entire period, you also notice dense lumps - the remains of a child's place.

Sometimes there is no gap between lochia and menstruation. This depends on the individual characteristics of the reproductive system. You can understand that you have menstruation and not lochia simply by the following signs:

1. They became abundant and red.
2. More than 2 months have passed since the baby was born.
3. If you don't see any blood clots or placental remains.

Sometimes menstruation starts earlier. This happens to mothers who, for some reason, do not breastfeed.

If you are breastfeeding and your cycle started very early, contact your gynecologist. This is especially important if the discharge is bad smell and a greenish tint.

Modern methods of protection

For the fair sex, many options open up to protect against unwanted pregnancy after childbirth. But are all options suitable for new mothers? Modern medicine offers a number of effective ways to prevent fertilization. There are 5 groups:

• barrier;
• intrauterine;
• hormonal;
• surgical;
• natural.

Do not forget that some elements can be combined and complement each other in different situations.

Barrier method

Condoms

Perhaps the most accessible and simplest method to prevent conception is the use of condoms. Even children know about this miracle weapon, and absolutely every person who is sexually active has encountered them. Another advantage is that their selection does not require consultation or prescription from a doctor.

Manufacturers open a whole range of different condoms to their consumers, so that everyone can find the best one for themselves. the best option and was reinsured against undesirable consequences.

If you study the instructions for this barrier product in detail and adhere to the rules stated in it, its effectiveness will be as much as 98%. A condom will not only help in family planning, but also, if necessary, ensure safe sexual intercourse with a partner who has sexually transmitted infections. Also, latex is compatible with the processes occurring in the body of a nursing mother and does not have a negative effect on lactation.

Very important factor The thing about using condoms is that they can be used from the first days of resumption of intimacy.

And now about the shortcomings. IN in rare cases, when the condom was chosen incorrectly and the rules of use were violated, it is likely to let its owner down - it will break or slip right during contact. If lovers do not notice what has happened in time, the process of unwanted fertilization may occur.

It is very important to give preference to condoms from a proven and reliable manufacturer. There is a list of companies, tested over the years, that manufacture them and are considered titans in the contraceptive market.

IN in some cases It is possible that one of the partners is intolerant to latex or lubricant, other measures will have to be taken.

Diaphragm

The diaphragm has a flexible latex base and is manufactured in a dome shape. Its function is to block the path of sperm and prevent them from reaching the finishing point in the uterine cavity due to its flexible springy rim. To use, three months must pass after the birth of the baby. The diaphragm may be considered and recommended by doctors as a form of protection.

It is worth noting that

diaphragms vary in size and are individually selected by the doctor for each woman. Size, before and after birth, often differs.

How to use this barrier? To do this, you do not need to perform any complex manipulations, just follow the recommendations given by gynecologists:

1. You need to lubricate the latex barrier with spermicide.
2. Insert into the vagina to close the cervix.
3. The diaphragm must not be removed within 6 hours after copulation.
4. The maximum time for wearing it, as required by the instructions, is 24 hours.
5. Remove and rinse warm water with soap.

You can contact a doctor who will help with this task and provide advice. According to the rules, the product is administered 20-30 minutes before intercourse. The diaphragm is used repeatedly and its efficiency level is 92-96%.

Cap

The cap differs from the previous product in that it has a more curved “cup” shape. Made from latex and soft silicone. Validity period: no more than two years. Its job is to prevent the seed from entering the uterus by suction to its surface. If about 4-5 weeks have passed since the birth of the baby, you can take a closer look at the cap.

How to use:

1. Make sure the product is not damaged.
2. Fill one third with spermicidal gel.
3. Insert it inside and press firmly against the cervix.

The cap should remain in the vagina for at least six hours. Maximum time is 36-48 hours. After use, the cap must be disinfected.

With proper use and during the feeding period, efficiency is achieved at a rate of 97%.

The above-mentioned methods of barrier protection have a list of contraindications that you need to know before using them. They cannot be used if:

• Cystitis was discovered.
• Treatment for vaginal infections is provided.
• There is an allergy to the components of this product.
• The vaginal muscles are weakened.
• There are several sexual partners.

Spermicides

This type of protection is a concentration chemical substance(benzalkonium or boric acid) and base (needed for distribution of the chemical). The purpose of spermicides is to kill the heads of the sperm. Most often, it is used in conjunction with other methods and, in this case, the risk of fertilization is reduced, since the components complement each other. For example, condoms work well with spermicides. This is called the double Dutch method.

May have different shapes:

• Jelly, creams and gels.
• Candles.
• Foam.
• Sponges.

The chemicals are suitable for nursing mothers, as they do not affect breastfeeding in any way, and their effectiveness varies from 74 to 94%. There is a caveat that you definitely need to know when using this product - there is no point in using spermicides during ovulation.

It is better not to get carried away with spermicides, as they can destroy the vaginal microflora and cause irritation!

Intrauterine method

Intrauterine device

The IUD wins more and more women’s hearts every year. The efficiency level reaches 98%, the effect is immediate, and the shelf life is from five to seven years. Also, it can be easily removed by a doctor when planning a new pregnancy.

The intrauterine device does not have a negative effect on feeding, but you will need to visit an antenatal clinic at least twice a year

The function is that the spiral is immersed in the uterine cavity and does not allow the fertilized egg to attach. There are IUDs that contain a hormone (progesterone).

