Contraception after childbirth, methods, means, methods. Features of contraception in the postpartum period. Vaginal suppositories, gels, pastes

The onset of pregnancy is often a surprise for new parents. Contraception after childbirth is the last thing a young mother thinks about when she returns from the hospital. A woman pins her hopes on the belief that it is impossible to get pregnant while breastfeeding. But is it worth playing Russian roulette and hoping that breastfeeding will protect against pregnancy?

Probably each of us has a friend who gave birth to children the same age, relying on the theory of “infertility” during lactation.

Choosing a method of contraception after childbirth is a responsible issue. And he undoubtedly requires the attention of young parents. Not all contraceptive methods are suitable for women who have recently given birth, and especially for nursing mothers.

• Involution (return to the pre-pregnancy state) of internal organs and body systems takes an average of 12 months.
• The supply of vitamins and minerals is especially depleted in women who are breastfeeding. To replenish nutrients, the body needs at least six months after the end of breastfeeding.
• Studies show that when pregnancy occurs earlier than 2 years after birth, the risk of complications increases: anemia, gestosis, miscarriage, intrauterine growth retardation.

A woman regains her ability to conceive after the appearance of her first menstruation. In mothers who do not breastfeed, menstruation resumes immediately after the end of lochia. However, you need to remember that ovulation occurs before the onset of your first period. Fertilization may already have occurred, but the woman does not yet know about it. You need to start using contraception three weeks after giving birth.

Breastfeeding mothers have different cycle recovery times. The first menstruation occurs between 1 and 2 years after childbirth. But this does not mean that breastfeeding can be regarded as a method of contraception.

Lactational amenorrhea method

Some breastfeeding mothers think that it is impossible to get pregnant while breastfeeding. Let's consider the principles of the lactational amenorrhea method, which can only be conditionally called a reliable method of contraception.

During breastfeeding, a woman's body produces the hormone prolactin. It suppresses follicle maturation and ovulation. The mechanism only works if the baby receives breastfeeding on demand, day and night. This means that the baby nurses 10-12 times a day and at least 4 times at night. If the break between feedings is more than 3 hours during the day and 6 hours at night, then prolactin levels decrease and ovulation may occur.

“After introducing complementary foods and, accordingly, reducing the number of feedings, MLA ceases to be a reliable method of protection against pregnancy.”

If the child is fed according to all modern rules for organizing breastfeeding recommended by WHO, then contraception can be postponed until the child is 6 months old.

Lactational amenorrhea only works if the following conditions are met:

1. Exclusive breastfeeding without additional water, supplementary feeding and the use of pacifiers and bottles.
2. Feeding every 3-4 hours during the day and a break in night feedings for no more than 6 hours.
3. The child is no more than 6 months old.
4. Menstruation has not yet started.

If early complementary feeding or feeding according to a schedule is planned, then the mother should consult a gynecologist 6-8 weeks after birth. The doctor will select contraceptives that are suitable for nursing mothers.

Barrier methods of contraception

Condom

A condom is a reliable way to protect against unwanted pregnancy, and also protects a woman from sexually transmitted infections. This is especially important now, when a woman’s body is not yet strong after childbirth. In the first 1.5-2 months, the uterus is in the process of involution. The internal pharynx is slightly open, and the infection can easily enter the uterine cavity.

Using a condom during the first time after childbirth can cause discomfort to a woman due to vaginal dryness. The reason for the lack of natural lubrication is a change in hormonal levels. After 2-3 months it will recover, but in the meantime you can use additional lubricant. But it is better to choose a gel-based lubricant, not an oil-based one. The oil base, when rubbed, can create microcracks in the latex of the condom. And this reduces its effectiveness.

Efficiency: 97% when using a condom correctly.

Contraceptive ring Nova Ring

A device in the form of a ring that is placed deep in the vagina for 21 days. After removal, there is a break in using the device for 7 days. This hormonal method of contraception is prohibited during breastfeeding because it contains estrogens. Hormones pass from the milk to the baby and reduce the level of lactation.

Efficiency: 97-98%. Suitable for non-breastfeeding women only.

Contraceptive ring Nova Ring

Intrauterine device

This is a special device that is inserted into the uterine cavity. Prevents the movement of sperm and the attachment of a fertilized egg to the uterine cavity. An IUD does not prevent ovulation or conception. Every pregnancy that occurs is terminated in the very first week.

IUDs are allowed to be used during lactation. But installing this device has a number of side effects. The intrauterine device thins the endometrium lining the uterine cavity. Which can lead to problems with subsequent conception. The risk of developing inflammatory processes in the pelvic organs increases.

The IUD is inserted 6 weeks after birth. When using this method of contraception, a woman needs to undergo a preventive examination by a gynecologist 2 times a year. The spiral is installed for up to 5 years. After its removal, you need to postpone conception for a period of 6 to 12 months.

Intrauterine device

Efficiency: 98-99% Allowed for use during lactation.

Natural methods of contraception

Coitus interruptus

During sexual intercourse, the man removes the penis from the vagina before ejaculating. But the thing is that some of the sperm may be contained in lubricant, which is released even before orgasm. And thus get into the vagina and fertilize the egg. After childbirth, using this method of birth control is completely unsafe.

Efficiency: 50%

Basal temperature measurement

An increase in basal temperature in the rectum indicates the onset of favorable days for conception. By regularly measuring basal temperature, the days of ovulation are calculated. This method should not be considered effective after childbirth. During postpartum recovery, temperature may fluctuate due to changes in the pelvic organs or due to lactation hormones. In addition, basal temperature is measured after a full night's sleep, without getting out of bed. But mothers of infants can hardly afford uninterrupted sleep at night. So you shouldn’t rely on this type of contraception.

Efficiency: no more than 60%

Calendar method

Keeping a calendar of dangerous and safe days after childbirth is not a reliable method of birth control. After childbirth, the cycle is established within several months. This method is also not suitable for a woman who is breastfeeding because even after the cycle has been established, menstruation may be delayed. This depends on the surge in lactation hormones. Prolactin “clogs” ovulation, it can be delayed for several days or even weeks.

Efficiency: less than 50%

Hormonal contraceptives

Hormonal drugs are considered the most effective methods of preventing unwanted pregnancy. The work of such drugs is based on the suppression of ovulation. The active substances included in the drug prevent the release of the egg from the ovary and suppress ovulation.

“Any hormonal medications must be prescribed by a gynecologist. What suits your friend may not suit you at all and may be harmful to your health. Especially if they are used during breastfeeding. Taking synthetic hormones is a disruption of the natural functioning of one’s own hormonal levels. Before interfering with the natural functioning of the body, it is worth weighing all the pros and cons.”

Before using contraceptives, you should consult your doctor.

