Postpartum contraception - how to protect yourself after childbirth. When the ability to conceive is restored. Intrauterine method of contraception

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 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 on artificial feeding, pick up 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 It's 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

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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 levels change. 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: so that female body The supply of important microelements has been replenished; 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 contraceptives are prohibited; before using the pill, 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. 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 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%.

The birth of a child is a real miracle, but only if it is desired. To prevent an unplanned pregnancy from spoiling the plans of young people, forcing them to choose between family and creating a career, they must always remember about contraception.

Many couples do not attach due importance to the choice of method of birth control. Often such negligence leads to unpleasant consequences:

1. The birth of an unwanted child. In Russia, even now, the most common method of family planning is abortion. Artificial termination of pregnancy can entail many serious problems with health, up to infertility and serious illnesses.
2. Danger of contracting sexually transmitted infections. Many diseases without proper treatment turn into chronic form and can cause serious complications.

Having information about how to properly protect yourself prevents many problems, allows you to maintain your health and the opportunity to create a full-fledged family at the time when it is needed.

How contraceptives work

Contraceptives are drugs used to protect against pregnancy. All methods of contraception are based on a simple principle - to prevent the egg and sperm from meeting, blocking the process of conception (barrier), and to prevent the egg from maturing in the woman’s body (hormonal).

Contraception methods

Everyone can determine for themselves how to protect themselves from unwanted pregnancy by studying the features of use and the degree of reliability of the contraceptive methods used.

Contraceptive patch

This method serves as a physical barrier against the penetration of sperm into the uterus. The device looks like an elastic band with a diameter of 50-100 mm with a springy rim. The device is placed on the cervix several hours before sexual intercourse.

The size of the diaphragm is selected individually after examination by a gynecologist. The advantages of the method are protection from sexually transmitted infections and reusability.

• Lack of efficiency;
• The need to insert and remove the device and care for it;
• Not recommended for nulliparous women;
• Inability to use during menstruation.

Intrauterine device

An IUD is a plastic T-shaped device measuring 25-35 mm that is placed inside the uterus. It works on the same principle as other physical barriers, preventing sperm from penetrating and further fertilizing the egg. The material from which modern spirals are made significantly increases their reliability compared to other means.

Advantages of the IUD:

• Efficiency up to 99%;
• Long service life (about 10 years);
• Absence side effects compared to other hormonal agents;
• Instant restoration of reproductive function after removal.

Disadvantages of use:

• The procedure is performed only by a doctor;
• Suitable only for women who have given birth;
• There is a risk of developing inflammation;
• Lack of protection against sexually transmitted diseases;
• Pain and increased menstrual bleeding during the first time after installation;
• In rare cases, the occurrence of an ectopic pregnancy;
• High risk of the coil falling out, especially in critical days and during active sports.

Symptothermal method

This is a method of natural family planning, including calendar, temperature, cervical methods. Based on calculation of the probable day of ovulation and the most auspicious days for conception. To do this, the woman keeps a chart for at least 3 cycles, in which she notes the data basal temperature. Typically, before ovulation its value decreases, and after it increases by 0.4 degrees.

The study is complemented by monitoring the condition of the cervical fluid. IN dangerous days the amount of discharge increases, they acquire a liquid and then a stretchy structure.

The positive aspects of this approach are absolute accessibility. Weak sides– time costs, the need to abstain on dangerous days, insufficient reliability.

Spermicides

The barrier type of protection is based on a chemical effect on sperm to prevent entry from the inside of the uterus. This group of drugs includes gels, foams, creams, suppositories, which are inserted into the vagina 15 minutes before intercourse using an applicator.

The reliability of this method is quite low; the number of unplanned pregnancies with this method of protection reaches 35%. Therefore, spermicides are recommended to be used in combination with other barrier methods: condom, diaphragm, cap.

Along with insufficient effectiveness, the products can cause disruption of the vaginal microflora, causing itching and irritation.

Sterilization operations

Sometimes, when deciding how to protect themselves from unwanted pregnancy, some people resort to a drastic method - sterilization: vasectomy (in men) or tubal ligation (in women).

Vasectomy is an operation to excise part of the vas deferens, preventing sperm from entering the seminal fluid. The intervention can be either reversible or irreversible. During temporary sterilization, only the clamp is installed on the seminal canal without removing it. But it will be possible to restore reproductive function only within 5 years; later it will be impossible.

