What contraceptives are best to take after childbirth. Contraception after childbirth. From the personal experience of young mothers: reviews of different methods of contraception

Contraception after childbirth

It is known that by the 10th day after childbirth the cervical canal is completely restored, and at 7-8 weeks the restoration of the mucous membrane (endometrium) of the uterus ends. 6 weeks after birth, 15% of non-breastfeeding and 5% of breastfeeding women ovulate. Thus, a woman can become pregnant by 3 months after birth.

However, pregnancy during the first 1.5-2 years after birth is extremely undesirable for most women: your body has not yet fully recovered for pregnancy next pregnancy. In addition, pregnancy may occur with various complications and risk for the child, and abortion during this period is extremely dangerous due to the development severe complications from the reproductive system. Thus, the use of contraception in the postpartum period provides the mother with required time to restore your health and provide normal care for your newborn baby.

Recommended methods of contraception in the postpartum period depend on whether the baby is breastfeeding, mixed or artificial feeding whether the mother has any contraindications to this or that type of contraception.

Determined that hormonal drugs for contraception containing estrogens and gestagens ( combined oral contraceptives) have a negative effect on the quantity and quality of milk and can shorten the period of breastfeeding, so they should not be taken until breastfeeding has stopped. If, nevertheless, the mother is determined to use hormonal contraceptives, then contraceptive medications containing only gestagens can be used.

Lactational amenorrhea method

The method is due to the fact that for 6 months a woman who breastfeeds her baby only (without a night break) and if she does not have menstruation, remains 98% infertile. The advantages of this method include accessibility to all breastfeeding women and absolute freeness. However, for women whose children are on mixed feeding, this method is ineffective and is not a reliable method of contraception.

Gestagen-containing contraceptives (mini-pills)

It has been noted that hormonal preparations containing only gestagens, in contrast to combined oral contraceptives, which contain both gestagens and estrogens, do not affect breastfeeding and do not affect physical and mental development kids. The results of numerous studies have also shown that drugs containing only gestagens are more effective for nursing mothers than for non-breastfeeding mothers, since the latter's acceptability of these drugs is reduced due to an increase in the frequency of spotting from the genital tract.

Mini-pills - contain only microdoses of gestagens (30-500 mcg).

Mini-pills affect the mucus of the cervical canal, reducing its amount in the middle of the cycle and maintaining its high viscosity, which makes it difficult for sperm to pass through. The viscosity of the mucus appears 2 hours after taking the tablet. Under the influence of the mini-pill, changes in the endometrium occur that are unfavorable for implantation; the movement of the egg through the fallopian tube slows down due to a decrease in contractile activity fallopian tubes. In the ovaries, mini-pills inhibit ovulation by 55-65%.

Contraindications: heavy vascular diseases brain and heart, liver dysfunction (liver cirrhosis, viral hepatitis, liver tumors), uterine bleeding of unknown cause, the presence of ovarian cysts, breast cancer, thrombo-embolic diseases.

Side effects: menstrual irregularities (possible uterine bleeding in the middle of the cycle; shortening of the menstrual cycle); nausea, vomiting; depression; weight gain; decreased sex drive; headache, dizziness; engorgement of the mammary glands; increased risk of developing functional cysts ovarian and ectopic pregnancy.

Advantage of the method: low hormone content, low risk cardiovascular disorders, no influence on carbohydrate metabolism and the blood coagulation system, therapeutic effect with some cycle disorders, premenstrual syndrome, pain during ovulation in the middle of the menstrual cycle, inflammatory diseases of the internal genital organs; fast recovery ability to conceive (within 3 months after discontinuation of the drug); used during lactation; possible use smoking women over 35 years old.

Disadvantages of the method: The drug should be taken at the same time every day. IN otherwise efficiency decreases sharply.

Attention! Hormonal contraceptives do not protect against sexually transmitted diseases.

Intrauterine devices (IUD)

This method meets all the requirements for pregnancy-preventing agents used in the postpartum period: it does not affect lactation; is reversible; does not have overall influence on the body; easy to use; available; highly effective.

The IUD increases the tone of the uterus and, therefore, promotes the expulsion of the embryo early stages, increases motor activity fallopian tubes and thereby prevents the development of a fertilized egg and implantation.

There are simple IUDs and copper IUDs.

Contraindications for IUD insertion are acute and chronic inflammatory diseases of the genital organs, pregnancy, malignant and benign tumors genital organs, abnormalities in the development of the reproductive system.