Mini-pill

Birth control pills, the so-called mini-pills, can be taken while breastfeeding. They contain the hormone progestin, which is a substitute for natural progesterone. You need to take these pills daily, without interruption. Otherwise, the risk of unplanned pregnancy increases. Continuous use of such drugs keeps progesterone levels high and prevents egg maturation and ovulation. Progestin does not affect the quantity and quality of milk produced.

Efficiency: 98% when taking medications correctly and regularly. Suitable for nursing women.

Combined oral contraceptives

Also hormonal drugs. But unlike mini-pills, in addition to progestin, they contain several other types of hormones, including estrogens and gestagens. Estrogens reduce the secretion of breast milk. Such drugs are prescribed only after breastfeeding is completed. In addition, these drugs have a number of contraindications.

Efficiency: up to 100% if you follow the rules for taking medications. Not recommended during breastfeeding.

Injections of progestogen drugs

Another type of hormonal contraception is the use of drugs intramuscularly. A gestagen injection is given once every 2 months. And you can’t skip the injection. Otherwise, its contraceptive properties are reduced.

Implantation of a contraceptive drug

A capsule with a progestin drug is implanted subcutaneously. The hormonal contraceptive is gradually released from the implant. The contraceptive provides a long-lasting effect – up to 5 years. Using this method, you can save yourself from constant torment and doubts about an unwanted pregnancy. But in this case, you need to be sure in advance that a new pregnancy will not be planned in the next five years. Although, if necessary, the drug can be removed. Such surgical intervention, although minimal, can still provoke an infectious and inflammatory process.

Efficiency: 95-97% Suitable for nursing mothers.

Emergency postcoital contraception

Hormonal drugs like Postinor, which are taken in emergency cases immediately after unprotected sexual intercourse during breastfeeding, should not be taken at all. They contain a loading dose of hormones that the baby receives through milk. Complications often include hormonal imbalance and intermenstrual bleeding.

Efficiency: 99%. Cannot be taken while breastfeeding.

Spermicides

This chemical type of contraception is the local application of tablets, suppositories, creams or gels. The drug is inserted into the vagina immediately before sexual intercourse. The active substances destroy the structure of the sperm, leading to their death or decreased motility. Validity period: up to 5 hours after application.

Efficiency: 77-98%. Can be used during lactation.

Of all the methods of contraception, a condom is the safest for a breastfeeding woman. 6 weeks after birth - intrauterine device. As a last resort, mini-pills without estrogen content. Such drugs do not affect milk production. But at the same time they put additional stress on a woman’s hormonal system.

Content

Many people believe that it is impossible to get pregnant while breastfeeding. Indeed, the chance of conception is much less, however, the possibility of fertilization of the egg is not completely excluded. Therefore, for all women who have recently given birth, the issue of contraception after childbirth becomes relevant. More details about the features and methods of protection later in the article.

Features of contraception in the postpartum period

If a girl categorically refuses to use contraception after childbirth, she should know under what conditions the possibility of pregnancy is practically zero. There are several such conditions:

1. Breastfeeding begins immediately after birth.
2. The child should be breastfed only without complementary foods or formula.
3. Breastfeeding should be as frequent as possible: at least every 3 hours during the day, and at night at intervals of 6 hours.
4. Lack of menstruation.
5. No more than six months have passed since the birth.

Even compliance with all these conditions does not provide a 100% guarantee. And early pregnancy prevents breastfeeding. In addition, there is a high likelihood of complications developing.

The simplest option for contraception after pregnancy is the use of condoms. It not only prevents unwanted re-pregnancy, but also protects against infectious diseases. But sometimes using a condom is not suitable for partners. There may be many reasons for this: discomfort due to vaginal dryness, dulling of natural sensations. Therefore, more attention should be paid to contraception for women after childbirth.

Modern methods of contraception for women after childbirth

Contraceptives that a girl uses after childbirth must have several properties:

• effectively protect against re-fertilization of the egg;
• have some activity against sexually transmitted infections;
• be absolutely safe for women and children;
• do not have a significant effect on hormonal levels.

The vast majority of modern types of contraception for women after childbirth have these properties.

Birth control pills after childbirth

The action of the tablets is based on changes in the level of hormones in the blood. This prevents the follicle from maturing in the ovary and the release of the egg. Also, under the influence of these drugs, the structure of the layer of the uterus (endometrium), which is located closer to its cavity, changes, due to which the egg cannot attach to the wall of this organ.

A feature of postpartum hormonal contraceptives is that they must contain only the hormone progesterone, without estrogen. Then the drug will not harm breastfeeding.

When can you take birth control pills after giving birth?

Doctors allow starting birth control pills 4 weeks after birth for non-breastfeeding mothers, and at least 6 weeks for breastfeeding mothers.

How to take birth control pills after childbirth

Oral contraceptives must be taken strictly on schedule. The woman drinks them every day, almost at the same time. A difference of one hour is acceptable. The daily dose is one tablet.

Warning! Breaks are not allowed!

It is necessary to adhere to these rules, since to prevent pregnancy a constant increased amount of the hormone in the body must be maintained.

Which birth control pills are best to take after childbirth?

Among all the abundance of contraception, preference should be given to drugs called “mini-pills”. These medicines include:

• "Femulen";
• "Continuin";
• "Exluton";
• "Charozetta."

Their peculiarity is that they contain only a hormone called gestagen, or progesterone. It does not change the composition of breast milk, and is also not transmitted to the baby during breastfeeding. The amount of hormone in the “mini-pill” is less than in standard progestin tablets, which causes their lower effectiveness.

Advice! For the best effect, you should combine “mini-pills” and barrier methods of contraception.

“Mini-pills” are made specifically for mothers who are breastfeeding. They are also suitable for women during menopause (over 45 years of age). Taking the medicine by non-breastfeeding girls of reproductive age leads to severe menstrual irregularities.

Despite their high effectiveness, the use of oral contraceptives after childbirth has a number of disadvantages:

• do not provide protection against infectious diseases;
• the need to take pills strictly on schedule;
• may cause unwanted side reactions: nausea and vomiting;
• can affect the frequency and abundance of menstruation;
• Skipping even one dose of medication significantly reduces the effectiveness of the drug.

Intrauterine device

Another effective method of contraception is the intrauterine device (IUD). It does not affect the amount of progesterone in any way, and therefore does not cause the development of unpleasant side effects or distort the menstrual cycle.

If you had a natural birth without complications, you can insert the IUD after 6 weeks.

The main contraindication to inserting an IUD after childbirth is delivery by cesarean section. After this surgical intervention, a scar remains on the uterus. Constantly impacting it from the inside with a foreign object, such as an intrauterine device, can lead to rupture of this scar. The use of IUDs is also contraindicated in other pathological conditions:

• endometriosis – growth of the endometrium in places where it should not normally be;
• endometritis – inflammation of the inner lining of the uterine wall;
• severe heart and vascular diseases.

