How to choose contraceptives for nursing mothers. Birth control pills while breastfeeding

Look for approved birth control pills when breastfeeding? Not all types of contraception are allowed for nursing mothers. Like any type of drug, there is a list of drugs that are permitted and prohibited for use by women during breastfeeding.

Which ones are better not to consume while breastfeeding, and which ones are okay? How do birth control pills affect breastfeeding and babies? What are the rules for taking contraceptives? Which ones exist? alternative methods contraception? Let's figure it out further.

Types of birth control pills

Among the contraceptive pills, taking into account the constituent component, there are:

• gestagenic, so-called. mini-pill;
• combination drugs or COC.

Mini-pills are single-component products containing gestagen or progestogen. Efficiency is based on the ability of progestogens to act on the mucus that covers the uterus, making it thicker, creating a barrier for sperm to the fertilization process.

It is transmitted to the infant from breast milk the proportion of hormones is insignificant and does not harm the baby. Such contraceptive pills are safe during breastfeeding because they do not have any effect on the functioning of the mammary gland. The body tolerates them normally; they do not contain a wide range of side effects, rarely have a negative impact.

Combined contraceptives are prohibited during lactation.

Approved tablets

A nursing mother believes that... But this is only half true. Only in the first six months is the risk of pregnancy reduced to a minimum.

Lactational amenorrhea is a natural contraception; it inhibits ovulation and gives 98% of results.

Even if you strictly adhere to lactational amenorrhea, a few percent risk still exists. Each woman is an individual - the menstrual cycle can begin in the second month of breastfeeding. But ovulation occurs before the establishment menstrual cycle. There is a possibility of conception while breastfeeding, even if the cycle has not yet begun.

Oral medications are 99% effective. Previously, breastfeeding mothers were not allowed to use this method of contraception. But with the development of medicine, drugs appeared that were approved for use by women with breastfeeding.

Birth control pills during lactation, it is prescribed by a specialist, taking into account physiological characteristics body, because most people have no idea what kind of birth control pills are possible while breastfeeding.

Mini-pill

Mini-pills are approved for use during breastfeeding.

The mini-pill is a suitable birth control pill after childbirth while breastfeeding.

They are gestagen-containing contraceptives. They do not affect lactation activity or the duration of feeding. There are no or minimal side effects. When used, the risk of thrombosis is reduced and does not reduce libido. They are an excellent option for menstrual periods with painful sensations, fibrocystic mastopathy, excessive growth of the endometrium.

The main side effect is a change in menstrual discharge. The drug acts in such a way that 40% of endometrial cells are inactive, and their thickness also changes. The amount of discharge decreases and may disappear altogether. If you stop taking it, the cycle is restored. The ability to become pregnant also resumes in as soon as possible. Manifestations of side effects in the form of headaches and nausea occur initially, but after a while they disappear.

Even taking into account the fact that such contraception is allowed for breastfeeding, it is recommended to consult a specialist before use.

The doctor will choose the appropriate contraceptive and the appropriate dose. Please note that there are drugs that are prohibited to be used after artificial birth(sections), during treatment with antibiotics.

List of approved contraceptives for breastfeeding

Even approved contraceptive pills for nursing mothers are used strictly following the instructions . The list of acceptable ones is given below.

Lactinet

These contraceptive pills are widely used during breastfeeding. Lactinet is effective and contains small doses of gestagen. Its effect is aimed at inhibiting ovulation.

Studies have been conducted according to which there is no difference between mental and physical development children whose mothers took Lactinet and the development of other children.

Charosetta

Dispensed by prescription. Active substance- Desogestrel.

Contraceptive pills Charozetta are similar in composition to Lactinet.

Charozetta is prohibited for liver problems, uterine bleeding, tumors, venous thromboembolism, blood clots in the deep veins, kidney dysfunction, and individual inability to tolerate certain components. The effect of the drug is similar to most COCs.

