When It Comes To Breastfeeding & Birth Control, Here's What You Really Need To Know
It seems preposterous that our bodies should be able to get pregnant soon after giving birth. Seriously, evolution, give us a break. But even if you're not ready for another baby, you may be concerned about how contraception affects your current baby — you know, the one you're still breastfeeding. With so many reports that birth control can tank your supply, is there a birth control that doesn't affect breastfeeding?
The simplest answer is the easiest — condoms. They're really reliable, easy to come by, inexpensive, and honestly, the clean-up couldn't be easier. However, we know that not everyone (chiefly men) enjoys using condoms, so you might be looking for an alternative method. (Or one that your new mom brain doesn't have to keep up with.) There are more options for birth control available to you directly after giving birth than you may have thought possible, and many of them are not contraindicated for breastfeeding as you would assume. They run the gamut from mini-pills to implants, and have a reasonably high success rate, according to The Cleveland Clinic. But just because they're safe doesn't mean they won't affect your supply, which is why some experts argue against their use entirely — or at least suggest you delay their use.
When I had my baby, like many women, I assumed that by exclusively breastfeeding I was protected from getting pregnant. However, according to Kelly Mom, a resource dedicated to breastfeeding advocacy and safety, this is only partly true. The website noted that "exclusive breastfeeding (by itself) is 98 to 99.5 percent effective in preventing pregnancy" provided that your baby is still under 6 months old and not eating solid foods (which decreases their need for breast milk.) You are not yet getting your period, and your baby is still feeding on-demand all day and during the night.
That's quite a lot of caveats, and if you're really not interested in having more children right away, you're justifiably concerned about the risks inherent with trusting your body to behave in the expected manner. I mean seriously. I trust my body to walk down the stairs properly, and I only get that right about 95 percent of the time. The other 5 percent, I'm grabbing the banister. On top of that, Kelly Mom cautioned that hormonal birth control can sometimes cause a dip in your supply, which is concerning if you're exclusively breastfeeding.
The Cleveland Clinic says that your best bets for birth control while you're breastfeeding are the shot, the implant, or an IUD. But as Kelly Mom noted, these are all hormonal, and therefore might affect your supply. Also available, as per the Cleveland Clinic, is the slightly less effective mini pills, which are a good option for many women, but again, still hormonal.
The shot, otherwise known as Depo-Provera, has been around for decades. This birth control that doesn't affect breastfeeding is estrogen-free and lasts for three months. It does have some pretty common side effects for some women, chiefly a decrease in libido and weight gain, which is why its popularity has lagged in recent years, according to The Mayo Clinic. Many OB-GYNs and lactation consultants argue against this birth control because of how long-lasting it is. It's also not removable, so if it affects your supply, you're out of luck, noted Mother and Child Health.
Another choice is the birth control implant Nexplanon, and it's a tiny, matchstick sized implant placed by a catheter beneath your skin that slowly releases progestin. It is removable, though that's kind of a pain when you're in the hubub of new motherhood. The hormone released by this method thickens your mucus so that the sperm cannot meet the egg, and also it prevents the egg from being released at ovulation, according to Planned Parenthood. The great thing about Nexplanon is that it lasts for up to four years, and if it doesn't affect your supply, you're set. The most common side effects of the implant are breast tenderness and mood swings, noted Rx List, which are also prevalent while you're breastfeeding in the immediate aftermath of giving birth.
The IUDs available to you postpartum are Mirena and Skyla, according to Planned Parenthood. Both of these use the hormone progesterone, and work in much the same fashion as the implant. IUD stands for intra-uterine device and can usually be placed at your first postpartum appointment — and they last for years. They are removable, and the procedure doesn't take long either. But be forewarned: the lactation consultants at Milkmakers noted that at least anecdotally, the IUD tends towards a dip in supply, so while it's considered safe, it might not be the greatest for your milk supply.
The final option is the mini-pill, and it is exactly what it sounds like, noted The Cleveland Clinic. It's progestin-only, and has a slightly higher failure rate than combined estrogen and progesterone medications, but they noted you're also less fertile when you're breastfeeding. If there's a drop, it's easy to quit taking them and build back your supply if possible, which is why it's the most popular method.
The bottom line is that you need to choose what's right for you, your body, and your baby. Talk to your provider and see what's the best fit, and watch your supply. Your doctor may suggest waiting a while after the baby is born to explore birth control options if you're breastfeeding, and that's OK, too. Do what makes you feel most comfortable. If you notice a dip in your supply, reach out to a lactation consultant for help and how to keep both your supply and your contraception in tact.