The issue of choosing a method of contraception during the postpartum period is relevant, since the newborn is still too small, and the woman’s body has not had time to recover. When choosing suitable contraceptives, consider their effect on lactation and all sorts of side effects. Otherwise, there is a risk of disruption of milk production, an allergic reaction is possible, and an incorrectly selected product can harm the baby.

There are many methods of contraception, the most natural of which is lactational amenorrhea. In addition, lactating women use barrier, intrauterine, hormonal and other methods of contraception. The gynecologist will select the appropriate method of protection against unwanted pregnancy for a woman who is breastfeeding.

Woman in the postpartum period

The body of a lactating woman requires restoration: weakened immunity, hormonal changes, energy consumption for lactation. Not all mothers have ideal health and can become pregnant 3-5 months after giving birth. This is possible, but dangerous to health. For a woman to fully recover during lactation, she needs at least 2 years.

The balance of hormones during intrauterine development was adjusted over a period of 9 months. After the birth of a child, a woman’s body is rebuilt again, the hormonal background changes. As a result, the woman becomes impressionable, absent-minded, and quick-tempered. The body needs about 3 months to regulate the production of the necessary hormones. A new pregnancy will only worsen the woman’s already unstable condition.

After unprotected intimacy, use an emergency contraceptive drug, for example, Postinor. This hormonal drug should be taken with caution if a woman is breastfeeding. The drug has not undergone medical studies, and therefore its effect on lactation and the newborn is not fully known. Breastfeeding is allowed only 36 hours after taking Postinor. The degree of protection of the drug is not higher than 98%.

Spermicidal contraception

Spermicidal preparations (Patentex Oval, Pharmatex, etc.) have a low level of reliability. Spermicides are produced in the form of suppositories (vaginal suppositories), foam, jelly, cream, etc. The drug envelops the vagina and uterine cavity, and the chemical components that make up it destroy sperm.

Spermicides help fight atrophic vaginitis (drying of the vaginal mucosa), this problem is typical for women in the postpartum period. Gynecologists recommend using them in combination with barrier agents. The effectiveness of spermicidal contraception is from 59% to 96%.

Sterilization

Voluntary surgical sterilization is a fundamental method of protection against unwanted pregnancy. This is an operation as a result of which an artificial obstruction of the fallopian tubes is created, and the woman is deprived of reproductive function. The effectiveness of this method is 99%, but the consequences of surgery are irreversible, so before making a decision, weigh the pros and cons. Entrust the operation to a professional, otherwise pregnancy is possible.

There are many more methods of contraception, among which you can choose the most suitable option. However, it should be remembered that it is not recommended to take hormonal drugs while breastfeeding. Otherwise, side effects occur in the form of bleeding of varying intensity. In addition, hormonal drugs negatively affect lactation and the body of the newborn. The gynecologist selects and prescribes a contraceptive.

Not every young mother plans her next pregnancy immediately after giving birth. In addition, pregnancy in the near future is undesirable for a woman’s health. Therefore, the need to control sexual activity and contraception becomes obvious.

The need for contraception after childbirth

After the birth of a long-awaited baby, many mothers are completely immersed in the atmosphere of household chores and caring for the child, sometimes forgetting about contraception. But young families most often do not plan for a new pregnancy in the postpartum period. And gynecologists recommend refraining from another pregnancy for 2–3 years after childbirth. Only after this period will the woman’s body fully recover and she will be able to easily endure the next pregnancy without complications for herself or the fetus.

A young mother may not notice the onset of pregnancy, because there are no periods when breastfeeding. This is how children of the same age appear. According to experts, more than 85% of such pregnancies in Russia are the result of ignorance or careless attitude of the family towards protection in the postpartum period.

Sometimes it happens that due to an unplanned pregnancy, a woman decides to have an abortion, which negatively affects her health. Young parents should pay more attention to pregnancy protection after childbirth. However, not all contraceptives are suitable for a nursing mother, as some pass into the milk and affect its quantity or can harm the baby.

Lactational amenorrhea

Many mothers are sure that it is impossible to get pregnant while breastfeeding. However, gynecologists warn about the need for contraception when breastfeeding immediately after the start of sexual activity. Every woman's body is individual. And, indeed, the lactational amenorrhea method works in 99% of cases in the first six months of breastfeeding.

The lactational amenorrhea method is a natural way of preventing pregnancy, which is based on the absence of ovulation in a woman during breastfeeding.

A 6-month-old baby begins to be introduced to complementary foods, which means that breastfeeding becomes less and less. The level of hormones responsible for a woman’s ovulation gradually increases, and the chance of getting pregnant becomes several times greater. The lactational amenorrhea method is recommended to be used only until the child is 6–7 months old and subject to the following conditions:

• refusal to supplement and complementary foods;
• breastfeeding at night;
• feeding on demand;
• absence of menstruation.

Even if all the rules are followed, breastfeeding cannot be considered a 100% contraceptive method in the postpartum period. Its contraceptive effect becomes less every month. The likelihood of pregnancy in the future depends on the characteristics of the body of each individual woman.