The IUD should be installed by an experienced specialist 6 weeks after the baby is born.

Before deciding to install an IUD, a young mother should be prepared for the consequences:

• In the first months of using the product, you may experience discomfort in the lower abdomen due to contraction of the uterus during lactation.
• Perhaps menstruation will be much heavier and more painful.
• Does not protect against sexually transmitted infections.
• Pain may occur during sexual intercourse.

If any severe pain, unusual and bloody discharge, you need to immediately contact a gynecologist!

Hormonal medications

Hormonal medications are one of the most popular ways to prevent unwanted pregnancy. The principle of these drugs is to suppress ovulation and thicken cervical mucus. Contraceptive drugs contain hormones similar to the female body, but after childbirth you can not drink all of them.

As contraception after the first meeting with the child, only medications containing gestagens are suitable (they do not affect milk production and its quality). Doctors prescribe them after 6 weeks. When used correctly and following all the rules, they are effective up to 99%.

For nursing mothers, only the following remedies are correct:

• Mini-drinks.
• Long-acting progestogens.

There are also combined OKs. Made for women who are not breastfeeding.

Mini-pill

These are the most suitable oral contraceptives for mothers after the birth of a child. For women after childbirth, only they are prescribed. Mini-pills are aimed at the period of breastfeeding, since the full menstrual cycle has not yet resumed, then it is recommended to switch to combined OCs.

Modern mini-pills make it possible to conceive a second child immediately after stopping their use. The most important condition for their use is regularity. You must take the tablets at the same time every day. Visiting the doctor should occur at least twice a year.

What you should pay attention to:

1. The formation of spotting between menstruation is normal because the body gets used to the composition of the mini-pill.
2. To avoid nausea and discomfort, it is recommended to take these medications with meals or before bed.
3. The first package of the mini-pill must be accompanied by other means.

There are contraindications:

• Ovarian cyst.
• Carrying a child.
• Kidney diseases.

Long-acting progestogens

They are injectable contraceptives that are injected deep into the muscle and then enter the bloodstream over a long period of time. The duration of the drug lasts from 12 weeks. Some long-acting progestogens protect against conception for up to 5 years. Does not affect the quality of milk.

The injection is administered only by a specialist, and is removed at any time by him. Between appointments of this product a certain amount of time must pass, prescribed by a specialist. The ability to conceive returns within six months.

Both options hormonal method have similar negative aspects that are worth paying attention to:

• Decreased libido.
• Headaches, migraines.
• Cycle disorders.
• Nausea, sweating, mood swings.
• Increase in body weight.

Combined OCs (oral contraceptives)

Hormonal contraceptives are trusted and considered a reliable way to prevent conception. Efficiency reaches 99%. But there are two main conditions when taking this remedy:

1. Breastfeeding is completed.
2. Breastfeeding was not carried out at all.

Unlike mini-pills, these medications contain not only gestagens, but also estrogens, which, in turn, can affect the duration and quality of lactation.

Not many people know that the contraceptive properties of combined OCs are side effect, since their main calling is:

• Normalize the cycle.
• Reduce pain during menstruation.
• Increase the properties of cervical canal mucus.
• Help cure acne and other endocrine diseases.
• Improve calcium absorption.

You should not choose OK for yourself; this should be done by a doctor, after passing certain tests and based on the characteristics of the body. Regular visits to a specialist are also recommended. During the first time of use, it is necessary to protect yourself with other contraceptives.

Surgical intervention

There are people who solve this problem radically - they use the method of surgical sterilization and act as contraception after childbirth.

Before deciding to take such a step, you need to weigh the pros and cons, since this process is irreversible.

There are female and male (vasectomy) sterilization. They have a similar principle and work 100%. Both operations are performed under anesthesia.

In men : produced at any time. The vas deferens is ligated using an incision in the scrotum. It does not affect erection and ejaculation (after vasectomy it does not contain sperm).

Among women : carried out immediately after the birth of the child, during a cesarean section or at any other time. During the operation, the fallopian tubes are ligated.

After surgical intervention Minor postoperative complications may occur.

Natural method

Lactational amenorrhea method

Breastfeeding allows the mother to take advantage of her position. During full feeding breasts, the menstrual cycle is not fully restored. Due to the production of milk in the female body, there is no strength left to bear another child. Efficiency - 50%.

Abstinence

The best defense is abstinence. But not many are ready to give up intimacy. Has 100% effectiveness. Often used in between.

PPA

Coitus interruptus can be combined with other medications during regular lactation. It is based on the removal of the penis until ejaculation. Has two disadvantages:

• There is a high probability of not being on time.
• During sexual intimacy, a secretion is released that contains sperm.

At the end of lactation, it is not perceived as reliable method and cannot perform independently. If intercourse is interrupted, 6 to 8 couples out of 100 are at risk.

Results

Every mother should consult a gynecologist to correctly select contraception. Then you need to think about and compare possible options yourself. The main thing to remember is that there is always a chance of getting pregnant! Protection must be chosen very carefully to ensure the healthy development of the baby.

There are many ways to distance yourself from pregnancy. Some methods of contraception are more effective, others less so; Some can be drunk, while others should be delayed. It all depends on the individual characteristics and preferences of the woman and her partner.