If a woman decides to use an IUD as a contraceptive after childbirth, its installation and removal should be entrusted to a gynecologist. You also need to go for a preventive examination twice a year, since wearing an IUD increases the risk of inflammation of the genital organs.

Barrier methods of contraception after childbirth

There are several barrier methods of contraception for women after childbirth:

• diaphragm;
• cap.

Installing a cap or diaphragm does not affect breastfeeding in any way. The peculiarity of contraception after childbirth using these methods is that a larger size should be chosen due to the expansion of the birth canal. For the first time, the installation of the diaphragm and cap should be carried out by a gynecologist. You can start using them 6 weeks after birth.

Chemical contraceptives

Spermicides are drugs that have the ability to destroy sperm. They also have activity against pathogens of infectious diseases. They are considered one of the least effective contraceptives in preventing pregnancy. Therefore, it is better to use them in combination with tablet drugs.

Injectable contraceptives

Injections are another form of contraception with gestagens, which are recommended for use after childbirth. This drug is called Depo-Provera. It is administered intramuscularly every two months. Just like taking pills, injections should be regular. This is the only way to achieve high efficiency of the method.

Injectable or tablet contraceptives, together with barrier methods, are recommended for use as contraception after cesarean section. These drugs do not irritate the uterus from the inside, and therefore cannot lead to its rupture.

Obstetricians and gynecologists recommend that women use protection even during breastfeeding. In this case, it is advisable to use two methods simultaneously. This will increase effectiveness in protecting against recurrent pregnancy and prevent sexual transmission of infections.

Doctors call the latest generation of contraception subcutaneous implants, which are installed on the inner surface of the shoulder. They contain a gestagen, which is constantly released in small doses. A one-time installation of such an implant prevents the development of pregnancy for three years.

Conclusion

Contraception after childbirth should be a matter of utmost importance for a new mother. Early repeated pregnancy is a risk for both the already born baby and the mother and unborn child. Therefore, regarding contraception after childbirth, a woman should consult with her obstetrician-gynecologist already during pregnancy in order to choose the optimal contraception option.

You recently gave birth to a child and are happy. Even if you want to have more children, you most likely are not going to get pregnant right away. And too frequent childbirth is harmful to the female body: it exhausts it.

You should discuss birth control options with your doctor during your postpartum consultation. However, it is useful to know in advance what the doctor can offer you, this will help you choose the appropriate and optimal method for you. You will have time to consider all your options in the weeks after birth and discuss them with your husband or partner. As you will see for yourself, during the postpartum period the choice of such products is not very large. Only after resuming your menstrual cycle and stopping breastfeeding will you really be able to choose from the whole variety of modern means and methods of birth control what suits you best.

Birth control (or contraception) allows a couple to have sexual intercourse without fear of pregnancy. And the use of contraceptives can be stopped at any time at the request of the spouses. These drugs must have a number of qualities:

Harmlessness - should not harm the health of a woman, a man, a breastfed child or a possible future child.

Efficiency - maximum contraceptive effectiveness.

Eligibility - it’s individual: some people don’t want to take hormonal pills, others don’t want to use, for example, condoms, etc.

Reversibility - fertility should not be impaired after stopping or using contraceptives

Breastfeeding provides excellent, complete, energy-rich nutrition for the baby, and at the same time is an effective method of natural contraception ( lactational amenorrhea method). Other contraceptive methods can be used to enhance the contraceptive effect of breastfeeding, and also if a woman stops breastfeeding.

But postpartum contraception has a number of features.

The main indicator of ovulation restoration is the first postpartum menstruation. Women usually wait for the first postpartum menstruation, the start of complementary feeding and a reduction in the frequency of breastfeeding, and only then use contraception. But the postpartum period (contrary to what many people believe) is not always infertile. True, resumption of ovulation is rare, especially in breastfeeding women, but it is still possible. It is known that the earliest ovulation was recorded in the fourth week after birth in non-breastfeeding women and in the seventh week in lactating women (not all women). The risk of pregnancy in breastfeeding women increases during the first 6 months after childbirth. Therefore, it is necessary to take precautions to avoid another pregnancy.

Let me remind you that you should not resume sexual intercourse earlier than 3-4 weeks after birth (risk of ascending infection).

Barrier methods of contraception (mechanical means, spermicides and vaginal sponges)

The use of a vaginal diaphragm, cervical cap or condom does not affect lactation and the health of the child and prevents sperm from entering the uterine cavity.

The diaphragm and caps are made of soft rubber. After delivery, you should check the size of your diaphragm and cap as you may need a larger size than before delivery. They have different sizes, corresponding to the vagina or cervix. It is advisable to wait until after the immediate postpartum period (6 weeks after birth) before trying on a diaphragm. The selection and insertion of the diaphragm for the first time should be carried out by a doctor. Caps and a diaphragm are used in combination with spermicides, which enhance the contraceptive effect, prevent certain sexually transmitted diseases (STDs) and solve the problem of vaginal dryness, which is often found in breastfeeding women.

At the moment, perhaps, few people use any other methods of mechanical contraception other than male condoms.

And this is understandable, since the condom has virtually no contraindications, protects against infection, and is easy to use. The use of condoms is the method of choice during breaks in taking hormonal contraceptives. Currently, a new type of condom is being produced, made from latex, to which a special agent has been added that kills sperm. "Ramses-Extra", "Contracept-Plus", "Jontex", Innotex, Durex, LifeStyles are also reliable. Spermicides can be used simultaneously with condoms, but water-based, since fat (cosmetic creams, petroleum jelly, etc.) loosens latex.

Female condoms made of soft polyurethane, resembling plastic, appeared. The condom is inserted into the vagina by the woman herself.
But it is an inconvenient, expensive and ineffective method of contraception.

The disadvantages of condoms include a decrease in the intensity of sexual sensations, there may be an allergy to rubber, they have a certain shelf life and require attention when removing from the vagina to avoid the release of sperm. When used correctly, taking into account the expiration date and storage conditions, condoms do not break.

If after sexual intercourse a defect is discovered in the condom, the woman needs to douche with warm water with the addition of table vinegar (1 teaspoon per 0.5 liter of water, lemon juice) or apply.

Spermicides: they are capable of killing sperm and are available in the form of foam, jelly creams, tablets or suppositories. Most of them consist of 2 components: an inert (cream, gel, paste) and a directly spermicidal substance (nonoxynol-9 or octoxynol-9). Spermicides are inserted into the vagina immediately before sexual intercourse. The mechanism of action is to inactivate sperm and prevent its penetration into the uterine cavity.