Complications when inserting an IUD: pain in lower sections belly, small bloody issues, which usually go away in 2 - 4 weeks. Possible development inflammatory diseases, spontaneous expulsion of the IUD, heavy and painful periods.

The spiral is introduced no earlier than 6 weeks after birth. This is due to the fact that in the period from 1 - 2 days to 6 weeks after birth there is high frequency spiral falling out.

The IUD does not protect against sexually transmitted diseases!

IN Lately The use of hormonal intrauterine systems has become increasingly widespread - systems that combine the advantages of traditional IUDs and hormonal contraceptives and have healing effect for some female diseases.

Hormonal intrauterine system

The intrauterine system is one of the most effective and acceptable reversible methods of prevention unwanted pregnancy. The essence of this method is that the gestagen levonor-gestrel is gradually released from the system introduced into the uterine cavity. It has a local effect on cervical mucus, endometrium and sperm motility, which provides a reliable contraceptive effect that is comparable to surgical sterilization. Moreover, this effect lasts for 5 years - set it and forget it! This is especially convenient for young mothers who simply do not have time to remember about contraception every day, since caring for a baby takes a lot of effort and time.

Mirena can be used during breastfeeding.

Thanks to local action system, the concentration of the hormone in breast milk is extremely low.
Does not affect the growth and development of a child during breastfeeding.
Does not affect quantity and quality breast milk.

Other advantages of the intrauterine system include a reduction in volume and duration. menstrual blood loss(in 82-96% of patients); therapeutic effect in idiopathic menorrhagia, dysfunctional uterine bleeding, uterine fibroids small sizes, adenomyosis, dysmenorrhea, premenstrual syndrome. Unlike traditional IUDs, the intrauterine system also significantly reduces the risk of pelvic inflammatory disease and ectopic pregnancy.

The system provides menstrual comfort- menstruation becomes less abundant and almost painless.

In the first months, intermenstrual bleeding may be observed, which later becomes more rare and scarce. For some women, they may stop altogether. Don't be afraid of this, because this is the uterus' reaction to local administration hormone.

During this period, you should not limit yourself to sports; you can visit the pool and have sex. You should lead a normal lifestyle, and Mirena® will be your reliable assistant. After discontinuing use of the Mirena system, menstrual cycle and the ability to get pregnant are quickly restored.

Barrier methods of contraception

Their main advantage is the absence of a systemic effect on the partners’ bodies. Among these methods, the condom is the most widely used. As a rule, modern condoms consist of latex and come with or without lubricant. Do not lubricate the condom with oils or saliva, as this may compromise its seal.

Benefits of using condoms:

Relatively low cost;
- ease of use;
- high efficiency at correct use;
- no effect on metabolism in the body;
- prevention of sexually transmitted diseases;
- reducing the risk of developing cervical cancer;

Disadvantages of condoms:

If the quality of the condom is poor or it is stored beyond the expiration date, as well as if used incorrectly, the condom may rupture;
- decreased sensation during sexual intercourse in both men and women;
- development of irritation phenomena in the area of ​​the external genitalia and vagina of women due to dryness of the vaginal mucosa or hypersensitivity To constituent components condom;

You can use diaphragms, but when choosing them you should remember that they require strict adherence to the rules of storage and use. This method is rarely used. The diaphragm is inserted into the vagina before sexual intercourse. Its dome should cover the cervix.

Contraindications to the use of diaphragms:

Sexual infantilism;
- prolapse of the walls of the vagina and uterus, decreased tone of the pelvic floor muscles;
- poorly healing perineal tears;
- very capacious vagina;
- pathology of the cervix;
- inflammatory processes of the genital organs.

It is better to use a condom and diaphragm in combination with chemical methods contraception- spermicides that destroy sperm. Spermicides are produced in the form of creams, jellies, foam aerosols, suppositories, tablets, films.

Spermicides are injected into top part vagina 10-15 minutes before sexual intercourse. For one sexual act, a single use of the drug is sufficient. With each subsequent sexual intercourse, additional administration of spermicide is necessary.

Benefits of spermicides: ease of use, providing some protection against some sexually transmitted diseases.

The main disadvantage of spermicides- low contraceptive effectiveness, therefore it is recommended to use spermicides in combination with barrier methods of contraception. Allergic reactions, itching and burning of the genitals may develop.