The advantages of the method are high efficiency, complete preservation of sexual function, no effect on the functioning of the body. But you should know that after this procedure the chances of becoming a father are reduced to a minimum. Therefore, the method is recommended for men who already have children. As with any surgical interventions After the operation, complications (suppuration, inflammation) are possible. It is also necessary to take into account that the effect occurs only after 1-2 months.

Female sterilization involves creating an artificial obstruction of the fallopian tubes. In this case, the meeting of sperm and egg is impossible. The operation is performed using laparoscopy with minimal incisions. Several types of sterilization are carried out: tubal ligation, cauterization or pinching with special clothespins.

The method has maximum protection from an unplanned pregnancy, but in practice they occur rare cases the onset of conception and with ligated tubes. Sterilization does not affect the menstrual cycle and hormonal functions of the body. The main disadvantage of this method of birth control is its irreversibility. But if you want to have children in the future, auxiliary help can come to your aid. reproductive technologies. With artificial conception, a woman is able to carry and give birth to a child.

The impact of contraception on health

Every adult must know how to protect themselves from unwanted pregnancy. Active use contraception as a method of family planning is important factor reducing the number of abortions and associated health risks.

Women have a great impact on the body hormonal agents protection: tablets, injections, patches. The negative consequences of taking these contraceptives are associated with incorrect selection of drugs and failure to take into account existing contraindications. The hormones they contain can negatively affect blood clotting, causing a high risk of blood clots.

Experts have also established some connection between the intake hormonal pills and the development of breast and cervical cancer. However, when using them, the likelihood of occurrence is significantly reduced. oncological diseases ovaries.

Many modern means bring undoubted benefits healthy women. Drugs can improve the quality menstrual cycle, regulating it, warning painful sensations, mood swings.

Choosing the Right Method

A wide range of contraceptive methods can confuse a woman. When deciding how to protect yourself from pregnancy, it is worth considering the reliability of the product, possible side effects, and features of use. Here are some conditions that you should pay attention to, giving preference to the most popular methods:

• In the absence of regular sexual activity or a permanent partner, it is recommended to use condoms. Along with birth control, this is the prevention of sexually transmitted diseases.
• Barrier protection devices (IUDs, caps, diaphragms) can only be used by women who have given birth.
• The choice of hormonal contraceptives should be made together with a specialist (gynecologist or endocrinologist).

A competent approach to the issue of choosing contraception provides effective protection from accidental pregnancy and associated negative consequences.

It’s wonderful and touching to watch children of the same age play, but if the birth of a second one is not included in your immediate plans, special attention should be paid to protection after childbirth.

Why special? Because many traditional methods can no longer be used. For example, classic birth control pills reduce milk supply and impair the development of the child. The method of contraception after childbirth must be both effective and safe for both - mother and baby.

When is fertility restored?

In order for conception to occur, it is necessary for the menstrual cycle to be restored, ovulation to occur and menstruation to begin. The time it takes a young mother’s body to do this is very individual and depends on many factors, such as complications of childbirth, breastfeeding, activity hormonal system. According to the latest WHO study, for those mothers who do not breastfeed after childbirth, the first ovulation most often occurs between 45 and 94 days. However, there are also shorter exceptions, up to 25 days.

In most cases, women do not become pregnant after the first ovulation, but there are exceptions to this rule. After childbirth, measuring basal temperature is ineffective, and therefore it is possible to know that ovulation has occurred only after the appearance of menstruation. But by that time, fertilization could potentially have occurred. This is where the unexpected comes from repeat pregnancies after childbirth, even before the start of menstruation.

Breastfeeding delays ovulation and menstruation, thus protecting against pregnancy. However, to use this tool effectively, you must follow several important rules, which we will talk about below.

Bloody discharge after childbirth is normal. But how to distinguish them from menstruation? There is a rule that any discharge before 8 weeks is considered postpartum and does not apply to menstruation. If they appear after this period, most likely we have to talk about menstruation. If the mother does not breastfeed, the cycle may resume before 8 weeks. Your periods may be irregular for some time after giving birth, so if you have any doubts or questions, you should contact your gynecologist.

When to start using contraception after childbirth

WHO experts recommend starting contraception 3 weeks after birth. Of course it is early attack pregnancy is unlikely, but minimal risk still there is. Most women who are not breastfeeding experience their first ovulation within 6 weeks of giving birth, and contraception after this period is mandatory.