If you choose Lactinet or Charozetta, you should take into account that the composition and effect of the drugs are identical, but the price of Charozetta is twice as high.

Exluton

Dispensed by prescription. The active substance is Linestrenol.

Exluton suppresses ovulation. Synthetic gestagen reduces the amount and viscosity of cervical mucus and reduces the penetrating ability of sperm. Reduces transport capacity fallopian tubes.

Microlute

The main component of the contraceptive is levonorgestrel. Quantity active component minimal, so it is perfectly tolerated.

Suppresses ovulation. Reduces menstrual bleeding, eliminates menstrual pain. Microlut is not prescribed for liver diseases or uterine bleeding.

comparison table

If side effects are detected, use is stopped; with the help of a specialist, you need to choose a different type of means or method of protection.

Prohibited pills

When breastfeeding, it is prohibited to take combination medications, no matter: single-, two-, or three-phase. They increase the volume of estrogen. The large proportion of estrogen affects the physical development of the baby. COCs have many side effects.

The components of these drugs are excreted in breast milk, and the amount may decrease.

List of prohibited contraceptive pills: Jess, Logest, Lindinet, Silest, Zoeli, Qlaira, Dimia, Miniziston, Novinet, Mercilon, Janine, Femoden, Demoulen, Chloe, Tri-Mercy, Microgynon, Silhouette, Marvelon, Miniziston, Rigevidon, Belara, Lindinet , Regulon, Triquilar, Non-Ovlon, Tri-Regol, Ovidon, Trizeston.

8 rules for taking birth control pills during lactation

In order for the contraceptive to have results and not cause harm, it is necessary to take birth control pills strictly following the instructions and recommendations.

1. It is recommended to start taking representatives of progesterone types after six months. It is recommended to start using drugs with a gestagen component after five weeks.
2. Full compliance with the instructions and recommendations of the specialist. Do not increase or decrease the dosage. Excessiveness will lead to unwanted side effects, A small dose- will not give results.
3. Observe the time of taking the drug.
4. Take before going to bed. Tablets can cause dizziness and temporary malaise.
5. If noticed side effect, the remedy is cancelled.
6. For the first couple of weeks, you need to insure yourself in additional ways.
7. When conception is diagnosed, use is stopped.
8. Do not use during antibiotic treatment.

The effect of contraceptives on infants

The main goal, besides protection, is not to harm the baby. It is important to determine which birth control pills can be taken during breastfeeding. The main rule: they should not have estrogen as an active component. It not only has a negative impact on the lactation process, but also on the baby, inhibiting development.

For nursing mothers, only gestogen-containing preparations - mini-pills - are ideal. They do not affect breast milk, the lactation process and the development of the baby.

Alternative methods of contraception

Eat individual reasons when a woman should not take birth control pills while breastfeeding. Experts advise choosing alternatives contraception when breastfeeding.

Barrier methods

Barrier methods include the use of condoms, diaphragms and caps. This contraception does not affect the functioning of the glands, which is very important for nursing mothers. They do not have any effect on the baby.

Before use, it is necessary to determine the size of the barrier feminine products, because after the birth of the baby the size of the vagina changed. To improve the effect, the use of spermicides is allowed.

Birth control pills for breastfeeding may be less effective barrier methods contraception.

Birth control suppositories

The active substances of the suppositories are not absorbed into the blood, do not penetrate into the milk and do not affect the child. This method of protection has some disadvantages. They consist in chemical composition contraceptive Contraceptive suppositories for breastfeeding during the period long-term use disrupt the vaginal microflora.

Also, sexual intercourse itself depends on the time of action of the drug - you have to wait until it takes effect. And after intimacy, you need to wait a certain period for hygiene.

Despite the inconvenience, contraceptive suppositories during breastfeeding have an advantage over by oral means protection - they are used only when necessary.