Voluntary surgical sterilization(DHS)

It represents the most effective and irreversible method of birth control for both men and women and at the same time is a safe and economical method of contraception. However, it is most often used in women over 40 years of age and if there are more than 2 children in the family (for more information about the method, see Pregnancy and childbirth in women over 35 years of age).

Low-dose and micro-dose combined (containing estrogens and gestagens) hormonal contraceptives

They can be used if a woman is not breastfeeding her baby. These drugs contain small amounts of the hormone estrogen, which is associated with almost all adverse effects combined hormonal contraception. At the same time, these are very effective drugs in terms of preventing pregnancy.

You can start taking combined hormonal medications 2 months after giving birth.
The mechanism of their action is to suppress ovulation, slow down the movement of the fallopian tubes, influence the endometrium, and increase the viscosity of the mucus of the cervical canal. Modern low- and micro-dose combined oral contraceptives do not have a pronounced effect on the metabolism in the body.

Contraindications to the use of combined oral contraceptives: pregnancy, breastfeeding, serious illnesses of cardio-vascular system, cerebral vessels; liver pathology ( acute diseases liver, severe violations liver functions, benign and malignant tumors liver); acute thrombophlebitis, thrombosis or thromboembolism, or their presence in the past, the presence of genetic and acquired thrombophilia; bleeding from the genital tract of unknown origin.

Contraindications taking into account age over 35 years: hypertonic disease, 3rd degree obesity, increased blood lipid and cholesterol levels, smoking more than 15 cigarettes per day, diabetes, migraine, epilepsy, depression, liver pathology ( cholelithiasis, itching and jaundice during pregnancy in the past, chronic diseases liver), tuberculosis, uterine fibroids.

The most unreliable methods of contraception include interrupted coitus and the calendar method.

Calendar (or biological) method

Based on definition dangerous days for conception depending on the duration of the menstrual cycle. In the postpartum period, especially in the first six months, it is unreliable, since the menstrual cycle is only established after childbirth. In addition, pregnancy can occur in the first menstrual cycle after childbirth, even in the absence of menstruation. This method is not suitable for women suffering from ovarian dysfunction. Therefore, it cannot be recommended as reliable method contraception.

Most likely days of conception

Coitus interruptus

Has a lot negative aspects: It often leads to sexual dysfunction in both men and women. In addition, some of the sperm can end up on the woman’s external genitalia, and from there into the vagina and uterus.

If we talk about the degree of reliability of a particular method of preventing unwanted pregnancy, then it is determined by the so-called Pearl index- the number of unwanted pregnancies occurring among 100 women using this method contraception for a year.

Content

Many people believe that during breastfeeding it is impossible to get pregnant. 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. A early pregnancy interferes with breastfeeding. In addition, there is Great chance development of complications.

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 have these properties. modern species contraception for women after childbirth.

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 me to start drinking 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. Daily dose– one tablet.

Warning! Breaks are not allowed!

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

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”. To these medicines include:

• "Femulen";
• "Continuin";
• "Exluton";
• "Charozette."

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 best effect“mini-pills” and barrier methods of contraception should be combined.

“Mini-pills” are made specifically for mothers who are breastfeeding. They are also suitable for women during menopause (over 45 years of age). Taking medication by non-breastfeeding girls 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 adverse 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 intrauterine device(Navy). It does not affect the amount of progesterone in any way, and therefore does not cause the development of unpleasant side effects, does not 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. Constant influence on him from the inside foreign object devices, such as an intrauterine device, can cause this scar to rupture. 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 to preventive examination twice a year, since wearing a spiral increases the risk of inflammation of the genital organs.

Barrier methods of contraception after childbirth

There are several barrier methods 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 you should choose larger size due to expansion 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 caesarean 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.

Contraception latest generation doctors call 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 repeat pregnancy– a risk for both the already born baby and the mother and unborn child. Therefore, regarding contraception after childbirth, a woman should consult her obstetrician-gynecologist already during pregnancy in order to choose best option protection.

The long-awaited time has come when you can say, not without pride, that you are now a real mother. And these are not just words! After all, in the playpen he quietly groans in his sleep - the most precious treasure in the world! My favorite! The most magnificent! Bringing with it new feelings, new joy, new anxiety, new troubles...

With the birth of a baby, mommy’s worries increase significantly. You need to not only take care of the baby, but also put yourself in order after a difficult ordeal. To be beautiful, charming, sexy. So that the husband will eventually move from the sofa to the marital bed and again look with adoration at the thin figure... Just do not forget with all these worries about what is no less important - contraception.

