Contraceptives during lactation. Birth control pills and other contraceptives while breastfeeding

Nursing mother, absorbed in caring for the baby, does not cease to be loving wife. And of course, soon after giving birth, she thinks about contraception suitable for this period. This is correct, since some women (including during lactation) are able to become pregnant in the first month after childbirth. And the birth of any child in the family should be conscious and desired, besides, bearing another baby immediately after birth is additional stress for a weakened female body.

Natural contraception while breastfeeding: is it worth relying on?

Many young mothers in matters of contraception have high hopes for natural method protection. They believe that when breastfeeding a child, they are completely and completely protected from new pregnancy. Of course, nature is wise and takes care of the female body during this period: for example, nursing mothers usually do not have periods for the first six months, since the hormone prolactin does not allow new eggs to mature. However, everything is not so simple, and for the method to work, a number of conditions must be strictly observed:

the child must be attached to the breast immediately after his birth (and this is problematic if the mother had a caesarean section or the birth was complicated);
the baby feeds exclusively on breast milk, even supplementing with water is undesirable;
feeding should be as frequent as possible: every three hours during the day, the night break is no more than six hours.
Mom has never had a period after giving birth.

A woman should not rely entirely on natural contraception during lactation

However, even if all the conditions are met, the method lactational amenorrhea sometimes brings lactating women. After all, pregnancy can occur even before the arrival of the first menstruation, and it is practically impossible to predict this moment.

It is clear that it is also not worth focusing on other methods of natural pregnancy planning during lactation. We are talking about the calendar method (calculating safe days for conception), measuring basal body temperature, ovulation tests. If in the normal state of the body all this works to one degree or another, then a nursing mother can only guess when she will ovulate for the first time after childbirth.

oral emergency contraception

If a young mother had an unexpected sexual intercourse and she did not take care of contraception in a timely manner, then the way out of the situation would be to take an emergency hormonal drug. Such pills, of course, are a shock remedy for the body (which gradually recovers after childbirth for several more months), but in some cases this is the only way out.

The modern pharmacological industry offers a woman a sufficient range of pills for emergency contraception. But for regular use, this method is unacceptable: the drugs contain horse doses of hormones that grossly interfere with female physiology. They can only be used a few times a year. These substances penetrate into breast milk and enter the baby's body. That's why breastfeeding for some period you will have to stop (from 3 to 14 days, depending on the chosen drug).

Emergency contraception preparations contain huge doses of hormones and do not in the best way affect the state of the female body

Table: hormonal pills for emergency contraception

		Escapelle	Ginepriston	Jenale
Active substance	Levongestrel		Mifepristone (synthetic steroid compound)
Mechanism of action	The drug suppresses ovulation, slows down the release of the egg from the ovary, makes its shell stronger. If fertilization does happen, then the changed structure of the egg will not allow it to attach to the uterine wall. In addition, the drug causes regression of the endometrium, which also makes implantation problematic.		Mifepristone suppresses the production of progesterone (a hormone responsible for the successful development of pregnancy). In the first phase of the cycle, the substance inhibits the development of the follicle, preventing it from bursting. In addition, due to the drug in the uterus, an unsuitable environment for the fertilization process is created, mucus thickens on the cervix. The structure of the endometrium changes (it begins to be rejected), even if the egg is fertilized, it cannot attach to the wall of the uterus.
How to use	The package contains two tablets (each 0.75 mg). The first one must be taken into for three days after unprotected intercourse, the second - 12 hours after the first. The earlier the first pill was taken, the higher the effectiveness of contraception (respectively, from 95 to 58%). If vomiting occurs shortly after taking the medicine, the tablet should be taken again.	One tablet (1.5 mg) is taken once within three days after contact.	The tablet is taken once (10 mg) within three days after unprotected intercourse. To enhance the effectiveness, do not eat two hours before the drug and the same amount of time after taking the pill. Maximum effect seen within 1-2 hours.
Contraindications	Hypersensitivity to drug components; lactose intolerance; age up to 16 years; liver failure in severe form; Crohn's disease.		Renal and liver failure; hypersensitivity to drug components; blood clotting disorder; heart failure; prior intake of drugs that increase blood clotting; simultaneous use with anti-inflammatory drugs (aspirin, analgin, paracetamol, etc.). If a woman has overweight body, then the effectiveness of the drugs decreases (regardless of the increase in dose - from 95 to 34%)
Side effects	Allergic reactions (rash, swelling, itching); delayed menstruation (no more than a week); nausea, vomiting and diarrhea; spotting outside the cycle; headache, dizziness and fatigue; engorgement of the mammary glands.		Vomiting and nausea; headache; allergic reactions; muscle weakness, feeling of discomfort in the lower abdomen; acyclic bleeding; delay of menstruation.	Similar symptoms plus diarrhea and exacerbation chronic diseases urinary system.
When can lactation be resumed?	For the period of use of the drugs, feeding should be interrupted (despite the fact that the concentration of the drug in breast milk is low). Before taking the pill, you need to give the child a breast, and then express the remaining milk. Feeding can be resumed a day after taking the second Postinor tablet or after a single use of Escapel.		Since the concentration of mifepristone in the blood decreases very slowly, it is necessary to stop breastfeeding for 14 days.