Known contraceptin T, lutenurin, traceptin, gramicidin paste, Pharmatex (France), Neo-Sampon (Japan), Nonoxynol (Conceptronol (Cilag)), Patantex-oval (Merz), Sterilin (?). The main advantage of these drugs is their simplicity, ease of use and the fact that they have high bacteriostatic activity against many microorganisms that cause STDs, reducing the risk of infection.

Our most popular ones are Pharmatex, Patentex-oval . But how antiseptics, when used regularly, can adversely affect the natural microflora of the vagina. Negative points: do not wash while using Farmatex. That is, you can only perform external irrigation 2 hours after sexual intercourse without using detergents, because they destroy the active component of the drug. It is possible to use Fatmatex detergent, specially created for such cases. This applies to all forms of the drug except tampons (sponges): you cannot wash all the time while it is in the vagina. Mechanism of action: surface activity (like synthetic detergents), due to which sperm membranes are destroyed. There are 4 forms of the drug: cream, tablets, balls (ovules, suppositories) and tampons (sponges). The duration of action of tablets is 3 hours, balls - 4 hours, cream - 10 hours, tampons - 24 hours. Before EACH sexual intercourse, a new dose of the drug should be administered. This does not apply to tampons. Read about the features of using each specific form of the drug in the instructions. Contraindications: individual intolerance. Nonoxynol (Conceptrol (Cilag)), Panentex-oval (Merz), Sterilin (?)) is produced only in the form of pellets (suppositories), its effectiveness is comparable to that of Pharmatex. Sterilin can be used without consulting a doctor. It begins to act from the moment of administration, is odorless and tasteless, and has the effect of artificial lubricant. Before each sexual intercourse, it is necessary to introduce a new suppository.

Recently, a contraceptive film from the Yugoslav pharmaceutical company Galenika appeared. The package contains several polyethylene films measuring 1.5 x 6 cm, treated with nonoxynol-9. The film is inserted into the vagina no more than 6 minutes before sexual intercourse; the effectiveness of the film remains for 2 hours. The disadvantage of this method is that slight irritation of the vagina or penis may occur, and sometimes there may be difficulties when inserting the film into the genital tract. Advantages: small size and ease of use.

The effectiveness of spermicides is low - 85%, so it is recommended to use them together with other methods (mechanical). In women whose fertility is reduced (and in old age), the use of spermicides alone can be quite effective. And another great advantage of spermicides is that they have high bacteriostatic activity against many microorganisms that cause STDs.

Vaginal sponges- soft polyurethane round sponges about 5 cm in size containing spermicides. They can be administered immediately before sexual intercourse or in advance (up to 24 hours). The sponge is inserted in such a way as to cover the cervix. Before insertion, it is moistened with water to activate the spermicide. After sexual intercourse, it should be removed no later than 6 hours later. Not reusable. Due to its low efficiency, the method should be used in combination with barrier or other methods.

Mechanical contraceptives that release hormones. These drugs secrete either progestogens or estrogens and progestogens. The indication for the use of these drugs is the inability to use OGK for any reason. Vaginal rings are inserted deep into the vagina for 3 consecutive cycles. The main effect of the ring is on the cervical mucus and endometrium. However, the absence of ovulation is observed more often than in 1/4 of the menstrual cycles. The levonorgestrel ring is a silastic ring 5.5 cm in diameter and 8.5 mm thick, releasing approximately 20 mcg of levonorgestrel per day. The core of the ring contains a hormonal drug coated with silastic. Unlike barrier methods (caps and diaphragms), there is no need for precise positioning of the ring. The effectiveness of these drugs is comparable to progesterone oral contraceptives. In the postpartum period, the use of vaginal rings with gestagens is recommended. Specific contraindications are liver failure and inflammatory diseases of the genital organs.

Intrauterine contraceptives (IUC)

Intrauterine devices do not affect lactation or the growth of the child and are especially acceptable during lactation due to their high effectiveness. When inserting an IUD immediately after childbirth, there is a high risk of expulsion (loss), so it is better to perform this procedure 6-8 weeks after birth. New intrauterine devices with a fixation mechanism may reduce their frequency. However, it is best to postpone this procedure for 6-8 weeks.

(IUDs) are made of plastic or metal, or a combination of both. They are differentiated into inert and bioactive.

Inert ones include a regular plastic loop (Lippes) with the addition of barium sulfate for the purpose of radiological detection in the uterus if necessary.

In bioactive products, various additives are included in the plastic component - copper, gold or gestagens. IUDs come in different shapes and sizes. The contraceptive effect is due to a local effect on the endometrium and uterus, since after the insertion of the IUD, contractions of the uterus and fallopian tubes intensify, and changes occur in the endometrium that prevent the implantation of a fertilized egg, due to which it is expelled from the uterus. In addition, copper, for example, is toxic to sperm and eggs.

There are such VMCs: Multiload (Organon), Gravigard, Copper-T 200, Nova-T Cu-200 Ag (Leiras) contain copper and are installed for up to 5 years.

Copper-T 380A (GynoPharma), Gaine-T 380S (Cilag - contains more copper and can be installed for up to 10 years.

Mirena (Levonova, Leiras), Progestasert is an intrauterine releasing system, that is, it contains a progestogen hormone. The system has only a local effect; the hormone is not absorbed into the systemic bloodstream. Therefore, it is free from the side effects of systemic hormonal drugs. The mechanism of action of MIRENA is to increase the viscosity of cervical mucus, suppress the growth of the endometrium, and also suppress sperm activity. Effective for 5 years from the date of installation.

The huge advantage of intrauterine contraceptives is that they do not require special care or any precautions, allowing a woman to forget that she is using a contraceptive. Due to the decrease in fear of unwanted pregnancy, the woman’s emotional state improves.

But there are some inconveniences with using an IUD:

• in 10-15% of cases, IUD is not tolerated by women. The uterus pushes out or constant uterine bleeding begins, forcing removal of the IUD. But minor bleeding may occur for 2 cycles after installation of the IUD.
• possible complications when inserting a spiral into the uterine cavity;
• heavier and more painful menstruation, especially in the first months,
• risk of inflammatory processes in the pelvic area,
• full or partial expulsion of the IUD,
• possible pregnancy, which increases the risk of infection.

This procedure is performed by a doctor if there are no contraindications.

Oral hormonal contraceptives (OCs)

In the postpartum period, if a woman continues to breastfeed, contraceptives containing only progestogens are used. These contraceptives do not affect the quantity and quality of milk or the duration of lactation. But it is recommended to use the progestogen method no earlier than six weeks after birth, and not for breastfeeding women - from the fourth week after birth.

This form of contraception includes: progestogen-only pills, injectables and subdermal implants.