Children of the same age are certainly good

They have more fun growing up. But is your strength enough for two toddlers in a row? Can your body withstand such ups and downs without a break? Pregnancy that occurs immediately after childbirth will most likely not be easy or prosperous. And an artificial interruption will cause mental and physical trauma to the young mother. So we, together with the doctors, advise maintaining an interval of 3-4 years. During this time, the body will “rest”, but will not “forget” the previous birth.

Never forget about contraception

We understand that during 9 months of pregnancy you have become relaxed and lazy... Leave your pregnant whims behind. Your body is already fully armed and ready to raise a new doll within itself. So what if you’re tired... And even if after giving birth you for a long time If you don’t have your period, you can still get pregnant at any time. Moreover, you will not notice this pregnancy right away. This is why experts recommend using protection during the first sexual intercourse after the baby is born. But don’t rush straight to the pharmacy in search of the usual box.

Now, dear mothers, you need to be especially careful when choosing contraceptives. Are you breastfeeding? Then your “safety” drug must meet all the requirements of a nursing mother. More precisely: it does not affect milk production, is safe for the baby and effective for you. Today there are many methods of contraception. We will describe the most common ones, and the choice is yours.

Lactational amenorrhea

1. Mother's milk is the only food for a child in the first six months of life. The baby does not receive any other food or drink.
2. The break between feedings is no more than 3 hours, both day and night.
3. The mother does not have periods during breastfeeding. But keep in mind, this is not an indicator that you cannot get pregnant! It happens that ovulation has resumed, but menstruation has not yet begun.
4. Mom should not sharply reduce the number of feedings. If you fed your baby, for example, 15 times a day, and then suddenly switched to feeding 10 times a day, this increases the risk of getting pregnant. In general, the reliability of this method is about 80%.

Condoms

They are the most common and affordable contraceptive. However, improper use of a condom or the use of low-quality latex in its production can lead to unwanted pregnancy. Therefore, many couples combine a condom with chemicals protection ( vaginal suppositories or gels). The only side effect may be allergic reaction on the material or lubricant of the condom. When used correctly, the method is 98% reliable.

Vaginal suppositories, gels, pastes

Protection, so to speak, “from time to time.” The drugs act in different ways: they either deprive sperm of motility or kill them. But this method is considered not very reliable if it is not “supported” by some other means. At frequent use may cause irritation of the vaginal mucosa.

Diaphragms and caps

Refers to “barrier” methods of protection. The diaphragm is a membrane that is inserted deep into the vagina. The cap is a cylinder that fits over the cervix. Both devices protect cervical canal(canal leading into the uterine cavity) from the penetration of sperm. The size is selected individually by the doctor. It is advisable to select the size no earlier than 6 weeks after birth. The drug is administered half an hour before sexual intercourse and then removed. Efficiency depends on correct use. But recently this method has not been very popular.

Birth control pills

For nursing mother required condition– the pills should not contain the hormone estrogen. If a woman is not breastfeeding, then any pill will suit her. Choose low-dose drugs, they contain two hormones, but in minimum quantity. Tablets can be monophasic ( equal amount hormones in all pills), biphasic or triphasic (hormones are distributed in two to three stages, imitating the natural processes occurring in the female body). Oral contraceptives are 98 – 99% reliable if you take the pills at the same time every day.

Injection method

The injection preparation contains only gestagen and is a highly effective contraceptive for correct use. Breastfeeding women are given an injection 6 weeks after birth, non-breastfeeding women - 4 weeks. Protection will be provided for 12 weeks, then the injection will need to be repeated. At first, you may experience spotting between periods, some changes in body weight, etc. If you choose this method, then follow the timing of the second injection to maintain effectiveness.

Intrauterine devices

Two months after birth, the IUD can be inserted (with earlier insertion there is a risk of it falling out). IUDs are divided into hormone-producing ones (they release a small amount of gestagen hormones) and regular ones. This method plays the role of a kind of “barrier” and refers to mechanical methods of protection. The spiral changes the mucus of the uterine pharynx, which makes it difficult for sperm to penetrate. The product is administered by a gynecologist, who also checks the “correctness” of her position from time to time. After a certain period of time (depending on the type of IUD), the doctor removes the contraceptive or replaces it with a new one. The reliability of the method is high – 99%. But there are some side effects, for example, painful or heavier periods.

Natural method of birth control (coitus interruptus, calendar, etc.)