Intrauterine device

Experts are inclined to use the IUD because it has a high degree of effectiveness. What is better to use: birth control pills during breastfeeding or an IUD - it is up to the nursing mother to decide after consulting with a specialist.

There are IUDs that contain hormones. They are also used to treat endometriosis.

The spiral is installed for several years. It does not have any effect on the baby or lactation. Spirals are not installed after artificial birth (caesarean section).

In the absence of contraindications (the birth proceeded normally), there is no suspicion of infection, the use of this method in the postpartum period is allowed. It is recommended to install after eight weeks, the likelihood of loss is reduced.

Intrauterine devices do not protect against infections.

Calendar method

When using the calendar method, the estimated date of ovulation is calculated and abstaining from sexual intercourse on fertile days. This method is ineffective. Out of 100 women, 9–40 will become pregnant.

Birth control pills are more effective during breastfeeding.

When deciding on contraception, you need to consult with a specialist: is it possible to take contraceptive drugs of this type. The main attention is paid to the influence of the main active substance on the condition of a nursing woman and on the development of a child. The physiological specificity of the woman and the side effects are taken into account.

There is a risk of becoming pregnant after childbirth while breastfeeding, so contraception during breastfeeding is important during this period. Because quick pregnancy after childbirth, it is undesirable for a woman’s weakened body. A number of doctors claim that after childbirth, when a woman is breastfeeding and menstruation does not occur, the body’s natural defense against unwanted pregnancy. Despite this, there were cases when women became pregnant even without menstruation, since ovulation still occurred. Therefore, you also need to take care of contraception during the breastfeeding period.

Criterias of choice

The best option is to think about how to protect yourself while breastfeeding, even during pregnancy, by consulting your gynecologist. If this could not be done earlier, you can always consult the women’s department of the clinic.

Such measures are associated with the fact that a woman is breastfeeding. No actions should be aimed at undermining the health of a growing baby. Often during lactation, contraceptive methods are combined.

Breastfeeding important not only for small child, but also for his mother. It promotes rapid recovery reproductive system women, since at the time of feeding there is a natural contraction of the uterus. In addition, breastfeeding is a natural contraception against pregnancy. Therefore, the question of conception arises for women whose child is on the artificial feeding. And the choice of contraception method in this case is not important.

Review of contraceptive methods for breastfeeding

The following methods Contraception is suitable for breastfeeding:

1. Abstinence(absolute sexual abstinence) - of course, this method is the most effective and does not harm breastfeeding in any way, but most couples do not practice it, but use it as an intermediate measure.
2. Lactational amenorrhea(absence of menstruation while breastfeeding). In this case, we can say that nature itself took care of the safety of mother and child during such a crucial period. Prolactin is a special hormone that is produced after childbirth, it promotes the formation of milk in mammary glands and suppresses the ovulation process.
3. Using condoms. Using them, you can protect yourself not only from unwanted early pregnancy, but also from various pathologies which are sexually transmitted. This method will not in any way affect the health of the mother and baby, as well as the production of breast milk. The disadvantages of condoms include allergic reaction on rubber, but this is extremely rare.
4. Vaginal suppositories destroy sperm after they enter the vagina. Active ingredients suppositories cannot penetrate the milk and bloodstream of a woman. In addition, they can protect against certain types of sexually transmitted infections.
5. Protection with an intrauterine device. The method is very effective. You can install the IUD immediately after childbirth or after some time. The disadvantage of this method of contraception may be an incorrectly installed IUD, which leads to inflammatory processes. And also for diseases of the genital area, painful and heavy menstruation. When inserting an intrauterine device, a woman needs to be examined every six months, as the device can move inside the uterus, which leads to further complications.
6. Subcutaneous implants V lactation period have the same effect as birth control pills. The ampoule is sewn under the skin in the shoulder area. The calculation is made over several years.
7. Interruption of sexual intercourse. The method is not always effective, but many couples use it, since it does not involve the use chemicals from pregnancy.