Injectable medications provide long-term protection against unwanted pregnancy. The drugs used for injections are DEPO-PROVERA (duration of action 3 months) and NET-EN (2 months). The advantage of these drugs is one thing - you don’t have to worry about taking pills every day. The disadvantage of the injection method is that there is no return. And if there are side effects of these drugs, you will have to put up with them for a long time.

Depo-Provera(Upjohn) is a depot suspension of 0.25 g of medoxyprogesterone acetate (DMPA). Injected into the muscle once every 3 months. The first administration can be carried out 2 months after birth.

Nat-en(?) is an oil solution of 0.2 g of norethisterone enanthate. Injected into the muscle once every 2 months. The rules of administration and specific side effects are the same as for DEPO-CHECKS.

Deladroxate(Dehydroxyprogesterone acetophenide) (?) - a monthly administered drug. The rules of administration and specific side effects are the same as for Depo-Provera (specific side effects are menorrhagia - heavy periods, or amenorrhea - absence of periods).

Biodegradable subcutaneous contraceptive systems, that is, granules with norethisterone (Norplant, Kapronor) are implanted under the skin of nursing women 6 weeks after childbirth or earlier, if necessary. Microcapsules can be administered by injection, and long capsules are implanted through a small incision. They are intended to provide contraception for 6 months to 5 years (depending on the amount of progestogen in the granules). Subcutaneous implants, unlike injections, can be removed at any time. The only problem that arises with them is the possibility of developing a local inflammatory reaction of an allergic or nonspecific type at the injection site, which threatens the presence of a scar on the skin at the injection site. This is especially true for women predisposed to keloidosis (adhesive disease, existing hypertrophic or keloid scars). For painless introduction of capsules under the skin, local infiltration anesthesia, usually novocaine, is used. Therefore, if you are allergic to novocaine or other local anesthetics, be sure to inform your doctor about this.

The use of bioerodible subcutaneous contraceptive systems eliminates the need for surgical removal of the capsule after its expiration date.

Mini-pills (oral contraceptives - tablets) contain a small amount of the artificial hormone gestagen, similar to the hormone of the corpus luteum. Unlike combined tablets, the primary effect is not based on inhibition of egg release. As a main action, the drug changes the quality of cervical mucus so that the latter becomes thicker and forms an impenetrable barrier for sperm that cannot meet the egg. If, nevertheless, the sperm passes through the mucus of the cervix and fertilizes the egg, then another important effect occurs. Under the influence of the mini-pill, the uterine mucosa changes and cannot accept a fertilized egg, i.e. the egg is unable to implant. It is also likely that the mini-pill has a harmful effect on the entry of the egg into the fallopian tube. These drugs are: Continuin, Exluton, Micronor, Ovrett, Microlut .

They should be taken daily, 1 tablet per day, without a break, always at the same time of day, regardless of whether bleeding of any nature appears or not. It is best to take the pill at 6-8 pm. This is necessary, since the maximum effect occurs 4-5 hours after taking the tablet. Since sexual intercourse often takes place at 22-24 hours, it is understandable to emphasize regular intake in the evenings at 6-8 hours. Naturally, this does not mean that this type of contraception is ineffective during sexual intercourse that occurs at other times.

Combined oral contraceptives (COCs) contain estrogens, which negatively affect the quantity and quality of breast milk and can reduce the lactation period. A non-breastfeeding woman can use COCs, but she must remember that in the first weeks after childbirth there is a high risk of thrombosis. If combined or progestogen oral contraceptives are the only form of contraception available, they should be started as early as possible, since pregnancy during lactation will be significantly worse for the health of the mother and her baby than a decrease in milk supply. As in other cases, you should take combined oral contraceptives with minimal doses of steroids.

If you used mili-pills during the breastfeeding period, then at the end of this period you need to switch to combined oral contraceptives (if, of course, you intend to continue taking oral contraceptives). The transition is carried out immediately after the end of taking the mili-pill, without interruption they begin to use the COC prescribed by the doctor.

Natural Methods

Natural methods (measuring rectal temperature, calendar method, examination of cervical mucus) are not recommended to be used until regular menstruation is restored, since it is difficult to determine the date of ovulation and the first menstruation after childbirth. Cervical mucus is difficult to interpret until regular menses resume. Basal body temperature changes when the mother wakes at night to breastfeed. Therefore, "early morning" rises in basal temperature after ovulation are not reliable. But there are no side effects and the spouses bear joint responsibility. The effectiveness of this method is low (if all rules are followed, no more than 50%).

Coitus interruptus

The method consists of interrupting sexual intercourse before ejaculation, that is, removing the penis from the vagina before ejaculation so that sperm does not enter the vagina and cervix. Its advantage is that it does not require any preparation or special equipment. This method is very common, but its effectiveness is very low, only 30%.

The method requires considerable attention on the part of the man, since some men have sperm in the secretion released even before orgasm. In addition, sperm, entering the skin of the genital organs, retains fertilizing properties for some time.

There is a widespread belief regarding the violation of sexual function of partners who use. The harmless use of this method is possible with a high sexual culture of partners, with sufficient motivation for choice. It is not recommended for young, inexperienced men and those who have difficulties with erection and potency.

Abstinence - abstinence from sexual intercourse

Withdrawal does not affect breastfeeding. With abstinence, 100% effective protection against pregnancy. But for some couples, long periods of postpartum abstinence are difficult to bear. Therefore, abstinence is convenient to use as an intermediate method.

Sterilization (male, female)

With the introduction of the laparoscopy method in gynecology, it became possible to sterilize a woman by applying special rings or clamps to the fallopian tubes, which prevents contact of sperm with the egg. This sterilization is reversible, since when the rings are removed, the patency of the tubes is restored. Irreversible sterilization is possible by ligation or occlusion of tubes using electrocoagulation. Indication: contraception for women of late reproductive age, for women of early reproductive age who have contraindications to pregnancy, as well as for men and women who have 2 or more children and do not want to have children in the future. The method is not associated with sexual intercourse, does not suppress sexual desire and does not disrupt the menstrual cycle.

The decision to undergo postpartum sterilization should be made only after serious consultation.

For medical reasons, this method can be used regardless of the age and number of children.

Vasectomy or male sterilization is a permanent surgical method of contraception in which the vas deferens is excised on both sides. As a result, sperm do not enter the ejaculate, and fertilization of the egg becomes impossible. The operation is simple and is performed on an outpatient basis under local anesthesia. This does not affect male hormones; they continue to enter the blood. The ejaculate continues to be released, since sperm makes up only part of it. The operation does not affect sexual activity. The sterility of male ejaculate does not appear immediately; it will take at least 12-20 ejaculations for sperm to be completely absent from the ejaculate and for conception to be 100% effective.