Some couples use it. But here there are more minuses than pluses. Sheer hassle and a high percentage of “failures”. Out of one hundred women who use abortion as a means of contraception, eighteen become pregnant. Think about it: while having sex, you will have to be on alert all the time. And doctors claim that the lubricant that is released in men when aroused also contains sperm. Where is the guarantee that they will not meet the egg? Long-term use of this method leads to neuroses and anorgasmia in women and weakened erections in gentlemen.

Implants

6 silicone capsules that are injected under the skin during inner side shoulder The hormone (gestagen) contained in them is released in impulses for 5 years. Then the contraceptive effectiveness of the drug decreases sharply and it must be removed. Only a doctor can insert and remove capsules. In the first months after administration, intermenstrual bleeding is possible, which goes away without taking any additional measures. Changes in body weight, dizziness, etc. are also sometimes observed. The reliability of the method is 99%.

Sterilization

The method is irreversible, but provides a 100% guarantee. Spouses need to weigh the pros and cons and consider various options that life can throw at you. There is no turning back and a woman (or man), after sterilization, will never be able to have children.

But no matter which method you choose, be sure to consult your doctor. It is important to understand that contraception is not just a way to avoid pregnancy, but a way to preserve what remains of nerves and health. Moreover, the health of not only the woman, but also her future children. Therefore, treat this issue with due responsibility.

Novikova Tatyana
Consultant: Aigul Tursunova, gynecologist
Magazine "Kangaroo" No. 34

Issues of protection against unwanted pregnancy are becoming extremely relevant. When one baby falls asleep in your arms, rarely does anyone think about a second child - at least in the next year or two. What contraceptives are suitable for young mothers and what to do if a woman is breastfeeding? Read and you will find out everything.

Course of the postpartum period

The postpartum period begins with the birth of the baby and ends 6 weeks after birth. Alone at this time reproductive organs, which have changed due to pregnancy and childbirth, normalize their work and return to their original state, while others acquire new functions.

Thus, involution processes quickly take place in the uterus, its mucous membrane is restored, and by the end of the 6th week the organ acquires its previous size. In the postpartum period, the ovaries begin to function as before gestation, and the production of hormones in them is normalized. The follicles mature again and the menstrual cycle is restored.

In most cases, in women who do not breastfeed, after postpartum period your period comes. If lactation is not disrupted, menstruation does not appear for several months or even throughout the entire time that the baby is breastfeeding. Both cases are variants of the norm, since the timing of recovery of the cycle after childbirth is individual for each woman. The fact is that along with the birth of a baby, prolactin is produced in the mother’s body, which stimulates milk production and suppresses the production of hormones in the ovaries. This prevents the maturation of female germ cells and the onset of ovulation.

Lactational amenorrhea method

LAM (lactation amenorrhea method) is called a natural method of birth control. Nature intends to suppress reproductive function during feeding after the baby is born. Immediately after delivery, prolactin begins to be produced, a substance that regulates the formation of breast milk. High content hormone leads to inhibition of ovulation and, as a consequence, to long absence menses. When sucking they are stimulated nerve endings nipples, which activates the production of prolactin. The more often a woman puts a baby to her breast, the more of it is formed.

Lactation is the best natural way to regulate conception.

Experts are convinced that this method of contraception should be used in conjunction with barrier contraception, since in rare cases fertilization is possible. If the mother feeds the baby at long intervals, reproductive function restored with the onset of menstruation.

An important criterion for protection using the lactational amenorrhea method is the mandatory absence of menstruation. If they appear at least once or the cycle schedule is floating, you cannot use a contraceptive method. This technique is effective only in the first six months after childbirth. Then reproductive function is being restored.

Gynecologists warn: the lactational amenorrhea method only works in the first 6 months, subject to exclusive breastfeeding on demand without night breaks. If the interval between feedings is more than 4 hours or complementary foods are introduced, additional methods contraception.

It is important to remember that ovulation always occurs before the first menstruation after childbirth, which means pregnancy can occur before visible to a woman recovery of the cycle.

Contraception for nursing mothers

IN lactation period Not all contraceptives are approved for use as some may pass into breast milk.

First choice remedies

They are absolutely safe for the baby and can be prescribed at any time after childbirth.

• Barrier method (cervical caps,). Used immediately before sexual intercourse.
• ( And ).