Does breastfeeding protect against pregnancy?

Breastfeeding can be used as a method of contraception (the so-called “lactation amenorrhea method”), but for its effectiveness several important conditions must be met:

You need to start breastfeeding immediately after birth. If for some reason the young mother was separated from the child in the first days or weeks of his life and could not feed, then contraception additional funds you need to start on a general basis, from three weeks.
Feeding should be completely breastfeeding, without complementary feeding or supplementary feeding. The introduction of formula or puree sharply reduces the effectiveness of breastfeeding as a means of contraception.
Feeding should be frequent, breaks between feedings should not exceed 4 hours, be sure to feed at least once, and preferably twice at night.
Lack of menstruation. If they start, it means there is ovulation and the possibility of getting pregnant. It is necessary to protect yourself!
Child's age is up to 6 months. Protective action GW lasts only until this period. Afterwards, there is a high probability of ovulation, and the contraceptive effect of breastfeeding is sharply reduced.

If at least one of these conditions is violated, the likelihood of pregnancy increases sharply, and you need to use additional methods contraception. If a new mother is not breastfeeding, she can in most cases return to her usual and tried and tested method, e.g. combination tablets(COC), however breastfeeding makes its own adjustments to this.

What methods of contraception are suitable for breastfeeding?

Condoms
Most universal method, at correct use its efficiency is quite high. It has no effect on mother and child, does not reduce the amount of milk and does not change its composition.
Flaws: subjective decrease in sensitivity, discomfort or allergy to latex.

Candles
Suitable for both occasional and permanent use. Contains a substance (nonoxynol or benzalkonium chloride) that destroys sperm. Active substance is not absorbed into the blood and does not enter the breast milk, which means it has no effect on the child. Suppositories are also effective against some sexually transmitted infections, pathogenic bacteria and viruses, without disturbing natural microflora.
Flaws:: possible burning sensation, allergies, destroyed by soap.

Intrauterine device
In some cases (discussed in advance with the doctor), it can be installed immediately after birth or caesarean section, but it is best to do this after 6 weeks. It has high contraceptive activity, although pregnancy with the IUD is not excluded. It can only be installed by an experienced gynecologist after examination.
Flaws: can severely irritate the uterus, cause discomfort and prolong bleeding time during menstruation.

Oral contraceptives(pills)
When breastfeeding, only monohormonal progestin preparations (mini-pills) can be used. They contain one hormone - an analogue of progesterone in the minimum required dosage, so it does not pass into breast milk and does not have any effect. harmful action per child. The effectiveness of the mini-pill is lower than that of classic estrogen tablets, so it is better to combine them with barrier methods. You can start taking the mini-pill from the 4th week if you are not breastfeeding, and from the 6th week if you are.
Flaws: do not give full protection, must be taken on schedule, do not skip doses, may cause nausea and vomiting, and change the cycle.

Hormonal injections and progestin implants
They are sewn or injected under the skin of the shoulder. Contains one progestin hormone, which can usually be used during feeding. They last for several years and are highly effective.
Flaws: change the cycle, can cause prolonged bleeding, as well as inflammation at the injection site.

Sterilization(tubal ligation)
Suitable only for women who no longer plan to have children. After a difficult birth, you may think that you will never want it again, but after sterilization, after a while you will begin to regret it. That is why it is performed on women only after 35 years of age or if they have at least two children. Sterilization can be combined with a caesarean section, but you should not make a decision about this hastily, and especially under pressure from others.

Which contraceptive methods are not suitable for breastfeeding?

Combined oral contraceptives
These are tablets containing two hormones - one from the estrogen group, the other from progesterone, in large doses. They have a high effect, but during breastfeeding they impair milk production, and, in addition, have a harmful effect on the child, causing mental and mental retardation. physical development. Suitable only if the child is completely bottle-fed. In this case, they can be used no earlier than 3-4 weeks after birth (since they can cause thrombosis) and must be prescribed by a gynecologist.

Calendar method
Not suitable after childbirth, since at this time there is no clearly established cycle. Ovulation can occur at any time, especially after a break in breastfeeding. Measuring basal temperature at this time does not give anything, because frequent awakenings At night they change it for feeding. As a result, it is impossible to predict “safe days.”

