Valerie Gommon Midwife’s Blog

Contraception

Posted on: August 24, 2010

It may seem a bit odd a midwife speaking about contraception, but of course most people want to plan when they have their children.  It is a well known fact that many pregnancies are not planned (this does not mean that the baby is not wanted, but that the pregnancy was unplanned at that time) and most midwives will tell you stories of women returning pregnant within weeks of the birth of their last baby.

I think that young women and men should be taught about their fertility; for example that the fertile period is usually fourteen days before a period and can last several days.  So for example in a menstrual cycle of 28 days the period of fertility will be around day 12 to day 16, with a longer cycle, of say 34 days, the fertile period will be around day 18 – day 22.  It is also useful to observe the vaginal discharge as this changes throughout the month, moving towards a thin, stringy, opaque discharge (similar to egg white) when the woman is fertile.  Some women also chart their temperature and notice a rise in temperature at ovulation.  Of course natural family planning or fertility awareness is much more difficult if you are breastfeeding as you may not be menstruating.

You can read more about fertility awareness and natural family planning at www.netdoctor.co.uk/health_advice/facts/naturalfamilyplanning.htm

If you have had a baby you should be aware that you can get pregnant very quickly again postnatally, especially if you are not breastfeeding.  If you are breastfeeding this MAY act to suppress your fertility, but its effectiveness as a contraceptive depends on how long and how often your baby feeds. You need to feed every three to four hours, day and night and give no other food to your baby for this to work. You need to understand that breastfeeding does not guarantee protection, however it is true that fertility is often suppressed when breastfeeding.

Women who are breastfeeding can use the mini-pill (progestogen-only) from 21 days after the birth.  To be effective it has to be taken in the same three-hour period every day without a break.  The combined pill (oestrogen and progestogen) isn’t suitable if you’re breastfeeding as it affects your milk.  But non-breastfeeding mums can take it 21 days after birth.

Intrauterine device (IUD) or coil, can be fitted six weeks after a vaginal delivery, or eight weeks after a caesarean and can be a good form of contraception and, once inserted, is something that you can just forget about.

The IUD works by sitting inside the uterus and stopping sperm from reaching the egg or stopping a fertilised egg implanting;  some coils also release a steady dose of progesterone.  Both are safe for mums who are breastfeeding.

The cap is a form of barrier contraception as are condoms.  The cap will need to be inserted prior to sex and left in place for several hours afterwards.  Barrier methods are good forms of contraception if you are unsure about hormonal methods, but they rely on correct usage.

You can have a depo provera injection every 12 weeks, or indeed implants which will last for up to three years from six weeks after the birth.  Both are suitable for breastfeeding mums and these are great forms of contraception if you are happy with using hormonal methods as you do not have to think about it!  The disadvantage is that if you experience any side-effects you will have to wait for a few weeks to allow the hormones diminish and anecdotally I have heard that it can take a while for your fertility to return.

The morning-after Pill can be taken even if you’re breastfeeding as there is a progestogen-only version, which won’t interfere with your milk supply.

Sterilisation should be viewed as a permanent form of birth control, but will be a good solution for many couples and will require a discussion/counselling with your GP.

Contraception is not an easy issue, but it is an important one, and you should feel free to seek advice from your Midwife, Health Visitor or GP, and also bear in mind that most hospitals will have a Family Planning Clinic that you are free to access if you prefer.

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4 Responses to "Contraception"

Not an easy decision…I have had awful experience with depo-provera as have all my sisters. I find GP’s unwilling to even discuss seriously anyother option for me apart from the pill. I hate it, after taking it for 20 years I feel my body needs a rest!
???What to do ?

I completely understand what you mean … it is a really difficult issue. I think it depends upon how important it is that you don’t get pregnant. You could consider a coil or barrier methods or even natural family planning, but … I agree it is difficult. If your GP isn’t sympathetic why not try a family planning clinic?

Hello!
Long time Lurker, First time Commenter..
My Husband and I have has alot of problems trying to concieve, We tried everything and spent quite a good chunk of our savings. Though I am happy to say last year we had our first little one. Life just hasn’t been the same since! Good luck to all of you and Keep your heads up!
-Lisa

Get Pregnant and Have Babies Now!

With so much choice it seems like it should be easy finding the contraception right for you, but its not. Over the years, I tried the pill and condoms have been a default method, but not as fun 😉 I used natural family planning between my three pregnancies, also so helpful to use when wanting a pregnancy as well! Following the end of my childbearing, being sick of condoms, didn’t love a cap and eventually after a lot of thought have tried an IUD and LOVE it!! With so much choice it seems like it should be easy finding the contraception right for you, but its not. Discussion is helpful, thanks!

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