Methods of contraception after childbirth

The basic rule when choosing contraceptives is that they should not pass into milk in large quantities and affect the baby. Some of them are also unsafe for a woman’s body that is fragile after childbirth. Having familiarized yourself with various methods of contraception, it is still worth consulting with a specialist. The gynecologist will help the nursing mother choose the option that will be safe, affordable and convenient for her.

Hormonal methods of contraception

Hormonal contraceptives against pregnancy act on a woman’s endocrine system, eliminating the possibility of conception.

Subcutaneous implant

The contraceptive is inserted under the skin into the woman's shoulder. This manipulation is simple - it is carried out by the doctor within a few minutes. The implant size is approximately 4 cm. The hormonal implant works for about three years and provides a guarantee of 99–100% protection. Its action is based on the daily uniform release of artificially created hormones into a woman’s blood. They block the release of eggs from the ovaries. This contraceptive can be installed 3 weeks after the birth of the baby. If more time has passed since childbirth, then it is necessary to use other means of protection against pregnancy (uterine caps, suppositories) for seven days after installation of the hormonal implant. The contraceptive does not negatively affect the quantity and quality of milk, therefore it can be used by nursing mothers.

The implant protects against unplanned pregnancy for about 3 years

Contraceptive injections

They begin their action after one injection. The effect lasts for three months. Then the procedure must be repeated.

Most women in Russia have not yet encountered contraceptive injections, while abroad they have already gained great popularity. Over the past 15 years, more than 8 million people around the world have used such injections.

The action of the injections is based on the introduction to the woman of a substance obtained from the natural hormone progesterone. The hormone suppresses ovulation, causing a thickening of the cervix and an increase in the amount of cervical mucus, which interferes with the movement of sperm. The injection is highly effective and protects against unwanted pregnancy by 99–100%. A woman is given a contraceptive injection in a medical facility once every three months on the fifth day of the monthly cycle. The drug is injected intramuscularly into the buttock or shoulder. It does not contain estrogen, which means it does not have a negative effect on lactation.

A contraceptive injection must be given once every three months.

Intrauterine device (IUD)

This is a small plastic device, T-shaped or otherwise shaped, that contains hormones or copper. It inhibits the entry of sperm into the egg and reduces its lifespan, and in the case of fertilization, it prevents the zygote from attaching to the walls of the uterus.

The intrauterine device has an abortive effect, that is, in many cases, fertilization occurs, but due to the presence of the device, the egg cannot be placed in the uterus and dies. The IUD is installed only in gynecologically healthy women with a regular menstrual cycle. Only a gynecologist can insert or remove it. In the absence of side symptoms or discomfort in a woman, the IUD can perform its function for 5 to 7 years. For nursing mothers, the installation of such a contraceptive is possible 5-6 weeks after birth. For women who have had a cesarean section, the installation of the IUD should be delayed until 6 months after birth. This method of protection against unwanted pregnancy does not affect lactation.

The intrauterine device can last from 5 to 7 years

Mini-pill

Minipills are hormonal pills that contain a small amount of progestin (300–500 mcg). Progestin also serves as an alternative to progesterone, which is produced by a woman's ovaries. However, mini-pills differ from combined oral contraceptives (COCs) in their small dose of active ingredient and single-component composition. They are gentler on the body and do not contain estrogen. The active ingredient of the tablets passes into the baby through breast milk in small quantities, but does not have any effect on him. Also, such contraceptives do not in any way affect the amount of milk produced.

The action of the mini-pill is based on the ability of the drug to change the consistency of cervical mucus. The discharge becomes thicker and more stringy, thereby preventing sperm from penetrating into the uterus. The drug also reduces the ability of the egg to move through the fallopian tubes towards the sperm. The substances contained in the mini-pill contribute to changes in the endometrium: even if fertilization has occurred, the zygote cannot attach to the walls of the uterus. But most often, this effect is achieved only when taking the mini-pill for several months.

Mini-pills do not affect lactation

Mini-pills include the following drugs:

Combined oral contraceptives (COCs)

COCs, unlike mini-pills, contain estrogen. Their use after childbirth is permissible only in a few cases:

• if there was no lactation initially;
• if lactation is already completed.

Combined contraceptives have a two-component composition and, in addition to protection against conception, can treat any gynecological diseases of women. You cannot make a decision about taking COCs on your own. It is necessary to undergo a full examination, after which the doctor will be able to prescribe contraceptives that are suitable for you. When taking properly selected combined oral contraceptives daily, following the instructions, you can achieve a 99-100 percent contraceptive effect.

Emergency contraception during breastfeeding

Emergency protection against unwanted pregnancy is used infrequently, as it contains a huge dose of hormones and has a strong effect on the body. You can use the pills within three days after sexual intercourse, when other methods of protection (suppositories, condoms, caps, etc.) were not used or did not help. During this time, it is advisable to consult a gynecologist.

Emergency contraception after sexual intercourse is contraindicated in women who are breastfeeding. This is due to the fact that such preparations contain a very large amount of substances that affect the quality of milk and pass along with it to the baby. In emergency situations, the drug Postinor 2 may be relatively safe for nursing women. However, after taking it, you must stop feeding for 10 hours.

According to studies conducted in which nursing mothers took part, it was found that the maximum amount of the active component of Postinor 2 is achieved three hours after administration. The half-life shows different times: from 10 to 48 hours.

The active substance of Postinor 2 is levonorgestrel. It has the following features:

• inhibits the growth of the endometrium, which does not allow the zygote to gain a foothold in the uterus;
• helps inhibit ovulation, which is why the mature egg does not enter the fallopian tube;
• promotes thickening of cervical mucus, which prevents sperm from moving towards the egg.

The drug is not suitable for regular use. Frequent use of Postinor 2 can cause pain and bleeding in a woman. Emergency contraceptive medications also include:

Emergency contraceptives are not suitable as the main contraceptive, as they place a large burden on the body. These medications have an abortifacient effect, but the time to stop breastfeeding is different for each drug:

• Escapelle, according to some experts, is absolutely safe for infants. It contains levonorgestrol, which is quickly eliminated from the body. If you do not put the baby to the breast for 5–7 hours, the substance will enter the child’s body in a safe amount. Escapelle is taken 1 tablet until 3 days after unprotected sexual intercourse.
• Contraceptives Zhenale and Ginepriston are very strong hormonal drugs, the entry of which into the baby’s body can cause serious disruptions in the functioning of his body. Therefore, after taking such contraceptives, it is necessary to stop breastfeeding for 14 days.
• When taking Miropriston, experts recommend stopping breastfeeding for three days.

Photo gallery: emergency contraception drugs

The active ingredient of Ginepristone - mifepristone Escapelle is quickly eliminated from a woman's body
After taking Zhenale, you must stop breastfeeding for two weeks.
If you had to take Miropriston, then for the safety of the baby it is recommended to cancel lactation for three days. After taking Postinor 2, it is recommended to stop breastfeeding for at least 10 hours

Barrier method

Barrier methods of contraception include condoms and silicone caps. These means of protection against unwanted pregnancy mechanically prevent sperm from entering the uterus, where fertilization can occur.

Condoms

A condom is placed immediately before sexual intercourse on the male genital organ in an erect state. It retains the male seed inside itself and prevents it from entering the female body. The effectiveness of protection against unwanted pregnancy is 96–99%. The disadvantage is the possibility of rupture if there is a strong impact on it. Unlike many other contraceptives, a condom protects both women and men from various sexually transmitted diseases. A condom is the simplest and most accessible method of preventing pregnancy, which has no contraindications when used during breastfeeding.

Uterine cap

It is most often made of silicone or latex and has the shape of a cup or hemisphere. The cap is a reusable product, the service life of which can reach from one to two years. The contraceptive cap is put on the woman’s own cervix and closes the passage for sperm. It does not protect against sexually transmitted infections. The effect of a cap in protecting against pregnancy depends on the correct selection and insertion of it.

The contraceptive cap can be reused multiple times

Without harm to health, the contraceptive cap can be left inside for 35–45 hours; after this time, an unpleasant odor may appear.

Before inserting the cap into the vagina, you must check it for cracks and tears, then wash your hands thoroughly. For the greatest effect, it is recommended to use spermicidal gel, which fills the cap a little less than halfway. The contraceptive is then inserted deep into the vagina, where it attaches to the cervix. It is most convenient to do this with your middle or index finger, squatting or lying on the bed.

The advantage of the cap is the possibility of repeated use. After sexual intercourse, you need to leave the cap in for at least another six hours: quick removal can allow the remaining sperm to penetrate the uterus. You also need to remove the cap with pre-washed hands, taking a position that is comfortable for you. After removing the contraceptive, rinse thoroughly and dry. The uterine cap has no contraindications for use during breastfeeding and does not have a negative effect on the condition of mother and child. However, after giving birth, you should refrain from using such a remedy for at least 4 months, until the cervix takes a permanent shape.

The cap must be inserted and removed with previously washed hands.

Sterilization

Sterilization is a surgical, irreversible method of contraception in 99% of cases. Its essence lies in the mechanical effect on the fallopian tubes, as a result of which their obstruction is created. They do this in one of four ways:

1. Removal of part of the fallopian tube.
2. Cauterization of the fallopian tubes using an electric current, resulting in scarring in the tube that prevents the movement of the egg and sperm towards each other.
3. Tubal ligation - tying the tubes and securing them with a clamp, which subsequently dissolves on its own.
4. Pipe clamping - blocking pipes using clamps. The advantage of this method is that such clamps can be removed later.

If the operation is performed correctly, protection from pregnancy is 100% guaranteed. Since in most cases such an effect is irreversible, before using it, a woman needs to weigh the pros and cons of this procedure. Usually the operation is performed on women who already have and do not want to have more children. It is also indicated in cases where pregnancy can cause harm to health. The woman must be consulted about the methods of sterilization and given an explanation about the irreversibility of the method, after which she must sign documents indicating her consent to sterilization.

If necessary, the clamp can be removed from the pipe using an operation

Conditions for sterilization:

• a complete examination of the woman’s physiological and psychological state;
• absence of health contraindications for surgical intervention, for example, sexually transmitted diseases, oncology, psychological instability, etc.;
• woman's age over 18 years;
• a healthy woman must have at least one child;
• the woman must not be pregnant;
• written consent of the woman to perform the operation.

Natural Family Planning Methods

The calendar method of family planning is the cheapest and most natural way to avoid unwanted pregnancy. It consists of monitoring the menstrual cycle and calculating the days when conceiving a child is possible and when it is impossible. On days when a woman cannot become pregnant, she can have unprotected sex. On the days of ovulation or the days closest to it, you can avoid pregnancy by excluding sexual intercourse or using contraception. This method of birth control is not contraindicated for nursing mothers, but is only suitable for women who have a regular and stable cycle, otherwise the calculations of non-fertile days will be incorrect. An ovulation calendar will help to correctly calculate safe days.

In addition to the ovulation calendar, body signals can help determine fertile days, such as:

• daily body temperature readings increase by 0.4 - 0.6 degrees;
• daily vaginal discharge becomes very abundant, sometimes a one-time small discharge of blood may be observed;
• increased libido;
• pain in the lower abdomen;
• prolapse and opening of the cervix;
• breast tenderness.

It is important to be guided by both the ovulation calendar and the body’s symptoms so that the natural method of family planning works 99 and 100%. Given the fact that people can make mistakes, be forgetful or inattentive, natural family planning provides only 75-80% protection against unwanted pregnancy.

The PPA method, or coitus interruptus, is another type of natural contraception. Its essence lies in the fact that the man manages to remove the penis from the woman’s vagina before the moment of ejaculation. This method is unreliable. Doctors do not recommend using it, since sperm are often present in the discharge even before ejaculation, or the man may not have time to remove the penis. Of course, using this method is better than not using any. However, it is worth knowing that in addition to the unreliability of pregnancy protection, it can bring psychological discomfort to both partners and the fear that the man will not have time to reach his penis before ejaculation.

Chemical contraception

Chemical means of protection against pregnancy include gels, suppositories, creams and aerosols. Due to their active substance, such contraceptives destroy sperm, bacteria and viruses. Chemical contraceptives are non-hormonal contraceptives; their action is based on the destruction of sperm and increasing the viscosity of cervical mucus, which prevents the passage of damaged sperm into the uterus. Chemical contraceptives should be used only before sexual intercourse. Introducing suppositories or cream after sex does not make any sense, since sperm have already managed to penetrate the uterus.

Chemical contraceptives include:

• Erotex;
• Benatex;
• Evitex;
• Pharmatex;
• Gynekotex.

Contraceptive suppositories and creams do not provide 100% protection against pregnancy. It is advisable to combine such contraceptives with other means of protection (condoms, caps). Using only chemical contraceptives provides 75–90% protection against unwanted pregnancy. Therefore, women who are sexually active should choose other methods of protection.

Since contraceptive suppositories and creams are non-hormonal, have a local effect and do not pass into breast milk, their use is possible during lactation. They are suitable for women if:

• rare sexual intercourse, in cases where installing an IUD or taking hormonal pills does not make sense;
• breastfeeding;
• the presence of contraindications for the use of hormonal pills or installation of an IUD;
• perimenopause (the period before menopause, when the production of sex hormones gradually decreases);
• additional protection when using a uterine cap or skipping a hormonal birth control pill.

To achieve 100% protection against pregnancy, contraceptive suppositories should be combined with other means of contraception.

The suppository must be administered 10–20 minutes before sexual intercourse in a comfortable position (lying or squatting). During this time, it will have time to melt, distribute evenly throughout the vagina and begin its action. For 3 hours after using the candle, you should not wash yourself with soap, as soap can neutralize the spermicide and its effect will be ineffective.

Contraceptive creams, gels and aerosols have the same properties and protection parameters as a candle. Their significant difference from each other is only in the form of release.

Most often, the cream comes with a tube with a special tip. The cream must also be administered in advance - 10–15 minutes before sexual intercourse. With frequent use, it can cause vaginal dryness and lead to dysbiosis, so regular use of the cream is not recommended. Another disadvantage of the cream is that when interacting with water and soap, its protective properties are lost. Cleaning up immediately after sexual intercourse or having sex in a pool can neutralize its effects.

Pharmatex contraceptives are available in the form of cream, tablets, suppositories

A new pregnancy immediately after the birth of a baby is rarely included in the plans of married couples. Firstly, a woman needs to rest and get herself in order, and secondly, adapt to the new position of a mother. Therefore, the issue of protection during breastfeeding is quite acute. It has long been known that breastfeeding is not a reliable method of contraception. Lactational amenorrhea “works” only under certain conditions and only for the first six months. Then, if there are no weather plans, you need to think about protection.

Birth control pills, pills, IUDs - when breastfeeding, the choice is wide, but you need to approach it consciously and carefully, with the advice of a doctor.

Do you need to protect yourself?

Most babies of the same age came as a surprise to their parents, because the idea that it will not be possible to get pregnant while breastfeeding is still firmly entrenched in many minds. This is partly true, of course. But there are several serious “buts”! Read more about them.

Lactational amenorrhea (the period when a woman’s menstrual cycle is “turned off” after childbirth, there is no ovulation, menstruation and, therefore, no chance of conception) lasts the first six months after the birth of a child. A prerequisite is complete breastfeeding:

• on demand (the breast replaces the child’s pacifier. The mother offers the breast at any squeak, except in cases where the problem is obviously elsewhere - a dirty diaper or an uncomfortable vest, for example);
• with breaks of no more than 3 hours during the day and 6 hours at night;
• no bottles, pacifiers, pacifiers;
• without additional drinking and complementary feeding (in any form!);
• without pumping, stimulation or “inhibition” of lactation by artificial methods.

If these rules are scrupulously followed, the lactational amenorrhea method provides a high level of protection - unplanned pregnancy occurs in only 2-3 women out of 100. For comparison, with condoms this figure averages 2-18 pregnancies out of 100.

If at least one of these conditions is violated, then menstruation during lactation may return within two to four months after the birth of the child. The result is often an unexpected pregnancy. It can occur without menstruation - at first glance. That is, the cycle has already been restored, ovulation has passed, but menstruation has not come, since the egg has already been fertilized. As a result, a woman may not immediately find out about her new interesting situation.

Two pregnancies in a row is a serious test, not only for health, although it will be subject to severe overload. A woman needs about 2-3 years to recover - to renew her supply of nutrients and put her muscles and organs in order. In addition, due to a new pregnancy, the first baby may suffer - he suddenly becomes “older” and an adult, although he still really needs his mother and her attention. And she has less and less strength for this.

Considering all this, the right birth control for breastfeeding mothers becomes an important issue. The choice here is wide, but there are a number of restrictions and prohibitions that protect the child’s health and the lactation process itself.

Oral contraceptives during breastfeeding

Birth control pills are a popular method of birth control. However, it has its own nuances. Firstly, they are divided into two large groups - combined pills (COCs) and mini-pills.

Combined hormonal contraceptives are contraindicated during breastfeeding because they contain estrogen. Firstly, it gets into the milk and negatively affects the development of the baby, slowing it down. Secondly, birth control pills can reduce milk production or even lead to an unplanned end of lactation. And thirdly, a side effect of taking COCs sometimes becomes depression, depression, and hormonal imbalance in the body. They are allowed to be used no earlier than six months after the birth of the child and strictly under the supervision of a doctor.

Mini-pills are optimal for nursing mothers - single-component contraceptives containing gestagen or progesterone. These hormones, according to research, almost never enter milk, do not affect the well-being of the mother or the health of the newborn, and rarely cause unpleasant side effects. And they do not affect the process of milk production in any way.

An additional bonus of the mini-pill is “permission” to be a little late with your appointment - from 3 to 12 hours. While combined contraceptive pills must be taken exactly at the same time, otherwise they become useless.

A doctor should prescribe contraceptives. You cannot choose them yourself, because they have different compositions and some contraindications. For example, they are prohibited after a cesarean section or may not be combined with the medications that the woman is taking. It is important to follow the dosage prescribed by the instructions or the doctor’s recommendations. An unauthorized increase in dose can lead to health problems, and a decrease will simply nullify the effectiveness of the pills.

Mini-pill tablets, popular for breastfeeding, fit into a list of four names - Microlut, Exluton, Lactinet and Charozetta. This, of course, is not a “sentence” or a final list of available remedies, but these are the ones prescribed to most mothers.

The tablets contain a hormone called levonorgestrel. Its main task is to reduce the activity of two other hormones, luteinizing and follicle-stimulating, which are responsible for the maturation and release of the egg. Plus, under its influence, the endometrium grows in the uterus, which is why an accidentally fertilized egg cannot implant in it. And to be absolutely sure, the hormone thickens the cervical mucus, which prevents sperm from penetrating the egg (in any case, it makes this task much more difficult for them).

Taking Microlut contraceptive pills during lactation is considered safe for the child. You need to take them 1 tablet per day, the package contains 28 pieces. Possible side effects include hives, itching, rashes, vomiting, flatulence, thrush, acne, chloasma and decreased libido.

You can take Microlut during breastfeeding if there are no contraindications or individual intolerance to the components. Also, a new pregnancy is a contraindication - at the first suspicion, you should stop taking the pills.

Exluton

Another remedy available during lactation is Exluton tablets based on the hormone linestrenol. Their area of ​​responsibility is the normalization and control of the menstrual cycle. An important “requirement” of these tablets is the need to take them regularly, 1 tablet per day. A missed or simply irregular dose can lead to another pregnancy.

Like other oral contraceptives for nursing, it has a number of side effects - it can cause headaches, breast swelling, nausea and swelling. It should also be taken into account that in case of vomiting or diarrhea, the effectiveness of the product is lower.

Lactinet

The active ingredient of Lactinet tablets is the hormone desogestrel. It suppresses ovulation, increases the viscosity of cervical mucus and reduces the level of luteotropic hormone and progesterone.

This is an effective remedy, but only if you follow the rules of administration - strictly 1 tablet once a day, at the same time. If you skip one dose, the effectiveness of the drug decreases significantly.

Another mini-pill that is safe during breastfeeding is based on desogestrel. Like the others, they should be taken one tablet per day. The action of birth control pills is based on suppressing ovulation, increasing the viscosity of mucus, and reducing the level of certain hormones (estradiol, progesterone). They do not affect milk production, carbohydrate or lipid metabolism.

In what cases are pills prohibited?

As has been said more than once, choosing birth control pills on your own for nursing mothers is not only not recommended, but almost prohibited. This is due to the fact that they have a list of contraindications and side effects. And only a doctor familiar with the health status of the mother and child can determine for sure which drug will be safe.

Contraindications to taking birth control pills:

• epilepsy;
• tuberculosis;
• migraine;
• kidney pathologies;
• breast cancer, tumors and neoplasms;
• bleeding of unknown origin (uterine and/or vaginal);
• herpes;
• suffered a stroke;
• diabetes;
• thromboembolism;
• sickle cell or hemolytic anemia;
• intolerance to ingredients.

As an alternative to the mini-pill, which must be taken regularly, some women use birth control pills such as Postinora or Expapela.

However, emergency contraception, although relatively safe during breastfeeding (since it contains levonorgestrel, compatible with breastfeeding), is still a one-time, emergency remedy. Its regular use is fraught with health problems.

All hormonal drugs, in addition to contraindications, also have possible side effects - dizziness, nausea, breast swelling, heavy periods, intermenstrual bleeding, digestive disorders, etc. In addition, after their withdrawal, it may take some time (sometimes a long time) to restore the body's reproductive capacity after birth control pills.

Other forms of contraception for breastfeeding women

If a woman does not want or cannot take contraceptives in the form of pills, there are a number of alternative contraceptives that are safe for nursing mothers and their babies.

Contraceptive suppositories are very popular - they are convenient and safe during breastfeeding. Although they also have a number of disadvantages. With long-term use, they can disrupt the normal microflora of the vagina, causing discomfort. When using them, sexual intercourse is tied to the time of their action, and you will have to go to the shower “clockwise” so as not to reduce the effectiveness of the product.

Other hormonal contraceptives for women are injections and subdermal implants. They also contain progestogen and are almost 100% effective. The injection is given once every three months, and the implant lasts about 5 years.

Two months after the baby is born, you can start using barrier methods. These include diaphragms and condoms. Their advantage is that they do not affect the functioning of a woman’s hormonal system, her well-being, or the health and development of the baby. And although their effectiveness is lower than that of hormonal drugs, for many couples this method of contraception, during breastfeeding and not only, becomes the main one.

Intrauterine devices are most often recommended by gynecologists. The spiral is installed 6-8 weeks after birth, if there are no complications and there are no contraindications, for a fairly long period - up to 5-7 years. The IUD installed in the uterus prevents the implantation of fertilized eggs and prevents the development of pregnancy.

The use of spermicides is allowed almost immediately after childbirth - as soon as the lochia ends and sexual activity becomes “available”. They are produced in several forms - ointments, suppositories, tablets - which allows you to choose the most convenient one. When used correctly, these are safe and effective drugs that provide more than 90% protection.

Natural methods of contraception

Prevention after childbirth is a rather individual task and each couple approaches its solution in its own way. Many women, when breastfeeding, reduce the use of medications (no matter what purpose) to a minimum or refuse them altogether, if possible. Natural methods of birth control come to the rescue.

Their effectiveness depends not only on the chosen method, but also on the correctness of its application. These methods include:

• calendar Effective with a regular cycle, which rarely happens immediately after childbirth.
• measurement of basal temperature. According to the rules, BBT is measured after 4 hours of continuous sleep, and breastfeeding rarely provides this opportunity. There is an opinion that the mother's body adapts to frequent awakenings at night, so temperature measurements still make sense.
• symptothermal method of fertility recognition (STMP). It is based on comprehensive observation of three signs at once - the state of cervical mucus, cervix and basal temperature. With regular observations and compliance with the rules of the method, it is effective and allows you to determine the beginning of the cycle before the onset of menstruation.

It is not difficult to choose a method of contraception during lactation. Only COCs are considered strictly prohibited drugs, and from the rest of the drugs, an experienced gynecologist will always select the safest and most suitable one for you.

The female body is unique. She is able to become pregnant just two weeks after the baby is born. Unfortunately, not every family is ready to immediately prepare for the next child. Even doctors do not recommend such a pregnancy, since the body has not yet had time to regain its strength. On average, this will take two years. Hormonal adjustment is a serious process, so it is important to provide it in full. Contraceptives during breastfeeding make it possible to take control of this process and prevent pregnancy.

Planning for the birth of a baby occurs differently within each family. Future parents must take into account many factors, because only in this case will they be able to form strong and healthy offspring. When breastfeeding, contraception should be used, which provides the couple with the proper level of protection during sexual intercourse.

Lactational amenorrhea

Nature has provided the woman’s body with the necessary mechanisms that take into account all her individual requirements. It is aimed at achieving the maximum level of protection for the health of mother and child. That is why, as a rule, there is no menstruation for several months after the baby is born. During breastfeeding, prolactin levels in the body increase. This hormone is necessary for the production of sufficient milk. Additionally, it blocks the function of egg maturation.

It is believed that lactational amenorrhea provides an almost one hundred percent level of protection to a woman for six months. However, for the proper functioning of the hormonal system, it is important to adhere to a number of basic rules:

• After the baby is born, it must be immediately put to the breast. Unfortunately, the process is not possible after a caesarean section.
• The baby must eat only mother's milk. The use of even the minimum amount of supplementary feeding is not allowed.
• The baby always has access to the breast. Between feedings it is allowed to take a break of three hours during the day and six hours at night. It is recommended to perform the procedure as often as possible.
• The woman has never had a period since the baby was born.

After birth, this method is considered effective until the baby is introduced to complementary foods and the intervals between feedings become too long.

Natural contraception

It is also recommended for a nursing mother to use symptothermal and calendar methods. An important role is played by the amount of mucus released from the vagina and basal temperature. Unfortunately, these criteria should not be used as contraception during breastfeeding. For example, when using the symptothermal method in a normal month, its effectiveness is 90%. After the baby is born, this figure drops to 50%.

Today, tests that help determine ovulation in a woman are very popular. It is generally advisable to use them for conception. However, contraception with their help also becomes possible.

To determine ovulation, it is enough to carry out a simple test, which involves a procedure similar to determining pregnancy. To do this, simply dip a strip of dough into freshly collected urine. Ovulation will be established or denied within a few minutes. A positive result is indicated by the presence of two stripes.

Depending on the amount of luteinizing hormone in the urine, the color of the band may change. If the stripe is light, then it is recommended to use additional measures for contraception.

Mechanical options

Condoms are barrier contraceptives for nursing mothers that have no contraindications and can be used without restrictions. They are completely safe for the baby, as they do not affect breast milk in any way.

Other advantages include low price and high degree of protection against unwanted pregnancy. Additionally, it should be noted that only with the help of condoms can you protect yourself from contracting sexually transmitted infections.

Barrier methods that can be used by a woman include:

• condoms for women;
• diaphragms and caps.

You can start using them for the first time only 1.5 years after the baby is born. It is best to consult your gynecologist first. He will be able to recommend an option that exactly matches the physiological characteristics of the female body. The size of the cervix is ​​individual for each woman, so the chosen option may not be effective. It should be noted that proper placement of the cap requires special skills. Otherwise, the possibility of becoming pregnant after intercourse remains.

You should think about contraception immediately after childbirth

Use of oral contraceptives

Until recently, lactation could not be carried out in conjunction with hormonal drugs. During this period, only progestogen pills, known as mini-pills, were allowed to be used. They contained a substance that prevented the egg from attaching to the wall of the uterus. This hormone cannot negatively affect the process of formation of breast milk. However, the use of combination drugs with this hormone is not allowed during breastfeeding.

A woman is allowed to drink mini-pills no earlier than 1.5 months after giving birth. The advantage of the method is a high degree of protection. They can be used for diabetes. Smoking and age are also contraindications. Unfortunately, there have been cases where the pills have caused high blood pressure, depression, vomiting, nausea and severe headaches.

Also, some women find it quite difficult to adhere to a certain schedule and take them only at a strictly defined time. All requirements specified in the instructions must be complied with. Otherwise, the required contraceptive effect will not be achieved. The drug does not protect against sexually transmitted diseases and may lead to weight gain.

There have been cases where taking a mini-pill during breastfeeding led to disruption of the menstrual cycle and exacerbation of thrush. Some women experienced an increase in the number of age spots, the amount of body hair and oily skin. During the first month of use, occasional nausea and vomiting may occur. It is necessary to completely stop taking it if there is bleeding that cannot be stopped for a long time. However, within just a few months the side effects are completely eliminated.

This type of tablet is not allowed to be taken if there is a tumor in the human body. They are also contraindicated for bleeding, hepatitis, and epilepsy. A preliminary consultation with a physician should be obtained in case of pathologies in the functioning of the heart, liver and kidneys. That is why an appointment can only be made after consultation with a specialist at a local clinic.

OK are prescribed only by a doctor

Contraception through the use of injectable drugs

Before using this method of preventing unwanted pregnancy, it is necessary to establish what pros and cons it contains. They are somewhat similar to oral contraceptives. To get the effect, it is enough to give an injection once every three months. Depending on the chosen vaccine, the specific day for its administration is determined. For example, this could be the fifth day after the return of menstruation or the fifth day after childbirth. Some gynecologists recommend giving the injection only 1.5 months after the baby is born.

There are also subcutaneous capsules (implants) that are used as an effective method of contraception. However, they are not registered in our country, so they are not used.

A woman should understand that not all components can be absorbed during injection. A certain portion continues to be excreted in breast milk. That is why the method can only be used after consultation with a doctor. Otherwise, the risk of harm to the baby’s body increases.

The method is very popular because it is allowed during lactation and provides the woman with the proper level of protection. It can be placed only 1.5 months after birth. Before this period, there remains an increased risk of loss. Today you can still find specialists who recommend giving it up for at least six months. Only a specialist in this field can give advice on this method of contraception.

The IUD is an effective method of preventing unwanted pregnancy

Spermicidal agents

Creams, suppositories, and tampons can also help prevent unwanted pregnancy. They must be inserted into the vagina a few minutes before sexual intercourse. The composition includes components that destroy sperm at the local level. The advantage of the method is also the additional hydration of the vagina.

Local methods are not effective when in contact with soapy water. That is why only plain water can be used for personal hygiene. A woman or partner may experience individual intolerance. In this case, you should stop using the drugs.

To date, there is no clear opinion regarding the effects of substances on the vaginal microflora. You can buy them at the pharmacy without a prescription, but you should consult a gynecologist before using them.

The feasibility of using emergency contraception

This option should only be used in rare cases. For example, Postinor is taken in the amount of two tablets for three days after unprotected sexual intercourse.

It contains a huge amount of hormones that are guaranteed to be included in breast milk. This is why you should not feed your baby for another eight hours after taking the pill.

As you can see, today there are a lot of methods of contraception, but only a doctor can prescribe them correctly, especially if we are talking about a nursing mother.

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What's the catch with lactational amenorrhea?

The effectiveness of lactational amenorrhea reaches 99%. But only on the condition that it is a woman and at least 6-10 times a day. To be sure, the break between feedings should be no more than 4 hours. And, of course, this method “works” only until menstruation begins.

What's the catch? Firstly, When the intervals between feedings become longer, the risk of becoming pregnant increases significantly. Even if it's one longer interval at night. And the mother believes that she is still under reliable protection and does not resort to additional methods of contraception.

Secondly, a woman’s first ovulation after childbirth will occur before the first (about 2 weeks). It turns out that all this time she will be hoping for a method of contraception that no longer works. So you should not rely only on this method of contraception.

How to insure yourself? And how can you protect yourself in the future while continuing to breastfeed your baby? Here are 6 possible options.

1. Condoms: the most important rules

The most, very reliable, protecting including against STIs (sexually transmitted infections). Although, it is worth recognizing, protection against STIs is irrelevant for many couples during lactation). Condoms are available for men and women. Moreover, their differences are only external, and the operating principle is the same - to create a mechanical barrier, preventing the sperm and egg from meeting.

The most important rule of this is: only correct and constant use will help avoid unwanted. After each sexual intercourse, the condom must be changed. And “to be sure,” you shouldn’t use both men’s and women’s products at the same time. The probability of getting pregnant with a male condom is 2-18%, with a female condom - 6-12%.

2. Diaphragm/cap: Apply spermicidal cream before use.

In fact, the diaphragm and the cap are different methods of contraception, but the protection mechanism (barrier) and the principle of operation are the same. To achieve an acceptable level of reliability, the diaphragm or cap should be treated with spermicidal cream before use.

Diaphragms and caps come in different sizes, so it’s best to choose the right one together with your gynecologist. You can use one product for several years. But after your baby is born, still check with your doctor before hoping for the same cap you had before pregnancy. Most likely, you will have to purchase a new, larger one.

On the plus side: you can set the diaphragm in advance, and during intercourse it does not require additional attention from the woman. Of the minuses: diaphragms and caps practically do not protect against STIs. and, besides, they are not sold in every pharmacy. The probability of pregnancy when used together with spermicides is 6-12%.

3. Progestin-only oral contraceptives (pills): can be taken as early as one month after birth

Progestin-only oral contraceptives (PPOCs) suppress ovulation, increase the viscosity of cervical mucus (it is more difficult for sperm to pass through the uterine cavity), and disrupt the growth of the endometrium (which means implantation of a fertilized egg is impossible if ovulation and fertilization do occur).

When using POCs, menstruation often disappears, especially if a woman starts taking them after giving birth. It is not harmful to health.

4. Injectable contraceptives: one injection for 3 months

How it works? Exactly the same as PSCs. However, medroxyprogesterone included in the injection enters the bloodstream after an injection in the buttock or shoulder (a certain “depot” is created, from where the drug is released within three months). During this time, medroxyprogesterone will suppress ovulation. Then the injection must be repeated.

The probability of getting pregnant with this method of contraception is quite low (0.2-6%). But most importantly, the injections do not affect either the quality of the mother’s milk or the development of the baby. You can start taking POCs even on the day of birth, but it is better to wait at least a month to avoid thromboembolic complications.

Because of the injections, a woman may miss her periods, as is the case with pills. If you notice any side effects after the injections, contact your gynecologist immediately.

5. Contraceptive implant: the most effective way

It resembles a piece of a fountain pen refill. The 4 cm long implant is inserted under the skin on the inside of the shoulder using a special syringe. The procedure is performed under local anesthesia. The Cu-spiral causes aseptic inflammation in the uterus (without the participation of microorganisms). As a result, sperm become less mobile. Also, drugs in the spiral disrupt the function of the endometrium and interfere with the implantation of a fertilized egg. The effectiveness of the method is 99.2-99.4%.

The LN-helix acts in almost the same way as purely progestin contraceptives. But the probability of pregnancy with it is only 0.2%.

The drugs included in the spirals pass into breast milk in doses that are safe for the baby. They do not affect either the quantity or quality of lactation. The IUD can be installed immediately after childbirth. However, if the baby was born by caesarean section, you will have to wait at least 6 weeks (LN-spiral) or from 8 to 12 weeks (Cu-spiral).

Examinations may be required before the IUD is installed.: examination in a gynecological chair (mandatory), as well as analysis for sexually transmitted infections and a PAP test.