• The method of voluntary surgical contraception is irreversible and is acceptable only for those who are absolutely sure that they will no longer want to have children.
• The decision to use the method should not be made under the influence of circumstances or emotional stress.
• If you have the slightest doubt, delay making a decision and use other effective methods of contraception at this time.
• The method does not protect against sexually transmitted infections and HIV/AIDS. If there is a risk of contracting these infections, it is necessary to use a condom to prevent them.

The method of male sterilization, which involves obstructing the vas deferens, is also carried out non-surgically. In this case, a substance is injected into the duct, which soon hardens and provides a reliable and permanent contraceptive effect. There is also a method of temporary sterilization. A soft rubber “plug” is inserted into the vas deferens, closing its lumen. The introduction and removal of such a contraceptive can be done on an outpatient basis under local anesthesia.

Also applies male hormonal contraception. Drugs from the group of gonadotropin-releasing hormone agonists have the ability to temporarily suppress sperm formation. By the way, they also exhibit contraceptive activity in women. There are forms for daily administration and long-acting ones. These drugs are highly effective, but have disadvantages associated with a sharp decrease in the level of sex hormones in the body, which makes it necessary to use small amounts of natural hormones together with them. Another group of hormonal drugs are derivatives of the male sex hormone - testosterone. For contraceptive purposes, they are usually administered as weekly injections or in tablets for daily use.

Gossypol, a substance obtained from the processing of cottonseed oil, is well known for its antiviral activity. But it turns out that it also has the ability to suppress sperm production. Now, based on gossypol, a number of drugs with higher activity and less toxicity have been created and are being studied.

Male “spiral”- another of the new methods. It looks like a small folded umbrella, which is inserted through the head of the penis into the scrotum using a special instrument. At the end of the “umbrella”, for greater reliability, there is a gel that kills sperm. This contraceptive is devoid of a number of side effects, to one degree or another, characteristic of hormonal and chemical drugs.

You have a wide choice of contraceptives. None of the modern methods of preventing pregnancy are perfect. Each of the means has its own advantages and disadvantages, and the couple chooses the optimal means, but only after consulting a doctor who will provide information about all contraceptives acceptable to you. In cases where there are no contraindications, you can choose freely. The selection criteria depend on many circumstances: the number of children in the family, the intensity of sexual activity, your character, physiology, constitution, life period, concomitant diseases, etc. Choose!

Yaroslavtseva Irena Vladimirovna

About 4 weeks after giving birth, the woman begins to be sexually active again. Of course, you need to take care in advance about choosing a contraceptive. Your doctor should choose the right remedy and tell you all the details. Nowadays, there are a lot of different modern methods of contraception for women who have given birth. The main thing is to choose the right one for you.

Why use protection after childbirth?

Contrary to popular belief that you cannot get pregnant while breastfeeding, this is not true. While a woman is breastfeeding, the likelihood of getting pregnant, although reduced, is quite small. The production of hormones that cause ovulation is suppressed during regular breastfeeding (every 4 hours and at night). This leads to a temporary absence of menstruation. This period is called lactational amenorrhea. However, this does not protect against unwanted pregnancy. Therefore, postpartum contraception is mandatory, even if the menstrual cycle has not yet returned.

Types of contraceptives for women after childbirth

Contraception in the postpartum period is not limited to the use of condoms and natural methods of birth control. Now we will look at all the means in more detail.

Barrier contraceptives

These include condoms, femidoms, diaphragms and spermicides.

- a universal remedy. They are sold in every pharmacy, are relatively inexpensive, and when used correctly, are up to 95% effective. The main thing is to choose the right brand, because... After giving birth, sensations may change.

Extremely poorly distributed in the Russian Federation.

Diaphragms quite popular among married couples abroad. But in Russia they did not receive such recognition. When using this method, it is worth considering that the size of your aperture may change. Therefore, you should definitely consult a gynecologist.

Spermicides Available in the form of tablets, suppositories, foam aerosols, tablets, and solutions. They destroy sperm before they enter the uterus and protect against many sexually transmitted diseases (STIs), but their frequent use can negatively affect the vaginal environment.

Hormonal contraceptives

Hormonal contraceptives, in turn, are divided into oral (pills), injectable and subcutaneous (implants).

Mini-pill(pills containing only one progestogen hormone) must be taken daily without breaks at the same time. Efficiency up to 98%. You can start using it as early as 6 weeks after birth.

COOK(combined oral contraceptives) consist of two synthetic hormones: estrogen and progestogen (progestogen), in different combinations. Suppress ovulation, thicken cervical mucus, prevent the passage of sperm, changes the endometrium (suppresses proliferation), which prevents implantation. Almost the same changes in a woman’s body occur in the early stages of pregnancy; this is completely natural for the body.

The tablets are taken in regular cycles: 21 days the tablet is crushed at the same time, 7 days off when taking monophasic drugs, without breaks, or according to a schedule when using triphasic COCs. Can be used no earlier than 21 days after birth.

Injections(contraceptive injections) contain either one hormone (gestagen) or a combination of hormones (akin to COCs). They are done intramuscularly into the arm or buttock. The principle of action is the same as that of tablets. Efficiency is almost 100%. You can start using this method no earlier than 6 weeks after birth.

Implants are injected subcutaneously into the inner surface of the shoulder. Silicone semi-permeable capsules contain the hormone gestagen, which is slowly released into the blood over five years. The capsule can be administered 6 weeks after birth. Efficiency is almost 100%.

Intrauterine devices (IUD)

IUDs can be either hormonal or mechanical. Efficiency up to 90%. The IUD does not affect milk production in any way. In the absence of contraindications, it can be installed as early as 6 weeks after birth.

Sterilization (surgical contraception)

This method is irreversible, therefore it is used only for women who have given birth (having at least two children) at least 35 years old with their written consent. Please note that this method will not protect you from STDs.

Emergency contraception

EC can be used no more than once a month! You should not practice this method on an ongoing basis. It's better to choose something safer.

Natural Methods

This includes:

• Temperature method
• Cervical method
• Coitus interruptus

The disadvantage of the first three is that after childbirth the cycle is unstable. The effectiveness of the methods will be very low. Interrupted sexual intercourse is also a rather unreliable way to protect against conception. In addition, none of the listed methods will protect you from sexually transmitted diseases (infections).

conclusions

The best method of contraception after childbirth is a purely individual choice. You must choose it based on your feelings, advice and doctor’s prescriptions, and also take into account the wishes of your partner. Contraception in the postpartum period is a responsibility, so you should not approach this issue carelessly.

Every young mother, after the birth of her little angel, thought about contraception after childbirth. This question becomes key when choosing a means to prevent unwanted pregnancy, and it should be approached with special care. In order not to harm yourself and your child, you need to explore different options and choose the right one for yourself. It is necessary to take precautions after childbirth with extreme caution.