Oral contraception

How to protect yourself while breastfeeding with oral contraceptives?

There are 2 types of birth control pills:

1. Containing progestogens that do not affect the activity of the ovaries and, accordingly, milk production. Due to the low content of hormones in such tablets, they are popularly called mini-pills.
2. Products based on gestagens and estrogens. They are aimed at blocking ovulation by influencing the functioning of the ovaries. They are not used during lactation, as these drugs negatively affect the quantity and quality of milk produced.

Thus, in order not to harm yourself and your child, before choosing a method of contraception using pills, you need to visit a gynecologist and consult with him. Preparations of the progesterone group create unfavourable conditions for further advancement of sperm.

IN natural conditions The cervix is ​​covered with a small amount of mucus, this is necessary to protect against infections. When a woman takes birth control pills, the mucus becomes more viscous and thick. Sperm cannot penetrate through it and fertilize the egg.

The following types of drugs are most often used: Mercilon, Fermulen, Charozetta, etc. The progestogen hormone contained in these drugs is not able to pass into breast milk.

Other advantages of such birth control pills include:

1. Side effects develop extremely rarely.
2. Milk does not change its taste.
3. Lactation production is carried out as always.
4. Fight inflammation or provide preventive action in this direction.
5. The composition of the blood does not change, platelet production is normal.
6. Unable to reduce sexual desire women.
7. If you stop taking progesterone-type contraceptives, the ability to conceive is quickly restored.

Contraindications and disadvantages of tablets

During lactation, pregnancy pills may be contraindicated the following reasons:

1. If breast cancer is diagnosed.
2. Liver diseases such as oncology, chronic diseases in the acute stage, cirrhosis.
3. Cancers in the kidneys.
4. Diseases of cerebrovascular vessels.
5. Epilepsy and other ailments for which anticonvulsants are used.
6. Bleeding from a woman's genitals due to an unknown cause.

Even if all these pathologies are absent, you still cannot take anti-conception pills on your own without consulting a doctor.

Hormonal contraception during breastfeeding should be used in accordance with the following rules:

1. The tablets are used strictly according to the schedule; missed doses are not allowed.
2. These drugs are prescribed no earlier than after 1.5-2 months; for the first 2-3 weeks you will have to use other methods of protection after childbirth.
3. You need to take the pills at the same time every day.

The main disadvantages of such mini-pills are that they do not protect a woman from STDs and are not as reliable as progestogen and estrogen drugs. If you plan to get pregnant quickly after childbirth, then you should stop taking birth control pills.

Female sterilization

Most often, sterilization after childbirth or abortion is used according to indications. For example, if another pregnancy may threaten the health or even life of a woman. The method is carried out by ligating the fallopian tubes.

A woman can independently express a desire to be sterilized. This is usually done if she already has children and is over 35 years old. But it's worth remembering that labor can no longer be restored. Therefore, before using this method of contraception, you should consider your step.

Video

In our video, an obstetrician-gynecologist gives answers to the most FAQ regarding contraception after childbirth.

Many women breastfeeding their baby are interested in - how to protect yourself while breastfeeding. After all, the onset of another pregnancy is not always desirable while the recently born child is very small.

The peculiarity of contraception during lactation is that properly carried out breastfeeding is already a method that helps protect against unwanted pregnancy and is called the “lactation amenorrhea method.” Rest contraceptive methods(barrier, intrauterine, progestin, etc.) are used to enhance the contraceptive effect even when the lactational amenorrhea method is no longer effective enough. This article will help you figure out what is possible contraception during breastfeeding, however, choose the most suitable method Only the attending physician can.

