Birth Control Basics for Moms
With more choices of birth control methods available than ever, it's not too soon for a mom-to-be to start considering her options.
It might be hard to believe—especially if you’re seven months pregnant with what feels like quintuplets, caring for a colicky infant, or just feeling about as desirable as sack of potatoes—but someday you’re going to want to have sex again, which means now is a good time to start thinking about what method of birth control you’ll want to use. Maybe your old method will work just fine, or perhaps you plan on nursing and want to try something hormone-free. Thankfully it seems a new birth control product hits the market each year (although we’re still waiting on a pill for the guys!), so moms have more choices today than ever before. Here’s a look at the basics to help you decide what will best fit your needs.
Birth control pills (BCPs) have been used in the US for over 50 years. They have been clinically proven to be safe and effective, and are one of the most extensively studied medications in the US. The first birth control pill, Enovid, was introduced in 1960; and since then, over 45 brands have been released.
The pill enlists the help of two hormones: estrogen and progesterone. These hormones are synthetic versions of naturally occurring female hormones. And they work together to prevent ovulation. The two common type of pill packs are:
The birth control pill is a very popular choice for contraception among women and is considered to be 99-percent effective when taken properly.
If you are nursing, your OB-GYN will recommend a progesterone-only pill (or mini pill) because this hormone won’t interfere with your breast milk production or quality (the pills that contain a combination of progesterone and estrogen can decrease milk production and pass through the breast milk to your infant). When taken as directed, the mini pill is 97-percent effective.
An intrauterine device (IUD) is ideal for some busy moms because it requires really no care or thought—you have it inserted and then forget about it. Even better, you should be able to get pregnant immediately after having an IUD removed. The efficacy rates of the following IUDs are about equal at 98- to 99-percent effective.
A progestin-releasing IUD (such as Mirena) administers the hormone progestin (about one-fifth the dose found in birth control pills), lasts for up to five years, and is as effective as sterilization in preventing pregnancy. In addition, it can reduce menstrual blood flow by up to 90-percent after a year, prevents menstrual cramps, and may even slow or prevent the growth of fibroid tumors of the uterus. It’s also safe for nursing moms.
The copper IUD is a hormone-free, T-shaped device wrapped with a fine copper wire (ParaGard® is a good example). The wire releases a tiny bit of copper (less than in the average daily diet), which immobilizes sperm and prevents fertilization. It will last for up to 10 years, making it very cost effective. Some copper IUDs can also be used as an emergency contraception method. There’s a downside to the copper IUD in that it can increase cramping and bleeding, especially during the first year of use.
A vaginal ring (like NuvaRing) is a flexible ring that’s inserted into the vaginal canal like a diaphragm, but unlike the diaphragm it stays in place for one month and releases a low dose of estrogen and progestin over a 21-day period. Thanks to the low dosage, NuvaRing causes fewer side effects than the pill. It’s 98-percent effective when inserted properly.
Birth control patches (like OrthoEvra) are adhesive patches that can be placed on the abdomen, hip, or upper arm. You must replace the patch every week. This method works by delivering progestin and estrogen through the skin and into the bloodstream. It’s a good option for women who can’t remember to take the pill but not those who are nursing. It’s 99-percent effective. Recent reports caution about a possible increase in the likelihood of blood clots with this method.
A progestin shot (for example, Depo-Provera) is a shot of synthetic progesterone administered in a doctor’s office every three months. It doesn’t affect breast milk quality, but having to go to a doctor’s office every three months can be a burden to busy moms. This is equally effective for non-breastfeeding moms.
A cervical cap (Prentif Cervical cap is an example) is a thimble-shaped, rubber cap that acts as a barrier preventing sperm from entering the uterus. It’s smaller than a diaphragm and can be kept in place for up to two days without additional applications of spermicide needed to maintain effectiveness. It’s hormone-free, but its success rate is alarming: there’s a one-year failure rate of 20 percent.
A diaphragm is a barrier method, usually a latex or silicon disk with a spring in the edge. It is inserted into and stays in the vagina and holds spermicide up to the cerivix. Sperm would have to swim through the spermicide to get to the egg. This one also has the advantage of no hormones, but the disadvantage of less than optimal effectiveness.
Condoms not only protect against pregnancy, but also sexually transmitted diseases. If used correctly, condoms are about 94- to 97-percent effective. On the other hand, the female condom is only 80- to 95-percent effective, but it can be inserted up to eight hours before intercourse. A good rule of thumb when using condoms is to also use a spermicide.
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