Birth Control for After Pregnancy

Put your health and goals first by making an informed choice about your birth control use after a pregnancy. — Content prepared by Gordana Nuhn

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Sterilization: #

> 1/100 individuals get pregnant 1

Implant: #

> 1/100 individuals get pregnant 1

Copper IUD: #

> 1/100 individuals get pregnant 1

Hormonal IUD: #

> 1/100 individuals get pregnant 1

Depo Injection: #

Approx 6/100 individuals get pregnant 1

Combined Oral Contraceptives (COCs): 

Approx 7/100 individuals get pregnant 6

Vaginal Ring, Patch: 

Approx 7/100 individuals get pregnant 6

Progestin-only Pills (POPs): #

Approx 7/100 individuals get pregnant 6

Barrier Methods: #

Approx 12 to 24/100 individuals get pregnant 1

Natural Family Planning Methods: #

Approx 24/100 individuals get pregnant 1

Optimal time of use:    # Immediately Postpartum (within 10 minutes of delivery)    Six Weeks after Pregnancy

I want a permanent birth control option.

Sterilization Procedures: Vasectomy, Tubal Ligation, or salpingectomy 6

Note: Must be 21 years or older
(18 for a vasectomy).

I am concerned about hormones.

Your Choices: Copper IUD, Natural Family Planning Methods and Barrier Methods* 8

Do Not Use: Hormone Based Methods such as: Hormonal IUD, Implant, Depo Injection, POPs, Vaginal Ring, and the Patch

Note: The hormones in some methods of birth control are similar enough that the body recognizes them as estrogen and progesterone. If you have had a bad experience with one hormonal birth control, other hormonal options may still work well for you. However, it is your personal choice to avoid methods that contain hormones. 3

I am nursing.

Your Choices: Progestin-only Pills (POPs), the Implant, most IUDs, the Depo Injection,** Barrier methods,* and Natural Family Planning Methods 8

Do Not Use: Combined Oral Contraceptives (COCs), Vaginal Ring, and the Patch

Note: Birth Control that contains hormones (progesterone and estrogen) can reduce milk supply so COCs, Vaginal Rings and the Patch are not recommended as the best options for those who are nursing. 9

I am taking an antidepressant.

All Birth Control options are acceptable 8

Note: There is no known link between anti-depressants and birth control effectiveness, so all birth control options are considered a safe and effective option. 5

I have a chronic health condition.

Your Choices: Hormonal IUDs and the Implant 8

Do Not Use: Oral contraceptive pills (including POPs and COCs)

Note: It is important to talk with your doctor about the best birth control method for you.

Examples include seizures, heart disease IBS, high blood pressure, lupus and history of fibroids.

I wish to lighten my menstrual cycle.

Your Choices: Hormonal IUDs, Progestin-only Pills (POPs) Depo injection,** and Combined Oral Contraceptives (COCs) (8)

Do Not Use: Copper IUDs

Note: The effects of birth control on your period may vary with the use of IUDs, the Depo Injection, and the implant. 4

I smoke tobacco/cigarettes.

Your Choices: Copper IUD, POPs, Depo Injection,** and the Implant (8)

Do Not Use: COCs, Vaginal Ring, and the Patch

Note: Nicotine increases the risk of blood clots and increases heart rate so any birth control containing estrogen should be avoided, especially if you are over the age of 35. 6

I smoke marijuana.

Your Choices: Copper and Hormonal IUDs, the Implant, Depo Injection,** Progesting-only Pills (POPs)

Do Not Use: COCs, Vaginal Ring, and the Patch

Note: Marijuana may increase blood pressure and heart rate, so any birth control containing estrogen should be avoided. 7

Diaphragms are considered a barrier method. In order to be most effective, diaphragms must be refitted after a delivery.

Higher body mass index (BMI) impacts the Depo injection. People with a higher BMI may also experience weight gain as a side effect.

References

1 American College of Obstetricians and Gynecologists. (2021, March). Effectiveness of birth control methods. | www.acog.org/womens-health/infographics/effectiveness-of-birth-control-methods

2 American College of Obstetricians and Gynecologists. (2017, April). Sterilization of Women: Ethical Issues and Considerations | www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/04/sterilization-of-women-ethical-issues-and-considerations

3 Bedsider. (2017, February 22). All About Hormones. | www.bedsider.org/features/317-all-about-hormones

4 Bedsider. (2021). Compare Birth Control Options | Benefits, Side Effects, Cost, Effort, Sti Prevention. | www.bedsider.org/birth-control/matrix

5 Centers for Disease Control and Prevention. (2021, May 20). CDC Contraceptive Guidance for Health Care Providers. | www.cdc.gov/reproductivehealth/contraception/contraception_guidance.htm

6 Centers for Disease Control and Prevention. (2020, August 13). Contraception- Reproductive Health. | www.cdc.gov/reproductivehealth/contraception/index.htm

7 Centers for Disease Control and Prevention. (2021, September 9). What We Know About Marijuana. | www.cdc.gov/marijuana/what-we-know.html

8 Centers for Disease Control and Prevention. (2016). Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use. | www.cdc.gov/reproductivehealth/contraception/pdf/summary-chart-us-medical-eligibility-criteria_508tagged.pdf

9 Tepper, N. K., Phillips, S. J., Kapp, N., Gaffield, M. E., & Curtis, K. M. (2016). Combined hormonal contraceptive use amoung breastfeeding women: an updated systematic review. Contraception, 94(3), 262-274 | doi.org/10.1016/j.contraception.2015.05.006