Is it possible to get pregnant after childbirth? Yes, yes and yes again. Protection after childbirth, with or without breastfeeding, is required every time, since obstetricians and gynecologists unanimously insist that there is still a small chance of getting pregnant.

After such stress, a woman is forced to take care of her body with even more attention than ever before in her life, because now she is responsible not only for herself, but also for another person who is completely dependent on her.

Before resuming sexual activity, you need to consult a doctor and find out when you can indulge in impulses of passion again. This question is among the key ones, and most often, it is asked during an interesting situation. Thus, future parents will be able to roughly plan their future intimate relationship.

To a greater extent, it depends on how exactly the process of bringing a baby into the world will take place. And, if the birth of the baby passed without complications, the mother feels great, and the father is already crossing out the days on the calendar, experts recommend restoring intimate relationships 6 weeks from the moment of delivery. But remember, each person is different, and the period of abstinence may vary.

When is a mommy able to get pregnant?

Restoring the functions of the ovaries and uterus is strictly individual. You can only roughly calculate when the egg will be ready for fertilization. On average, the egg is released between 40 and 90 days after delivery, but it happens that this process occurs much earlier.

Two lines on the test while you are still breastfeeding your first toddler is a surprise. Often a woman during this period does not even suspect fertilization.

The logic is this: if there is no menstruation, then this is good and it means that my body is not ready yet. This is how children of the same age are born.

Such cases are not uncommon and, unfortunately, often end in termination at the request of the mother or for medical reasons. Doctors say that most happen due to the ignorance and negligence of the girls themselves. If they knew how and with what to protect themselves after giving birth to a nursing mother, excessive stress and medical intervention could be avoided.

The World Health Organization recommends using contraceptives 21 days after leaving hospital. Of course, the likelihood of conceiving again within 40 days after resolution is extremely low. But it exists and it is better to “play it safe” than to allow an undesirable development of events.

Conception during lactation

Many are sure that fertilization during lactation is impossible. And there is part of the truth in this, but there are also a lot of pitfalls and conventions for those who decide to use feeding as the only method of protection.

Lactation can be used to protect yourself with the following caveats:

• It is effective only for six months, then ovulation is restored regardless of whether you breastfeed or not.
• If you give your baby breasts according to each request every 2 or three hours.
• If you wake up at least three times a night and let him eat.
• If the little one feeds only on your milk and you do not give additional water or nutritional formula.

However, even if you follow all the rules, this will not protect you 100 percent from re-fertilization. It is important to at least combine this method with the method of coitus interruptus.

How to distinguish menstruation from lochia

The body is able to reaccept the egg before menstruation during the first cycle after resolution. The danger is that no one can accurately calculate when a new menstruation will occur and when ovulation will occur. It is difficult not only to determine when the egg left the ovaries, but also to understand when menstruation began, because lochia comes out of the vagina within 6-8 weeks.

Lochia is part of the baby's place, lubricant and blood that leaves the mother's body over a long time.

This is similar to how the cycle manifests itself on the last day: light spotting that may not occur continuously and stop for almost a day. Over time, they become lighter, since there is practically no blood left in the uterus. During the entire period, you also notice dense lumps - the remains of a child's place.

Sometimes there is no gap between lochia and menstruation. This depends on the individual characteristics of the reproductive system. You can understand that you have menstruation and not lochia simply by the following signs:

1. They became abundant and red.
2. More than 2 months have passed since the baby was born.
3. If you don't see any blood clots or placental remains.

Sometimes menstruation starts earlier. This happens to mothers who, for some reason, do not breastfeed.

If you are breastfeeding and your cycle started very early, contact your gynecologist. This is especially important if the discharge has an unpleasant odor and a greenish tint.

Modern methods of protection

For the fair sex, many options open up to protect against unwanted pregnancy after childbirth. But are all options suitable for new mothers? Modern medicine offers a number of effective ways to prevent fertilization. There are 5 groups:

• barrier;
• intrauterine;
• hormonal;
• surgical;
• natural.

Do not forget that some elements can be combined and complement each other in different situations.

Barrier method

Condoms

Perhaps the most accessible and simplest method to prevent conception is the use of condoms. Even children know about this miracle weapon, and absolutely every person who is sexually active has encountered them. Another advantage is that their selection does not require consultation or prescription from a doctor.

Manufacturers offer their consumers a whole range of different condoms so that everyone can find the best option for themselves and be protected from unwanted consequences.

If you study the instructions for this barrier product in detail and adhere to the rules stated in it, its effectiveness will be as much as 98%. A condom will not only help in family planning, but also, if necessary, ensure safe sexual intercourse with a partner who has sexually transmitted infections. Also, latex is compatible with the processes occurring in the body of a nursing mother and does not have a negative effect on lactation.

A very important factor in the use of condoms is that they can be used from the first days of renewed intimacy.

And now about the shortcomings. In rare cases, when the condom was chosen incorrectly and the rules of use were violated, it is likely to let its owner down - it will break or slip right during contact. If lovers do not notice what has happened in time, the process of unwanted fertilization may occur.

It is very important to give preference to condoms from a proven and reliable manufacturer. There is a list of companies, tested over the years, that manufacture them and are considered titans in the contraceptive market.

In some cases, it is possible that one of the partners is intolerant to latex or lubricant; other measures will have to be taken.

Diaphragm

The diaphragm has a flexible latex base and is manufactured in a dome shape. Its function is to block the path of sperm and prevent them from reaching the finishing point in the uterine cavity due to its flexible springy rim. To use, three months must pass after the birth of the baby. The diaphragm may be considered and recommended by doctors as a form of protection.

It is worth noting that

diaphragms vary in size and are individually selected by the doctor for each woman. Size, before and after birth, often differs.

How to use this barrier? To do this, you do not need to perform any complex manipulations, just follow the recommendations given by gynecologists:

1. You need to lubricate the latex barrier with spermicide.
2. Insert into the vagina to close the cervix.
3. The diaphragm must not be removed within 6 hours after copulation.
4. The maximum time for wearing it, as required by the instructions, is 24 hours.
5. Remove and wash with warm water and soap.

You can contact a doctor who will help with this task and provide advice. According to the rules, the product is administered 20-30 minutes before intercourse. The diaphragm is used repeatedly and its efficiency level is 92-96%.

Cap

The cap differs from the previous product in that it has a more curved “cup” shape. Made from latex and soft silicone. Validity period: no more than two years. Its job is to prevent the seed from entering the uterus by suction to its surface. If about 4-5 weeks have passed since the birth of the baby, you can take a closer look at the cap.

How to use:

1. Make sure the product is not damaged.
2. Fill one third with spermicidal gel.
3. Insert it inside and press firmly against the cervix.

The cap should remain in the vagina for at least six hours. Maximum time is 36-48 hours. After use, the cap must be disinfected.