Lactational amenorrhea method (LAM)

Amenorrhea is the absence of menstruation, so the lactational amenorrhea method is based on the fact that a nursing mother does not have menstruation for some time after the birth of her child. This happens because the hormone prolactin, synthesized in the body of a nursing woman, suppresses ovulation. For LAM to work correctly, all of the following factors must be met:

1. The child on breastfeeding is not yet 6 months old.
2. A woman has not yet returned to menstruation after giving birth.
3. The baby is exclusively on breastfeeding without taking any other food or liquid, and:

• The baby took the breast for the first time within an hour after birth.
• There is frequent breastfeeding of the baby during the day (about 10 times).
• Night feedings are a must.

The advantages of LAM are obvious: it is free and does not require medical intervention, and it has no side effects. Disadvantages include a short period of use (only the first six months after childbirth) and lack of protection against STDs.

With properly established breastfeeding, without the use of nipples and bottles, this contraception during lactation 98% effective.

Natural Methods

Efficiency of use natural methods contraception (such as: calendar method, monitoring method cervical mucus, method of determination, symptomothermal method) during lactation is very small - only 50%. This is due to changes occurring in the body of a woman who has recently given birth.

Barrier methods

The use of barrier methods (condoms, caps, diaphragms) during lactation is acceptable because this method protection does not affect breast milk and is safe for the baby.

Depending on the quality of the condom and the presence or absence of spermicidal drugs in it, the effectiveness of its use is 85-98%.

You can use a cervical cap or diaphragm after 6 weeks from the date of birth. Together with your doctor you should choose right size cap or diaphragm, as the size used before birth may not be appropriate. Their first administration should also be made by a doctor.

The efficiency of using the cap is 73-92%, and the diaphragm is 82-86%.

Intrauterine devices (IUD)

Intrauterine devices (ring, coil or T-shaped) do not affect lactation and can be used during breastfeeding. However, if the IUD was introduced immediately after the birth of the child, then there is high risk its loss, therefore it is recommended to use the IUD 1.5 months after birth.

Modern intrauterine hormonal systems(for example, the Mirena spiral) contain a container with the synthetic hormone levonorgestrel, which is released in small doses and provides additional contraceptive protection.

Usage intrauterine devices– quite reliable protection during breastfeeding, since the effectiveness of this method reaches 99% when used hormonal IUD and 97-98% when using a conventional spiral.

Chemicals (spermicides)

During lactation, it is permissible to use various spermicides in the form of suppositories (candles), foam, jelly, creams, etc. Spermicide coats the cervix and vagina, and chemical substances The drug destroys sperm. Besides this contraception during breastfeeding solves the problem of vaginal dryness, which often occurs in women after childbirth. Depending on correct use, the effectiveness of the method varies from 64 to 98%.

Hormonal contraceptives

Combined hormonal birth control pills during lactation cannot be used (regardless of whether they are monophasic, biphasic or triphasic), since they affect not only the quantity of breast milk, but also its quality, which can unpredictably affect the baby’s health.

During breastfeeding, you can use purely progestin tablets, the so-called “mini-pills,” since they contain only microdoses of progestin. According to experts, these birth control pills while breastfeeding are quite safe and do not affect milk and the baby. The efficiency of use is quite high - up to 99%, but only if exact schedule taking pills.

Postcoital (emergency) contraception. Postinor during breastfeeding

Emergency contraception is used in very in rare cases after sexual intercourse, when conventional contraceptive methods did not help (for example, the condom broke). In the question is it possible to use such hormonal pills, How Postinor during breastfeeding Expert opinions differ. Some believe that it is definitely not possible, some that it is possible, but with caution. This is explained by the fact that the effect of the drug on lactation and the child has not been sufficiently studied. If a woman does take an “emergency” pill, then she can feed the baby only after 36 hours. The effectiveness of postcoital contraception is about 97%.

Sterilization

Female (tubal occlusion) or male (vasectomy) sterilization is very radical ways contraception. This method, of course, is almost 100% effective, but it is absolutely irreversible, so its use is possible after long and careful consideration: the decision not to have more children should not be made under the influence of stress or any circumstances.

