Contraception after you have had your baby (postnatal contraception)

What is postnatal contraception?

Postnatal contraception is birth control after having your baby to delay or avoid another pregnancy. Many unplanned pregnancies occur in the first few months after pregnancy so it is important to have a plan for contraception that suits you.

When do I need to start contraception?

You need to start contraception from 3 weeks after birth; it is not possible to become pregnant prior to this. You should not wait until your periods return to start contraception as you may become pregnant before this.

If you are fully breastfeeding, you may choose to rely on this for contraception for 6 months.

Some methods of contraception can be started immediately after giving birth and others are started later on. If you choose a method that is started after 3 weeks, you will need to use another method of contraception in the meantime. 

Important advice:

Immediately after birth

  • Male or female condoms
  • Progesterone-only (mini) pill*
  • Injection*
  • Implant
Important advice:

From 3 weeks (or 6 weeks if breastfeeding)

  • Combined pill*
  • Contraceptive patch*
  • Contraceptive vaginal ring
Important advice:

From 4 weeks (or within 48 hours)

  • Intrauterine device (IUD) ‘copper coil’
  • Intrauterine system (IUS) e.g. Mirena coil
Important advice:

From 6 weeks

  • Diaphragm or cap (must be fitted correctly)

At the Queen Elizabeth Hospital, the methods marked with a * can be provided after birth for you to start when appropriate. An appointment can be made in clinic to arrange IUD or IUS insertion. Implants can be arranged at Trinity Square Health Centre, Gateshead call 0191 283 1577.

Does breastfeeding act as contraception?

Breastfeeding alone does not prevent pregnancy. However, breastfeeding can be used as a method of contraception for 6 months and is up to 98% effective at preventing pregnancy if all of the following conditions are met:

  • Fully breastfeeding – this means that you give your baby breast milk and no other liquids (even water), breastfeed regularly (no more than 4-6 hours between feeds) and continue to breastfeed at night
  • Baby less than 6 months old
  • No period since birth

We would recommend that you use another form of contraception alongside breastfeeding in case you stop meeting these conditions.

Which contraception is right for me?

This will depend on your personal preferences and medical history. The table at the end of this leaflet outlines the advantages and disadvantages of the different methods of contraception, their efficacy (how effective they are at preventing pregnancy) and instances in which certain types of contraception may not be suitable. More information about the suitability of hormonal contraception is outlined below. In general, long-acting reversible contraceptives are the most effective at preventing pregnancy, as they do not rely on you remembering to take or use them.

Can I use a hormonal contraception?

Hormonal contraceptives can be combined (contain oestrogen and progestogen) or progestogen-only. Combined contraceptives include the combined pill, contraceptive patch and vaginal ring. Progestogen-only methods include the progestogen-only pill, implant, injection and intrauterine system (e.g. the Mirena coil). 

Combined contraceptives might not be suitable if you:

  • Are 35 years old or more and smoke or gave up smoking less than a year ago
  • Are very overweight
  • Take certain medications
  • Have a personal or family history of certain medical conditions

Progestogen-only contraceptives might not be suitable if you:

  • Take certain medications
  • Have a personal history of certain medical conditions

If you are thinking about starting one of these methods, you should speak to your midwife, nurse or doctor. They will need to ask about your own and your family’s medical history to decide whether hormonal contraception is suitable for you.

What about permanent contraception?

The methods of permanent contraception are female sterilisation (tubal occlusion) and male sterilisation (vasectomy). These should only be considered if you are absolutely sure that you do not want to have any more children. If you are thinking about this, you should discuss it with your doctor.

Where can I get more information?

This leaflet is intended as a guide only. If you have any questions, you can contact your midwife, nurse, doctor, or attend your local sexual health clinic. Further information can also be found at:

  1. FPA Sexual Health
  2. Trinity Square Health Centre, Gateshead call 0191 283 1577

Types of contraception

Hormones

None

Advantages

Protect from STIs

Disadvantages

Can slip off or split

May be unsuitable if

Latex allergy –polyurethane option

Efficacy*

95-98% (perfect use)

79-82% (typical use)

Timing after birth

Can be started immediately

Hormones

None

Advantages

Can be inserted any time before sex

Disadvantages

Can take time to learn to use it

May be unsuitable if

Unable to fit properly

Sensitive to spermicide

Efficacy*

92-96% (perfect use)

71-88% (typical use)

Timing after birth

6 weeks

Hormones

Oestrogen and progestogen

Advantages

Often lighter, less painful periods

Can help premenstrual symptoms and acne

Disadvantages

Temporary headaches, breast tenderness, mood changes, spotting

Some serious side effects (uncommon)

May be unsuitable if

>35yo

Smoker

Very overweight

Personal or family history of certain medical conditions

Efficacy*

99% (perfect use)

91% (typical use)

Timing after birth

3 weeks (or 6 weeks if breastfeeding)

Hormones

Progestogen

Advantages

Useful if you can’t take oestrogen

Can help premenstrual symptoms and heavy, painful periods

Disadvantages

Taken at the same time every day

Temporary headaches, breast tenderness, skin changes

May be unsuitable if

Certain medical conditions

Efficacy*

99% (perfect use)

91% (typical use)

Timing after birth

Can be started immediately

Hormones

Progestogen

Advantages

Works for 3 years

Often lighter, less painful periods

Disadvantages

Small procedure

Temporary headaches, breast tenderness, skin changes, spotting

May be unsuitable if

Certain medical conditions

Efficacy*

>99%

Timing after birth

Can be started immediately

Hormones

Progestogen

Advantages

Works for 13 weeks

Can help premenstrual symptoms and heavy, painful periods

Disadvantages

Temporary  headaches, breast tenderness, skin changes, spotting

Can cause weight gain

May be unsuitable if

Certain medical conditions

Efficacy*

>99% (perfect use)

94% (typical use)

Timing after birth

Can be started immediately

Hormones

Progestogen

Advantages

Works for 3-5 years

Often lighter, less painful periods

Disadvantages

Temporary  headaches, breast tenderness, skin changes, spotting

Risks of procedure

May be unsuitable if

Certain medical conditions

Untreated infection

Efficacy*

>99%

Timing after birth

Within 48h or after 4 weeks

Hormones

None

Advantages

Works for 5-10 years

Immediately effective

Disadvantages

May have heavier/more painful periods

Risks of procedure

May be unsuitable if

Untreated infection

Anatomical abnormality

Efficacy*

>99%

Timing after birth

Within 48h or after 4 weeks

Data Protection

Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.

In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews and Statistics.  

Further information is available via Gateshead Health NHS Foundation Trust website or by contacting the Data Protection Officer by telephone on 0191 445 8418 or by email ghnt.ig.team@nhs.net.

This leaflet can be made available in other languages and formats upon request