Coitus interruptus
The “method of contraception” is as harmful as it is common. Firstly, it is not at all effective in preventing pregnancy, since the most active sperm can penetrate even before ejaculation. Secondly, the interrupt method has negative impact on the psyche of both – husband and wife, preventing the normal course of sexual intercourse. The result is dissatisfaction, irritability, nervous breakdowns, and all this, coupled with lack of sleep and stress from caring for a small child, contributes to discord in the family.

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 classified as high risk upon the occurrence of an 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 the involution of the organs of the reproductive system (their return 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: various methods contraception, which will be discussed below, has varying 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 combining 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 an effective method of 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 periods are often observed. bloody issues, 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 medicines, vomiting or diarrhea are reduced 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 products long acting. 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 the period of 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. When used correctly, 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 access or by minilaparotomy, as well as during cesarean 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.

There are times when, in a fit of passion, there is no time to think about contraceptives and protection. Our article will help you with tips, the use of which will reduce the risk of unwanted pregnancy.

We will tell you about methods to prevent pregnancy within 24 hours like folk remedies, and pharmaceutical contraceptives, we will talk about the consequences of some of the methods and give a brief tour of emergency pharmaceutical contraceptives.

The most effective home method for preventing pregnancy

The most effective home protection method within 24 hours after completion of PA.

This method involves both mechanical and chemical effects on the microflora of the vagina and sperm.

1. The main thing to do is to wash yourself and rinse the vagina with a syringe with warm water, or better yet, a spermicidal solution.
2. On the Internet they also recommend washing with your own urine. This procedure should be done immediately after sex, but this method is quite dangerous and ineffective. Urine, as a product of the breakdown of substances consumed by the body, contains ammonia and creatinine. A this method involves the return of substances that the body itself rejects back. If this procedure is repeated regularly, there is a risk of developing serious illnesses.
3. Another type of douching is acidic water. After completion of sexual intercourse, using warm water and citric acid, juice or vinegar should carry out the procedure. Exposure to these components destroys sperm, which die in an acidic environment. The disadvantage of this method is that it can seriously damage the vaginal microflora, cause irritation, allergic reaction And various diseases. When using this method, one condition must be observed. PA must not be completed in the woman’s vagina, that is, ejaculation occurs after the removal of the male genital organ. The effect of this method appears in 3 cases out of 10, according to statistics.
4. Douching with potassium permanganate immediately after sexual intercourse is also popular. Potassium permanganate is mixed with warm boiled water in the ratio: 1 teaspoon per 1 liter. This method only helps if the proportions are strictly observed. If the ratio of components is inaccurate, the solution may turn out to be quite weak and not have any effect on sperm, or if the concentration is high, you may get a burn to the vaginal mucosa.
5. Douching with aspirin is also common. For this method, dilute aspirin tablets in warm water and administer the solution after sexual intercourse. Due to the acid contained in the tablets and the collision of the vaginal lining with it, the environment changes and the sperm die. This method can also be hazardous to health and lead to consequences in the form of various diseases.
6. Douching with St. John's wort, which has anti-inflammatory and antiseptic effects, is not little known, but its effectiveness as a contraceptive is negligible.

Drugs used after sexual intercourse

Thanks to modern research In the pharmaceutical industry, 2 main options have been invented emergency contraception after unprotected sexual intercourse.

Scientists involved in the development of these drugs have created several types emergency contraceptives that help avoid unwanted pregnancy.

Emergency oral and vaginal contraceptives are based on large doses progesterone. This is a hormone that affects changes in the lining of the uterus and blocks the release of an egg from the ovary. IN oral contraceptives This hormone is used in the smallest quantities.

It should be noted that frequent use Such drugs threaten to disrupt the functioning of the ovaries.

But it can be found in the following tablets:

• "Postinor". Directions for use: 1 tablet after PA for 48 hours, 12 hours after taking the first dose you need to take another one. This medicine may only help if taken within 72 hours.
• Escapelle should be taken no later than 96 hours after PA.

Antigestagens are drugs containing a small dosage of antiprogesterone. They are a fairly effective method of protection after PA. Antiprogesterone is contained in these drugs:

• "Agest" - has an effect that prevents ovulation and fertilization. Applicable this remedy within 72 hours after PA.

Candles to prevent pregnancy before PA

In common parlance, these suppositories are called spermicides. It’s worth starting with the fact that the candle should be placed just before the beginning of PA, giving it the opportunity to dissolve in the woman’s vagina and release substances that will eliminate the activity of sperm, decreasing the vital ones.