Intrauterine contraceptive determined by a gynecologist after a preliminary examination. Depending on the type of delivery, there are terms for installing an IUD:

• At natural childbirth it can be administered after 6-8 weeks. Installation allowed non-hormonal IUD within 48 hours after the birth of the baby, but in this case there is a high risk of its loss.
• After a caesarean section, the procedure should be postponed for 3-6 months.
• In case of complicated childbirth, it will take about 2 months for the reproductive organs to recover before installing the IUD.

Second choice remedies

Second-line drugs include contraceptives that contain progestin. Progestin can pass into breast milk in small quantities, but does not pose a danger to the baby. Progestin agents do not affect lactation. To minimize the risk to the baby, they should be used 6-8 weeks after birth.

• (Charosetta, Laktinet).

The tablets can be taken 5 weeks after the baby is born. They should be taken at the same time every day. It is strictly forbidden to miss a dose even for a day. Gynecologists recommend that women use mini-pills at 18-20 hours, because its maximum contraceptive effect occurs after 4 hours.

• (Depo-Provera).

Can be used immediately after childbirth. The injection is given in gluteal muscle or the upper part of the shoulder. The drug has a contraceptive effect for 2-3 months.

• (Norplant).

It is possible to put on contraception 3 weeks after the baby is born. The doctor puts the contraceptive under local anesthesia, making a small incision on the inner surface of the shoulder 10 cm above the elbow. A special applicator inserts the contraceptive capsule. The doctor then examines the location of the implant. The product should not cause severe discomfort to the patient. When painful sensations you should contact a gynecologist.

Contraception for those who are not breastfeeding

In addition to the methods listed above, in the absence of lactation, the following contraceptives are used:

Approved for use from 21 days after the birth of the child. A woman should take the pills at the same time every day. As soon as the pack is used up, you need to take a break for a week. During this period, it is not necessary to use other contraceptives, since contraceptive effect. When the package contains 28 tablets, breaks are not provided.

It is not advisable to apply a transdermal contraceptive no earlier than 4 weeks after birth. The Evra patch is installed on the first day of menstruation and is not removed for 1 week. The patch is replaced on the 8th and 15th day of the cycle. On the 22nd day, the patch is removed and not used until the 28th day of the menstrual cycle.

When can you plan a new pregnancy?

Turns out, female body after childbirth is so weakened that a second pregnancy within a year after the birth of the baby can threaten negative consequences For reproductive system mother and fetus:

• spontaneous miscarriage;
• placental insufficiency;
• chronic fetal hypoxia;
• improper attachment of the placenta;
• premature birth, etc.

Obstetricians strongly advise taking a break between births of children for at least 2 years.

Until the body recovers completely, it is recommended to use reliable contraception, selected by a doctor taking into account the wishes of the young mother.

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 even more so for nursing mothers.

• Involution (return to pre-pregnancy state) 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 baby is fed according to all modern rules organization of 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 reliable way protection against unwanted pregnancy, and also protects the 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. Internal os 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 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. Oil base When rubbed, it 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 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. Increased risk of developing inflammatory processes in the area of ​​the pelvic organs.

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. Measuring regularly basal temperature, calculate the days of ovulation. 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 continuous night sleep. So you shouldn’t rely on this type of contraception.

Efficiency: no more than 60%

Calendar method

Maintaining a calendar of hazardous 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 protection against unwanted pregnancy. The work of such drugs is based on the suppression of ovulation. Active ingredients, 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. Reception synthetic hormones– this 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 use contraceptive drugs 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. Constant reception such drugs maintain progesterone levels at high level and prevents egg maturation and ovulation. Progestin does not affect the quantity and quality of milk produced.

Efficiency: 98% with proper and regular intake drugs. 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. Gradually hormonal contraceptive 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 new pregnancy will not be planned in the next five years. Although, if necessary, the drug can be removed. This surgical intervention although minimal, it can still provoke an infectious-inflammatory process.

Efficiency: 95-97% Suitable for nursing mothers.

Emergency postcoital contraception

Hormonal drugs like Postinor, which are taken in in case of emergency Immediately after unprotected sexual intercourse during breastfeeding, it is strictly forbidden to take it. They contain loading dose hormones that the baby receives through milk. A complication is often hormonal disbalance and intermenstrual bleeding.

Efficiency: 99%. Cannot be taken while breastfeeding.

Spermicides

This chemical species contraception is local application 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. IN as a last resort mini-pills without estrogen. Such drugs do not affect milk production. But at the same time they put additional stress on hormonal system women.