Birth control

During your pregnancy, start thinking about what kind of birth control you will use after the baby arrives.

You can still get pregnant even if you haven’t had your period yet. Ovulation can occur as soon as the third week after vaginal or caesarean delivery. Use an effective birth control method to prevent an unplanned pregnancy.

Breastfeeding and lactational amenorrhea method (LAM)

If you breastfeed exclusively, ovulation may be delayed. To use breastfeeding (lactation) as a birth control method, you have to understand the principle behind the lactational amenorrhea method (LAM).

To be effective, LAM requires the following conditions:

  • Your baby is less than six months old.
  • You breastfeed exclusively (no commercial infant formulas, food, or water is given to the baby)
  • You haven’t had any bleeding or started having your period again.

Before using LAM or another natural method of birth control (e.g., Billings or symptothermal), it’s a good idea to contact the Serena organization for further information and support.

Serena
Organization promoting natural family planning methods
514 273-7531 / 1 866 273-7362
www.serena.ca

You can also visit the following website:

World Alliance for Breastfeeding Action (WABA)
www.waba.org.my/resources/lam

Birth control methods

Your choice of a birth control method depends on your preference and your personal situation, which should be assessed with your health professional. This assessment can be done at the end of pregnancy or before you leave the hospital or birthing centre.

The following table describes the birth control methods available.

Method

When you can start if you have no contraindications

Hormonal IUD (Kyleena®, Mirena®)

Any time after giving birth, depending on your state of health

Copper IUD

Any time after giving birth, depending on your state of health

Contraceptive injection (Depo-Provera®)

Any time after giving birth

Progestin-only pill (Micronor®)

Any time after giving birth

Combined hormonal contraceptives that contain an estrogen and a progestin:

  • Pills
  • Contraceptive patch
  • Contraceptive vaginal ring
  • 6 weeks after giving birth
  • Depending on your situation, your healthcare provider may recommend you start three to four weeks after giving birth
  • Diaphragm
  • Cervical cap

6 weeks after giving birth

Condom

From the start of sexual relations

IUDs, contraceptive injections, the progestin-only pill (Micronor®), and combined hormonal contraceptives are the most effective types of birth control. Don’t stop your current birth control method before starting another. To avoid unprotected sex, keep a supply of condoms handy.

The withdrawal method, or coitus interruptus, and the calendar method are not effective.

Learn about birth control methods by visiting the website prepared by the Society of Obstetricians and Gynaecologists of Canada sexandu.ca.

Possible effects of hormonal contraceptives on milk production

Hormonal contraceptives do not affect the quality of your milk or the health of your baby.

However, if you use a combined hormonal contraceptive and you are breastfeeding, it’s possible you will experience a slight drop in milk production. If this happens, contact a lactation consultant, your midwife, your doctor, or a CLSC nurse.

If you use a hormonal IUD, contraceptive injection, or progestin-only pill, it is unlikely that any of these methods will affect your breastfeeding. If you do notice a problem, contact a lactation consultant, your midwife, your doctor, or a CLSC nurse.

Emergency contraception

If you have had unprotected or poorly protected sex, there are emergency contraception methods you can use.

Emergency oral contraception (EOC; the morning after pill)

This method works up to five days after unprotected or poorly protected sex, at any time after a vaginal delivery or a caesarean, whether or not you’re breastfeeding. The sooner it is taken after poorly protected or unprotected sex, the more effective it is. You can get it from a pharmacist without a doctor’s prescription.

If you’re breastfeeding, be sure to mention it to the pharmacist or doctor. They can prescribe an EOC that you can take while you’re breastfeeding.

Copper IUD

Provided it is not contraindicated for you, your doctor can insert a copper IUD up to 7 days after unprotected or poorly protected sex.