With proper use and during the feeding period, efficiency is achieved at a rate of 97%.

The above-mentioned methods of barrier protection have a list of contraindications that you need to know before using them. They cannot be used if:

• Cystitis was discovered.
• Treatment for vaginal infections is provided.
• There is an allergy to the components of this product.
• The vaginal muscles are weakened.
• There are several sexual partners.

Spermicides

This type of protection is a concentration of the chemical (benzalkonium or boric acid) and the base (needed to distribute the chemical). The purpose of spermicides is to kill the heads of the sperm. Most often, it is used in conjunction with other methods and, in this case, the risk of fertilization is reduced, since the components complement each other. For example, condoms work well with spermicides. This is called the double Dutch method.

May have different shapes:

• Jelly, creams and gels.
• Candles.
• Foam.
• Sponges.

The chemicals are suitable for nursing mothers, as they do not affect breastfeeding in any way, and their effectiveness varies from 74 to 94%. There is a caveat that you definitely need to know when using this product - there is no point in using spermicides during ovulation.

It is better not to get carried away with spermicides, as they can destroy the vaginal microflora and cause irritation!

Intrauterine method

Intrauterine device

The IUD wins more and more women’s hearts every year. The efficiency level reaches 98%, the effect is immediate, and the shelf life is from five to seven years. Also, it can be easily removed by a doctor when planning a new pregnancy.

The intrauterine device does not have a negative effect on feeding, but you will need to visit an antenatal clinic at least twice a year

The function is that the spiral is immersed in the uterine cavity and does not allow the fertilized egg to attach. There are IUDs that contain a hormone (progesterone).

The IUD should be installed by an experienced specialist 6 weeks after the baby is born.

Before deciding to install an IUD, a young mother should be prepared for the consequences:

• In the first months of using the product, you may experience discomfort in the lower abdomen due to contraction of the uterus during lactation.
• Perhaps menstruation will be much heavier and more painful.
• Does not protect against sexually transmitted infections.
• Pain may occur during sexual intercourse.

If you experience severe pain, unusual or bloody discharge, you should immediately contact a gynecologist!

Hormonal medications

Hormonal medications are one of the most popular ways to prevent unwanted pregnancy. The principle of these drugs is to suppress ovulation and thicken cervical mucus. Birth control pills contain hormones similar to those in the female body, but not all of them can be taken after childbirth.

As contraception after the first meeting with the child, only medications containing gestagens are suitable (they do not affect milk production and its quality). Doctors prescribe them after 6 weeks. When used correctly and following all the rules, they are effective up to 99%.

For nursing mothers, only the following remedies are correct:

• Mini-drinks.
• Long-acting progestogens.

There are also combined OKs. Made for women who are not breastfeeding.

Mini-pill

These are the most suitable oral contraceptives for mothers after the birth of a child. For women after childbirth, only they are prescribed. Mini-pills are aimed at the period of breastfeeding, since the full menstrual cycle has not yet resumed, then it is recommended to switch to combined OCs.

Modern mini-pills make it possible to conceive a second child immediately after stopping their use. The most important condition for their use is regularity. You must take the tablets at the same time every day. Visiting the doctor should occur at least twice a year.

What you should pay attention to:

1. The formation of spotting between menstruation is normal because the body gets used to the composition of the mini-pill.
2. To avoid nausea and discomfort, it is recommended to take these medications with meals or before bed.
3. The first package of the mini-pill must be accompanied by other means.

There are contraindications:

• Ovarian cyst.
• Carrying a child.
• Kidney diseases.

Long-acting progestogens

They are injectable contraceptives that are injected deep into the muscle and then enter the bloodstream over a long period of time. The duration of the drug lasts from 12 weeks. Some long-acting progestogens protect against conception for up to 5 years. Does not affect the quality of milk.

The injection is administered only by a specialist, and is removed at any time by him. A certain amount of time, prescribed by a specialist, should pass between doses of this product. The ability to conceive returns within six months.

Both options for the hormonal method have similar negative aspects that are worth paying attention to:

• Decreased libido.
• Headaches, migraines.
• Cycle disorders.
• Nausea, sweating, mood swings.
• Increase in body weight.

Combined OCs (oral contraceptives)

Hormonal contraceptives are trusted and considered a reliable way to prevent conception. Efficiency reaches 99%. But there are two main conditions when taking this remedy:

1. Breastfeeding is completed.
2. Breastfeeding was not carried out at all.

Unlike mini-pills, these medications contain not only gestagens, but also estrogens, which, in turn, can affect the duration and quality of lactation.

Not many people know that the contraceptive properties of combined OCs are a side effect, since their main purpose is:

• Normalize the cycle.
• Reduce pain during menstruation.
• Increase the properties of cervical canal mucus.
• Help cure acne and other endocrine diseases.
• Improve calcium absorption.

You should not choose OK for yourself; this should be done by a doctor, after passing certain tests and based on the characteristics of the body. Regular visits to a specialist are also recommended. During the first time of use, it is necessary to protect yourself with other contraceptives.

Surgical intervention

There are people who solve this problem radically - they use the method of surgical sterilization and act as contraception after childbirth.

Before deciding to take such a step, you need to weigh the pros and cons, since this process is irreversible.

There are female and male (vasectomy) sterilization. They have a similar principle and work 100%. Both operations are performed under anesthesia.

In men : produced at any time. The vas deferens is ligated using an incision in the scrotum. It does not affect erection and ejaculation (after vasectomy it does not contain sperm).

Among women : carried out immediately after the birth of the child, during a cesarean section or at any other time. During the operation, the fallopian tubes are ligated.

Minor postoperative complications may occur after surgery.

Natural method

Lactational amenorrhea method

Breastfeeding allows the mother to take advantage of her position. During full breastfeeding, the menstrual cycle is not fully restored. Due to the production of milk in the female body, there is no strength left to bear another child. Efficiency - 50%.

Abstinence

The best defense is abstinence. But not many are ready to give up intimacy. Has 100% effectiveness. Often used in between.

PPA

Coitus interruptus can be combined with other medications during regular lactation. It is based on the removal of the penis until ejaculation. Has two disadvantages:

• There is a high probability of not being on time.
• During sexual intimacy, a secretion is released that contains sperm.

At the end of lactation, it is not perceived as a reliable method and cannot act independently. If intercourse is interrupted, 6 to 8 couples out of 100 are at risk.

Results

Every mother should consult a gynecologist to correctly select contraception. Then you need to think about and compare possible options yourself. The main thing to remember is that there is always a chance of getting pregnant! Protection must be chosen very carefully to ensure the healthy development of the baby.

There are many ways to distance yourself from pregnancy. Some methods of contraception are more effective, others less so; Some can be drunk, while others should be delayed. It all depends on the individual characteristics and preferences of the woman and her partner.