Contraception After Birth

If you are a new mum, contraception is probably the furthest thought from your mind. You may not be aware that many unplanned pregnancies can occur just a few months after giving birth. It is important that even if you have not yet thought about sex, you should be contraception ready. Below is our guide to contraception after birth, sex after birth and contraception whilst breastfeeding.

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When can I have sex after giving birth?

Many women wonder when they can have sex again after they have given birth. There is no right or wrong answer because it's down to the individual. Women who've had a straightforward birth may return to sex earlier, whereas women who've had stitches or an intervention may need to wait longer.

It's not only physical issues that can stop you feeling like sex. New parents are often tired from a lack of sleep, they are busy, and have little time for themselves. It may take a while before sex is back on the agenda.

It's safe to say that any bleeding after birth - known as lochia - should have stopped before you consider sex after birth. This should be around 3 weeks after labour. Be able to have sex again, and feeling like having sex again are obviously very different things.

Do not feel pressured into having sex. Usually, your midwife will check you over at your six-week appointment and if you are fully healed then it's safe to have sex again, but this is not the point at which you must have sex. All women should wait until they feel ready again.

When you start having sex again take it slowly and use lubrication if necessary. A new mum's vagina can be sore or dry, particularly if she's breastfeeding. It is also important to know which contraception you can use and when.

When will I be fertile again?

This can be different for every woman, but it's best to take contraceptive precautions, even if you have sex relatively early on after giving birth. Most women will need to start using a contraceptive method around 21 days after delivery.

Contraception after delivery calendar

When will I have my first period after pregnancy?

It takes your body a while to settle after a birth and every woman is different but the earliest your period will return is after 4 to 10 weeks. If you are breastfeeding your period may not appear until six months.

A period is the result of your womb shedding its lining because conception has not taken place. This means an egg has been available for fertilisation and you are able to conceive before your period arrives.

When do I need to start using contraception after birth?

The length of time will largely depend on whether you are ready for sexual intercourse, and if you are breastfeeding or not.

The general rule of thumb is for the first three weeks (21 days) after giving birth you will not need contraception as no eggs are released during this time. In the weeks following birth, women often bleed or have a discharge that takes several weeks to cease. You could have stitches. You should not have sex if you are experiencing discharge or have stitches as this may lead to an infection.

It's possible that you may be able to fall pregnant within as little as three weeks after pregnancy, even if you are breastfeeding and you haven't experienced your period yet. Therefore it's important to consider contraception after having given birth unless you are ready for another baby.

If you are breastfeeding your baby, you should not use a hormonal contraceptive such as the combined pill, even if you used it before your pregnancy. This is because oestrogen can influence lactation.

What contraception can I use if I'm breastfeeding?

It is possible to take the mini pill while you are breastfeeding. Unlike the combined pill, this contraceptive contains just artificial progestogen and is almost as effective as the regular pill. A contraceptive injection is also an option because it contains progestogen only. You can also choose to use male or female condoms or speak to your doctor about having a coil (IUD – intrauterine device) fitted, as these methods don't influence the hormone levels in the body.

Is breastfeeding a contraceptive method?

When you are breastfeeding, your body produces hormones that regulate the production of milk for lactation. This hormone is known as prolactin. When it's active in the body it prevents the release of hormones that can stimulate the production of an egg. It is for this reason that breastfeeding can act as a form of contraception, particularly if you are fully breastfeeding, you aren't having your period and it's within six months after you had your baby.

The risks of falling pregnant during the first six months after having a baby using breastfeeding as a contraceptive method, something which is also known as the lactation amenorrhoea method, is very low - about 2 in every 100 women. However, most doctors will advise that you use an additional method of contraception as a precaution.

Once you stop breastfeeding exclusively, this method will become less effective as a form of contraception.

Contraception after birth timeline

So in the first 3 weeks after pregnancy, it is highly unlikely to fall pregnant, if you decide you want to have sex this soon after. Depending on whether you're breastfeeding, if you wish to fall pregnant again or how long you want to be protected for all depend on the type of contraception you wish to use.

Within 21 days of giving birth

Three weeks after giving birth your body will start to fall back into a routine of ovulation and a resulting period, although they may be infrequent if you are breastfeeding. During this time you will need to use contraception of risk falling pregnant. Options at this early point include:

  • Condoms - Both male and female condoms prevent pregnancy when used correctly. They are a good choice because they don't involve hormones.
  • The contraceptive implant - This is a good choice for new mums as it progesterone only and you don't need to remember a pill every day in the new baby routine.
  • The mini pill - It's easy to take and progesterone only so there are no ill effects on the baby when breastfeeding.
  • Natural methods - Monitoring your temperature and cervical fluids to avoid pregnancy is risky at this point because the signs are not always clear after a pregnancy.
  • Withdrawal method - This is a good choice because it requires no planning or hormones, but accidents happen.
  • Breastfeeding - Breastfeeding can be used as a contraceptive under certain conditions. The NHS states that in women who are fully breastfeeding for the first six months only one in 200 falls pregnant. To use this method you should only breastfeed as giving other foods will reduce breast milk production, have no periods, and not continue beyond six months.

21 days after birth

Women who are not breastfeeding and are able to use oestrogen as a contraceptive can use the combined pill, vaginal ring or patch from three weeks after giving birth. If you are breastfeeding these methods are not suitable as they will restrict your supply of milk. Under this scenario, the mini pill is a good option.

Six weeks after birth

As well as the above methods women who have reached the six-week point and are not breastfeeding can use a contraceptive injection or a diaphragm/cap. You should make sure your diaphragm or cap still fits because pregnancy changes your body shape.

Six to eight weeks after birth

At six to eight weeks post birth you can have an intrauterine device (IUD) or an intrauterine system (IUS) fitted. This is better known as the coil.

Which contraceptive is right for me?

The right contraceptive for you will depend on a number of factors. If you are:

  • Breastfeeding
  • Contraceptives that don't contain oestrogen (mini pill or injection are advised)
    • If you are not breastfeeding

      The combined pill, patch, and vaginal ring are options to consider. If you are not looking to get pregnant in the foreseeable future, long-acting reversible contraceptives like the contraceptive injection, implant, IUD and IUS can provide long-term protection against pregnancy.

      You should be aware that fertility can take up to a year to get back to normal for some women on long-acting reversible contraceptives, You should speak to a health professional if you are considering taking this type of contraception.

      Our interactive contraception tool can help you find out which contraception is right for you.

Can I use emergency contraception after giving birth?

Yes, but only after 21 days after giving birth. Emergency contraception will not affect your breast milk and will not harm your baby. Containing progestogen only, the emergency contraception pill works by delaying ovulation and preventing a fertilised egg from implanting itself to the womb. These actions prevent pregnancy from occurring. Our emergency contraception page can provide you with the necessary information, advice and treatment.

Contraception after pregnancy - Video advice

Dr Hilary Jones gives advice on contraceptive use after pregnancy

When can I get pregnant again?

Some women are fertile a few weeks after the baby is born. Arranging contraception is important if you are not planning another pregnancy because you will be busy in the period following birth. Choosing the right contraceptive can be tricky particularly if you are breastfeeding, so have a chat with your midwife or doctor about the right one for you.

Remember that only condoms can prevent you from sexually transmitted infections. STIs can affect your baby if you are breastfeeding, so always protect yourself from infection.

Ordering contraception online

You can order the combined pill, mini pill, contraceptive patch and contraception ring online at HealthExpress. Firstly, complete a quick and easy online consultation stating your contraception preference and include details about your pregnancy. This will be sent to our doctor for approval and your contraception will be sent straight to your preferred address.