The list of contraceptives that can be used during lactation is quite large, so each couple can choose for themselves best option. However, it should be noted once again that combined hormonal birth control while breastfeeding cannot be used. When using combined oral contraceptives there is a risk various types unscheduled bleeding: from spotting to heavy breakthrough bleeding, when a visit to the doctor cannot be delayed. The hormones contained in contraceptive drugs, of course, pass into breast milk, and, accordingly, into the child’s body. This can lead to disruption of the baby’s hormonal levels and negatively affect his health: for example, there are cases where girls reached premature puberty at the age of 5-7 years, instead of the usual 12-13 years.

The issue of proper contraception is acute for every woman, and in postpartum period it is especially relevant, because the woman in labor does not yet know which drugs she can take and which are prohibited. Very often, at the first appointment with a gynecologist, a woman, together with her doctor, selects suitable birth control pills for nursing mothers. After all, pregnancy in the first year after childbirth is undesirable, since the female body has not yet fully recovered; at least two years must pass before the fair sex is ready to bear a new life. In the meantime, you need to carefully select suitable means, contraceptives. The most common contraceptives during the postpartum period are birth control pills.

Choosing the ideal contraceptive method

What products are best for nursing mothers? During the postpartum period, there are many methods of contraception; during this time you can use:

• condoms;
• spiral;
• special caps that are attached to the cervix;
• various contraceptive injections;
• candles;
• mini-pills - according to many gynecologists, these are the most best contraceptives during breastfeeding.

As you can see, even at this period of her life, a young mother can protect herself from unwanted pregnancy in several ways. However, we will consider in detail the latter - mini-pills, as well as other hormonal pills indicated during breastfeeding. After all, it is precisely because of the amount of hormones that the choice of these drugs for young mothers is limited.

The woman in labor will not be able to use her usual contraceptive pills, because... all such products consist of estrogen, which can significantly reduce the production of breast milk, and even negatively affect further development newborn baby. The basis of these drugs contains a hormone such as gestan. Numerous studies have confirmed that the use of this synthetic hormone during breastfeeding is completely safe for both the mother and her baby. When carrying a child in female body observed high concentration gestan, and the use of these contraceptives simulates the conception of a child, in such artificially created conditions the egg simply cannot mature. Therefore, mothers who have given birth can take medications containing gestan without fear for milk production and the development of the baby.

Responsibility of contraception after childbirth

Birth control pills for young mothers

It must be remembered that all modern oral contraceptives can be divided into two types:

• single-component, so-called mini-pills;
• two-component (another name is combined).

The former contains only one hormone - progesterone, while the latter, in addition to the above component, also contains a synthetic hormone called estrogen.

Also, combination preparations are divided into some varieties according to the number of listed hormones: with microscopic doses, with reduced, medium and high content hormones.

However, experts are of the opinion that a nursing woman can only drink mini-pills due to their low progesterone content and gentle effect on the body.

Mini-pills include drugs such as:

• Charosetta;
• Lactinet;
• Eskluton;
• Femulen.

However, you need to remember that any contraceptives can be used only after consultation with a gynecologist. It is also worth mentioning that mini-pills do not provide 100% protection against unwanted conception; this is due to the low content of hormonal components.

What is their effect?

These tablets contain synthetic hormones, which are absolutely identical to those produced in the body of a pregnant woman. IN small quantities progesterone and estrogen can stop the maturation of the egg. This is how all two-component oral contraceptives work.

Mini-pills work on almost the same principle, but here the effect is on the mucous membrane of the cervix. These agents increase the secretion of contents cervical canal, as a result of which it is impossible for the spermatozoon to fertilize the egg, and that, in turn, cannot gain a foothold inside the uterus. After stopping taking these medications, you can become pregnant within 2-3 months.

Contraception during breastfeeding has the following indications:

• to protect against unwanted pregnancy;
• for the treatment of various hormonal diseases;
• with the development of mastopathy;
• prevention of the risk of developing an inflammatory process after a difficult birth.

Milk stagnation in a nursing mother, what to do?

Like any medications, mini-pills have the following contraindications:

• when diagnosing malignant tumor mammary gland;
• for liver and kidney diseases;
• with bleeding;
• for cardiovascular diseases.

Reception

If a woman decides to use this contraceptive while breastfeeding, then she must strictly adhere to the dosage and time of administration. You must strictly follow the instructions.

You need to take one tablet a day, preferably at the same time. For example, if a woman took a pill at 8 am, then next appointment should be exactly in a day, you can deviate from the schedule for a few minutes, if bigger difference the effectiveness of the product decreases.

If the rules of administration are violated, conception can occur even during breastfeeding; it is also necessary to remember what to take similar drugs possible only 2 months after the birth of the child. During this time, lactation should improve and rebuild hormonal background women in labor.

There is a rule for discontinuing oral contraceptives: you cannot stop taking them in the middle of the cycle, you must finish the package to the end and wait for the onset of menstruation.

During breastfeeding, a woman is responsible not only for her own health, but also for the health of the baby, so the question of which birth control pills to choose must be taken seriously. It is recommended to start taking them after consultation with a gynecologist.

Breastfeeding protects against pregnancy if the following conditions are met:

1. Feedings should be frequent, during the day and at night, with intervals between them of no more than 3 hours.
2. You need to latch on to your baby and not limit the sucking time.
3. The baby should not consume anything other than breast milk - water, formula, complementary foods. The use of a pacifier is also not permitted.
4. must be missing.

A high contraceptive effect is achieved only if the entire list of conditions is met. When the baby begins to sleep more at night, or he has to be given, the effectiveness of this method drops sharply. The most effective lactation method of contraception is for mothers of restless, actively suckling babies. And even in this case, you will have to think about additional contraceptives when the child turns 6 months old and should normally begin.

The disadvantages of the method are:

• the need to control the frequency of breastfeeding, sometimes the child will have to be woken up to give him breastfeeding;
• a strong decrease in the contraceptive effect when the child is ill, when it is necessary to give him the medicine in a diluted form or additionally supplement it with saline solutions;
• lack of protection against infection in a woman’s genital tract, so it should be used only if you have complete confidence in your partner.

If the contraceptive effect decreases, pregnancy can occur during the first ovulation; the appearance of menstruation is not required for conception. Gynecologists do not consider breastfeeding a sufficiently reliable method of contraception and insist on using other methods, especially in cases where repeat pregnancy in the near future is contraindicated.

Methods of protection during breastfeeding

Resume sexual intercourse after childbirth in most cases resolved after 2 months, with a mandatory preliminary examination by a gynecologist. From now on, it is worth thinking about contraceptives.

There are quite a few contraceptive options for a nursing mother; adjusted for maintaining lactation, all main methods are allowed:

1. Interrupted act in combination with calendar method– the riskiest contraceptive method. In 73% of cases, pregnancy occurs within the first year of its use, and in the case of insufficient self-control of the man, even earlier. In addition, it negatively affects sexual function both the woman and her partner.
2. Spermicides in the form vaginal tablets, gels, creams and suppositories are not much more effective, with them the probability of pregnancy is 71%. These drugs can also cause allergic reactions.
3. Condoms in quality contraceptive method especially recommended when changing sexual partners. Besides venereal diseases, they will protect against the introduction of new microflora, which can disrupt the balanced system of bacteria in a woman’s vagina. When using high-quality products in accordance with the instructions, pregnancy will not occur in 98% of cases. In case of errors in application contraceptive effect decreases to 85%.
4. Other barrier methods - uterine caps, condoms for women - are often used in Western countries, but are not very common in Russia. It's pretty effective ways, which allow a woman to control the possibility of conception herself, without relying on a man.
5. The intrauterine device is the best contraceptive for women who do not plan to become pregnant within the next 5 years. Copper coils provide 99.2% protection. The Mirena system, which contains the hormone levonorgestrel, which is approved for breastfeeding, is considered the most effective contraceptive and provides 99.9% protection against pregnancy. Prerequisites for their use - installation only by a gynecologist and no inflammatory diseases in the pelvic organs.
6. Oral contraceptives have a contraceptive effect in 99.7% of cases. Not all pills are allowed for nursing mothers, only mini-pills. They contain only the hormone desogestrel, which is safe during breastfeeding. Despite this, they are no less effective than full-fledged birth control pills.

