Post-Pregnancy Contraception:... Video Transcript

Participants

Lucien Côt&# MD, Blair Ford MD, Suzanne LaJoie MD, William J. Marks Jr. MD, Kenneth Powers MD

Summary

How quickly you become fertile after a pregnancy varies. And if you are interested in birth control you have a few options. Learn about the methods available after childbirth.

Webcast Transcript

ANNOUNCER: It's a miracle! The baby has finally fallen asleep and your sex drive wakes up from a long, long nap.

SUZANNE LaJOIE, MD: I usually tell women to wait about six weeks and just to check in with their doctor or whoever's providing their care before they go ahead and resume sexual intercourse.

ANNOUNCER: A woman's body after childbirth is still going through a lot of changes.

SUZANNE LaJOIE, MD: The uterus has to contract down to a non-pregnant state and the cervix, especially after a vaginal delivery, it dilates completely, so it's like wide open to let the baby out and then it takes a while for that cervix to close. And sometimes there are tears in the vagina and the perineum, you want to make sure those are really well-healed and that the woman's feeling well physically before I tell them to resume sex again.

ANNOUNCER: Many women mistakenly think that because they have just given birth or because they are nursing, that they are not ovulating and therefore cannot become pregnant. But ovulation can occur again shortly after childbirth.

SUZANNE LaJOIE, MD: When a woman ovulates after delivery is variable. In women who are nursing, lots of times ovulation is suspended for a while. A woman who is not nursing may ovulate, actually, six weeks after delivery. When women are breast-feeding, they're not as fertile. And, a lot of times, women will not get a period when they are nursing.

ANNOUNCER: But that doesn't guarantee they won't get pregnant.

SUZANNE LaJOIE, MD: My recommendation is that women don't rely on that for contraception, especially if they feel strongly that they want to hold off on getting pregnant again.

ANNOUNCER: The choices that couples have for contraception after childbirth fall into four categories: hormonal methods, barrier methods, sterilization, and natural methods.

SUZANNE LaJOIE, MD: In terms of hormonal methods of contraception, there are birth control pills, there are birth control patches, there are vaginal rings and there are injectables that can be used. There's also an IUD that has a hormone in it as well.

ANNOUNCER: But hormonal choices have to be made carefully.

SUZANNE LaJOIE, MD: If a woman is breast-feeding, I won't put her on a method that contains estrogen. I'll use either a progesterone-only pill, a progesterone-only injectable or an IUD.

ANNOUNCER: Certainly, of all the hormonal methods, birth control pills have been the most popular, particularly in women under the age of 35.

SUZANNE LaJOIE, MD: Lots of women use birth control pills before they get pregnant. It's something that they're familiar with, it's easy to use, and it's effective.

The pills that contain estrogen and progesterone are probably a little bit more effective than the progesterone-only pills. The progesterone-only pills are really good for women who are either having a medical problem that we don't want them to take estrogen or in someone who's nursing where estrogen really isn't a good idea.

ANNOUNCER: Gaining popularity are three other types of hormonal contraceptives.

SUZANNE LaJOIE, MD: It's actually a patch that women can wear on their skin, anywhere on the body except on the breasts. And they change it once a week. So it's a bit more convenient for women who forget pills, for instance.

ANNOUNCER: The vaginal ring works the same way as the patch and the birth control pills.

SUZANNE LaJOIE, MD: Women insert it into the vagina and they keep it in for actually three weeks.