Spermicide suppositories

There are no suppositories that are used after PA to eliminate the risk of unwanted pregnancy. When a suppository penetrates the vagina after PA, sperm enter the uterine cavity much faster than the suppository begins its effect.

Suppositories differ in the concentration of nonoxynolone or non-alkonium chloride and the type of carrier substance. Like any other contraceptives, it is better to choose individually, with your gynecologist. To monitor the variety of drugs, you can also turn to the Internet.

Choice contraceptive drug occurs after a full examination, tests and individual characteristics of the patient. After a thorough analysis of the examination results, the doctor can choose a method of protection.

It is important to remember that abortion suppositories do not exist.

Traditional methods of preventing pregnancy

There are a huge number of methods to prevent unwanted pregnancy using folk remedies. Some of them can help, and some, while harming the body, will not produce the desired effect, so as not to push your luck, you should get acquainted with the main ones.

To the most effective and widespread physical and chemical methods, the following are included:

1. PPA (coitus interruptus). This method consists of removing the penis from the vagina before ejaculation, but this is not always effective, because a small amount of sperm comes out of the head of the partner’s penis along with the lubricant produced, and for fertilization the production of only one active sperm is sufficient.
2. Also, there is a method that suggests taking hot bath partner. When the water temperature is not lower than 40 degrees, most sperm lose their energy, which reduces the possibility of fertilizing the egg. But there is a risk, because part remains active and capable of impact.
3. After sexual intercourse, a woman needs to take a hot bath. The procedure should be carried out by pouring a liter of the mixture boiled water And mustard powder. It is necessary to use this method carefully, because with a strong concentration of mustard powder you can get an allergic reaction and burns.
4. Calculating days according to the menstrual cycle calendar. This method is also called the Ogino method. In honor of the doctor who invented it. The bottom line is that 8 days a month you should abstain from PA. The ovulation period can also be determined by measuring basal temperature.

Herbal infusions

Brewing herbs is one of the most ancient and widespread methods of prevention among our ancestors after PA. But here it is important to be able to brew and infuse correctly in order to avoid side effects. It is important whether any of the herbs are contraindicated for you and whether they will harm your body.

1. Rowan flowers - quite old contraceptive, but ineffective, like most traditional methods. The recipe for an infusion of rowan flowers is as follows: you need to mix a tablespoon of rowan and pour a glass of boiling water. Keep this decoction covered for 1 hour and then strain. Usually it is drunk 3 times a day after meals, but do not forget that rowan leads to increased blood clotting.
2. There is also a common recipe for infusion pomegranate peels. The crusts and membranes are poured with boiling water and left to steep until tender. After which there is a course of using this infusion.

Aspirin

Aspirin is used as a contraceptive before and after sexual intercourse. They came to its use due to the fact of the existence in its composition acetylsalicylic acid, which, by disturbing the vaginal microflora, kills the favorable environment for sperm.

Aspirin, as written above, after PA is used in the form of a solution, which is introduced into the vagina with a syringe. Before PA Aspirin in the form of a tablet is inserted into the vaginal opening 15 minutes before the start of PA.

This method is very dangerous for a woman’s health and in some cases leads to serious consequences in the form of health problems; according to statistics, it has the desired effect in 1 in 10 cases.

Impact of laundry soap and lemon acid

Laundry soap or a slice of lemon, like aspirin, should be placed in the vagina for 15-20 minutes before PA; this method can turn out very badly and provide you with worries in the form of a sexual disease. It also does not provide full confidence that the sperm has not lost its properties and activity after using this product.

Emergency contraception methods

There are various methods of emergency contraception around the world, but not all of them are effective or safe. It's worth remembering that traditional methods may lead to problems with women's health And reproductive function, and frequent use of pharmaceutical drugs promises a violation hormonal levels and early menopause. Don’t forget about sexually transmitted infections that you can catch if you don’t have a contraceptive.

There are different unexpected situations, but you should not neglect your health and take care of yourself. If intimacy does not take place with a regular partner, you should immediately contact a gynecologist and get tested (smear, blood, etc.)

The article we provided talked about famous and effective methods emergency contraception, using them will undoubtedly reduce the risk of unwanted pregnancy. You should still do a test after a few days to make sure that there is no fertilized egg.

IN next video with Elena Malysheva you will learn about the pros and cons of emergency contraception: