This sheet answers common questions about starting contraception after you’ve had a baby. If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.

The World Health Organisation (WHO) recommends an interval of at least 24 months after giving birth before attempting your next pregnancy to reduce the risk of adverse maternal, perinatal, and infant outcomes.

However, many unplanned pregnancies happen in the first few months after having a baby. You can become pregnant as early as 21 days following delivery, even if you are breastfeeding, so it’s important to consider contraception in a timely manner.

Following delivery, there are several methods of effective contraception that can be offered to you to help delay or prevent further pregnancies. For more information on which methods of contraception are available at our hospitals, please speak to your nurse or doctor.

When do I need to start using contraception?

You can get pregnant from day 21 following delivery, but many of the different contraceptive methods are safe and available to start immediately following delivery. We will aim to provide them either during delivery or on the postnatal ward, to ensure that you have access to the desired contraceptive methods prior to leaving the hospital.

We would advise to begin contraception before your six-week postnatal check with your GP, as you could get pregnant before then.

Your likelihood of falling pregnant is reduced if:

  • Your baby is less than six months old.
  • You are fully breastfeeding, with no bottle feeds (including overnight).
  • Your periods have not returned (even light spotting counts).

Using breastfeeding as a contraception method is called the lactational amenorrhoea
method, however it is not a reliable method. Its efficacy is unknown, and it can be less effective compared to other contraceptive methods. 

Contraception options

Many contraceptive options available will not affect either your baby or your supply of milk. 

The progesterone-only contraception pill, also known as the mini pill, contains one hormone: progestogen. This pill is suitable to take immediately following delivery and needs to be taken every day. The postnatal ward can provide these, which work by preventing the ovary from releasing an egg. This prevents the risk of pregnancy.

Advantages

  • It is 91 per cent effective.
  • Your fertility will return as soon as you stop taking the pill.
  • It is safe for use by those who cannot have oestrogen.
  • It is suitable to take when breastfeeding.
  • You may have no bleeding or periods.

Disadvantages

  • You may experience irregular bleeding.
  • The pill l must be taken at the same time each day.

This is a matchstick-sized rod which is inserted into the upper arm of your non-dominant hand. It releases progestogen and thickens the mucus of your cervix to prevent sperm from passing through, in addition to preventing your ovary from releasing an egg, to prevent pregnancy. It provides effective contraception for up to three years.

Advantages

  • It lasts for three years once fitted; it is a ‘fit and forget’ contraception.
  • It is more than 99 per cent effective.
  • It is suitable to have when breastfeeding.
  • Your periods may be lighter, or you may not have your period.
  • There is a quick return to fertility upon removal.

Disadvantages

  • You may experience irregular periods.
  • The implant must be fitted and removed by a clinician.

The injection contains progestogen which prevents your ovaries from releasing eggs and thickens the mucus of your cervix to prevent sperm from passing through. It is safe to be given immediately after birth and can be given on the postnatal ward.

Advantages

  • It lasts for three months per injection.
  • It is more than 94 per cent effective.
  • Your periods may be lighter, or you may not have your period.
  • It is suitable to have when breastfeeding.

Disadvantages

  • You must see a healthcare professional every three months for a repeat injection.
  • You may experience irregular periods.
  • There is a possible delay of up to one year for your fertility to return when you stop having the injection.

The IUS, also known as a hormonal coil or Mirena coil, is a T-shaped device that is fitted into your uterus (womb). It can remain in place for eight years and works by releasing a small amount of progestogen to thicken the mucus of your cervix to prevent sperm from passing through. It can be fitted at the time of a caesarean section, or after four weeks following delivery.

Advantages

  • It provides contraception for up to five years; it is a ‘fit and forget’ contraception.
  • It is more than 99% effective.
  • It is suitable to have when breastfeeding.
  • Your periods may be lighter, or you may not have your period.
  • It is easy to remove.
  • There is a quick return to fertility upon removal.

Disadvantages

  • You may experience irregular bleeding or periods.
  • It must be fitted and removed by a clinician.

The IUCD, also known as an IUD or Copper coil, is a T-shaped device that is fitted into your uterus. It can remain in place for 10 years, and works by altering the movement of sperm, thus preventing them from fertilising an egg. It does not use hormones and contains only a small amount of safe copper. It can be inserted at the time of caesarean section, or from six weeks following delivery.

Advantages

  • It provides effective contraception for up to 10 years; it is a ‘fit and forget’ contraception.
  • It is more than 99 per cent effective. 
  • It is suitable to have when breastfeeding.
  • It is easy to remove.
  • There is a quick return to fertility upon removal.
  • It does not use hormones.
  • You will likely have continued regular periods.

Disadvantages

  • Your periods may be heavier and more painful than before.
  • It must be fitted and removed by a clinician. 

Of note, there are also combined hormonal contraceptives (including the combined oral contraceptive pill, the patch, and the vaginal ring). These contain both oestrogen and progestogen and work by preventing your ovaries from releasing an egg.

  • If you are breastfeeding, this method is unsuitable for at least six weeks following delivery.
  • If you are not breastfeeding, this method may be suitable after three weeks following delivery, but for many women it will remain unsuitable for six weeks.

This is a permanent surgical procedure where the fallopian tubes are blocked to prevent sperm from meeting an egg. The procedure can be performed during an elective caesarean section, or a separate procedure can be arranged after delivery.

Advantages

  • It is more than 99 per cent effective and permanent.
  • There will be no change to your periods.

Disadvantages

  • There is a higher failure rate (one in 200) compared to other long-acting contraception if performed during caesarean section.
  • Sterilisation is irreversible. You must be certain you don’t want another pregnancy.
  • This is a surgical procedure with risk of complications. If the procedure fails, there is a risk of ectopic pregnancy, where a fertilised egg is implanted outside of the womb.

If you are considering sterilisation, you should discuss this with your midwife or doctor as early as possible to consider arrangements. 

This is a permanent surgical procedure where the tubes that carry sperm from the testicles to the penis are blocked. Male sterilisation is effective, quick, and simple but it is also irreversible. You will usually be advised to wait until your youngest child is one year old before having the procedure, and your GP can arrange a referral. It can be done in a community clinic.

Advantages

  • It is more than 99 per cent effective and permanent.
  • The procedure can be performed under local anaesthetic.

Disadvantages

  • Sterilisation is irreversible. You must be certain you don’t want another baby.
  • This is a surgical procedure with risk of complications.

If you have unprotected sex in the first 21 days following delivery, you will not require any emergency contraception. If you have sex without using reliable contraception after this time, there is a risk of pregnancy. There are two main types of emergency contraception: emergency contraception pills (“morning after” pills) and emergency copper IUCD (coil).

You can take this up to 72 hours following intercourse, but it becomes less effective the longer you wait. It delays the release of an egg (if this has not already happened). You can get this pill from a pharmacy, your GP, or a local sexual health clinic.

It is suitable to take when breastfeeding and will not affect your baby or milk supply.

You can take this pill up to five days following intercourse, but it becomes less effective the longer you wait. It delays the release of an egg (if this has not happened already). You can get this pill from a pharmacy, your GP, or a local sexual health clinic.

If you are breastfeeding, you should discard breast milk for seven days after taking this pill. You should avoid taking hormonal methods of contraception for five days after taking this pill, as it can make it less effective.

This is the most effective method of emergency contraception (99 per cent effective) and can be fitted up to five days after having unprotected sex. You must keep the IUCD for the duration of one period cycle, after then it can be removed or left in for long-term contraception.

It can be fitted up to five days after unprotected sex (longer in some cases). It is suitable to take when breastfeeding and will not affect your baby or milk supply.