If after sexual intercourse you need emergency contraception, nursing mothers can use drugs based on levonorgestrel - Postinor and Escapelle. The sooner you take them unprotected sex, the better the protection will be. Breastfeeding will have to be interrupted for a day after using them. Levonogestrel suppresses fertilization, but is safe for an already established pregnancy; it is not an abortifacient.

Contraceptives for breastfeeding mothers (names)

Contraceptive pills for nursing mothers are allowed to be used 2 months after the birth of the child, that is, they can be protected immediately after the start of sexual relations. Regular pills are combined, that is, they contain progestogen and estrogen. They cannot be used in the first six months of the child, since estrogen suppresses lactation. For nursing mothers, tablets containing only gestagen are suitable.

The characteristics of the most common oral contraceptives allowed during breastfeeding are given in the table:

Effect of birth control pills

Birth control pills that contain only progestin least amount, providing contraception, are called minimal pills, or mini-pills. They were created for use in cases where estrogen is contraindicated - for smoking women, for diseases of cardio-vascular system, for mothers who are breastfeeding.

When using these contraceptives There is no risk for a breastfeeding child. To receive the dose of gestagen contained in just one tablet, the baby must be fed breast milk for 3 years. Negative influence Mini-pills also do not affect the amount of milk and feeding time. Moreover, some studies note an increase in lactation volumes with their use.

The action of birth control pills with gestagen is based on a change in the density of the mucus that is located on the cervix. It becomes more viscous and sperm cannot reach the egg. Also, drugs containing desogestrel suppress ovulation; in 99% of cases, the release of an egg does not occur. For linestrenol-based mini-pills, this figure is lower (about 50%), which explains their lower contraceptive effect.

With the birth of a baby, the mother has a lot of worries that can disrupt emotional condition. Keep it handy.

How to take contraceptives during lactation

Contraception should be started no earlier than 3 weeks after the baby is born. Best time for the first tablet – 6 weeks after birth, before resuming sexual activity. In this case, additional protection is not necessary. If you start taking it later, you need to make sure there is no pregnancy and use other contraceptives in the first week.

You need to take birth control pills during lactation 1 piece per day at the same time. With different times of administration, the contraceptive effect decreases, especially with Exluton. If you miss a dose, you need to use other methods of protection for 7 days and continue to take the mini-pill. A pass is considered a break of more than 36 hours (27 for Exluton).

For diarrhea and vomiting due to stomach upset, absorption contraceptive drug may be incomplete. In this case, additional protection is necessary, as when missing a pill.

Some antiepileptic, sedative, antifungal agents, part of antibiotics, St. John's wort, Activated carbon. When prescribing these drugs, you should ask your doctor about the possibility of taking them together.

Side effects during hepatitis B

The main side effect when taking gestagen-based tablets is a change in character menstrual flow. In 40% of women, the endometrium enters an inactive phase and its thickness decreases. In this regard, the discharge becomes scanty, irregular, and may disappear completely, especially after six months of use. These phenomena are considered normal and disappear in the first cycle after discontinuation of contraceptives.

When taking the pills, the follicles in the egg continue to mature, they may be larger in size than usual, and then they resolve on their own. When performing an ultrasound, it is necessary to warn the specialist about taking contraceptives in order to exclude incorrect diagnosis.

In the first months of use, mini-pills may cause headache, mood changes, nausea. With further use of the drugs they disappear or decrease significantly.