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Contraceptive choices after you have had your baby

Having a new baby is a busy time and it is easy to forget about contraception. Your periods can return 5-6 weeks after you have your baby, however as ovulation occurs 2 weeks before your period, it is possible to become pregnant before you experience your first period after giving birth. For this reason, it is recommended that contraception is started by the time your baby is 21 days old.

We currently offer three types of contraception that can be made available to you before you are discharged home from hospital. Please see the information in this leaflet for more detail around each option. Please be assured that all these options are safe to use whilst breastfeeding. There are also other types of contraception, these are available from your GP or Sexual Health Centre. Please speak to a doctor on the ward and see the websites at the
bottom of this leaflet.

The Contraceptive Injection

The contraceptive injection is given once every 13 weeks. It contains progestogen which is like the progesterone hormone produced by the ovaries. We offer two types: Depot-Provera and Sayana Press. Depot-Provera is injected into a muscle (usually the buttock) by a healthcare professional. Sayana Press is injected beneath the skin at the front of the thigh or the abdomen. You can learn to inject Sayana Press yourself.

How does the contraception injection work?

  • It stops your ovaries releasing an egg (ovulation)
  • It thickens your cervical mucous making it difficult for sperm to pass through.
  • It thins the lining of your womb, making it difficult for a fertilised egg to be accepted.

When can I have the injection?

  • You can have it before leaving the postnatal ward.

How effective is the injection?

  • The injection is most effective when used according to instructions. It’s 99% effective at preventing pregnancy with perfect use and 94% effective with typical use.

What are the advantages of the contraceptive injection?

  • Protects you from pregnancy for 13 weeks
  • You do not have to remember to take it every day
  • It may reduce heavy periods
  • It is not affected by other medicines

What are the disadvantages of the contraceptive injection?

  • You need a new injection every 13 weeks
  • Some people may be sensitive to the hormone progestogen and suffer mood changes, skin changes, weight gain and headaches
  • There is a delay in fertility returning after stopping injection
  • It does not protect you against sexually transmitted infections

Further information on contraceptive injections: www.fpa.org.uk/product/injections-contraceptive-methods/

Progestogen Only Pill (POP)

The progestogen only pill is a pill that is taken daily. It can be started straight away after birth.
Progestogen is like the hormone progesterone that is produced by the ovaries.

How does the POP work?

  • It thickens the mucous from your cervix, so it is difficult for sperm to pass through
  • It makes the lining of your womb thin, so it is less likely to accept a fertilised egg

How do I take it?

  • Take one pill at the same time every day

How effective is it?

  • If the POP is always used according to instructions, it is over 99% effective. This means that less than one POP user in 100 will get pregnant in one year.
  • If the POP is not always used according to instructions, about nine in 100 POP users will get pregnant in one year.

What are the advantages of the POP?

  • It may help with pre-menstrual symptoms and painful periods
  • You can start it up to 21 days after birth and be protected from pregnancy immediately
  • Safe with breastfeeding

What are the disadvantages of the POP?

  • You may not be able to take the POP if you have certain medical conditions such as liver disease
  • If you miss a pill or take it late it may be less effective
  • It does not protect you against sexually transmitted infections
  • You may get temporary sides effects such as breast tenderness, skin changes and headaches

Further information on the POP: www.fpa.org.uk/download/your-guide-to-the-progestogen-only-pill/

If you would like to learn about other contraceptive options, please visit the following
websites:

Contraceptive choices at caesarean section

Intrauterine contraception commonly known as “the coil” is very effective and can be inserted at the time of your caesarean section. Please speak to your doctor in antenatal clinic about this option before the day of your caesarean section. We offer the hormonal coil Levosert. If you do not have a caesarean section and wish to have a coil fitted you can get this at the local sexual health centre (see details below).

Hormonal coil (Intra-uterine system or IUS) at caesarean section

The hormonal coil is a small device that can be placed in the womb at caesarean section. It slowly releases the hormone progesterone.

How does the IUS work?

  • It thins the lining of the womb making it less likely to accept a fertilised egg.
  • It thickens the mucous of the cervix so it is more difficult for a sperm to meet an egg.

How effective is it?

The hormonal coil is more than 99 percent effective. That means if 100 women have the coil, less than 1 woman will become pregnant each year. It is very effective because it does not depend on you remembering to take or use contraception.

What are the advantages of the IUS?

  • It usually makes periods lighter, in some people periods stop completely
  • It can stay in for 5-6 years
  • You do not have to remember to use it
  • It is easy to remove and fertility returns immediately

What are the disadvantages of the IUS?

  • There is only a small amount of hormone in the hormonal coil, but some people are still affected and may notice mood and skin changes
  • Bleeding can be irregular for the for the first 6 months
  • It does not protect you against sexually transmitted infections

Further information on the IUS coil: www.fpa.org.uk/download/your-guide-to-the-ius/

If you are still unsure about the coil and would like to look at your other contraceptive options, please visit the following websites:

Your GP or local Sexual Health Centre can also offer you contraception. Remember to start before day 21 after your baby is born.

Sexual Health Buckinghamshire (bSHaW)

Please remember that this leaflet is intended as general information only. We aim to make the information as up to date and accurate as possible, but please note that it is subject to change. Please therefore always check specific advice on any concerns you may have with your doctor.

How can I help reduce healthcare associated infections?

Infection prevention and control is important to the well-being of our patients and for that reason we have infection prevention and control procedures in place. Keeping your hands clean is an effective way of preventing the spread of infections. We ask that you, and anyone visiting you, use the hand sanitiser available at the entrance to every ward before coming into and after leaving the ward. In some situations, hands may need to be washed at the sink using soap and water rather than using the hand sanitiser as hand sanitisers are not suitable for use when dealing with patients who have symptoms of diarrhoea.

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