Non-emergency hormonal pills allowed during lactation

Traditional birth control hormonal preparations are combined (for example, Jess, Regulon). They are made up of the hormones estrogen and progesterone. Pills suppress ovulation and also increase viscosity cervical mucus(which prevents the advancement of spermatozoa). However, estrogen, entering the body of a nursing mother, can significantly reduce the amount of breast milk produced. For this reason, combined hormonal pills during lactation are unacceptable.

The way out is the use of progestin preparations, they are also called "mini drank". According to numerous studies, the synthetic hormone gestane is absolutely safe for both the nursing mother and the baby. When a woman is carrying a child, her body produces gestane in in large numbers. Thus, the use of "mini pili" imitates the process of pregnancy, and the egg does not mature under such conditions.

Unlike combined hormonal pills, gestagens practically do not suppress ovulation (the egg does not mature in only 30% of women). The effect of contraception occurs through a different mechanism: the “mini-drank” increases the viscosity of the mucus in the cervical canal, makes the fallopian tubes inactive - spermatozoa have very little chance of moving towards the egg. Plus, the “mini-drank” does not allow the endometrium to grow: the embryo will not be able to attach.

Examples of gestagenic preparations:

Charosetta;
Femulen;
Exluton.

Each tablet contains 75 micrograms of desogestrel (there are 28 of them in a package).

Lactinet is one of the progestin preparations suitable for use during lactation.

Admission rules

When taking oral contraceptives, you must follow the rules:

You can start using the drug about a month after giving birth.
You should drink a pill daily at the same time (there should be no break, a deviation of only a few minutes is acceptable, otherwise the effectiveness of the remedy will drop sharply).
For the first two weeks, a woman should take care of additional methods of contraception.
Tablets are best taken at bedtime: this will reduce the manifestation of adverse reactions.
If pregnancy does occur, the medication should be stopped immediately.
Cancel oral contraceptives should be according to a certain rule: this can not be done in the middle of the cycle. The package should be drunk to the end and wait for menstruation.

Contraindications and adverse reactions of progestogen contraception

Of course, Lactinet, Charozetta and other gestagens have a number of advantages compared to combined hormonal drugs. They do not harm mothers who suffer from varicose veins, diabetes who have heart problems. However, they also do not protect against genital infections.

"Mini drank" have their own strict contraindications:

malignant tumors;
acute hepatitis;
epilepsy;
serious pathologies of the heart, liver, kidneys.

You do not need to prescribe the drug yourself: only a gynecologist does this, having carefully studied the woman's health status, in particular, her hormonal background.

Adverse reactions that progestin contraception can provoke:

crashes menstrual cycle;
frequent exacerbations of thrush (if a woman is prone to it);
risk of ectopic pregnancy;
ovarian cysts;
uterine bleeding;
swelling of the lower extremities;
excessive hair on the legs;
increased oiliness of the skin;
nausea, general malaise (usually at the beginning of the intake);
headache;
mood swings.

Some gestagens also have individual side effects. So, Charosetta can provoke acne in a woman.

If the above negative reactions do not decrease three months after the start of taking the pills (especially for bleeding from the uterus), then the drug should be discontinued and a more gentle method of contraception should be preferred.

Candles, tampons and other local contraceptives

Not allowed during lactation chemicals contraception (spermicides). This group includes vaginal suppositories, tablets, tampons, creams (Farmateks, Sterilin, Zhinofilm, etc.).

The mechanism of action here is based on the destruction of spermatozoa due to the impact chemical substances. In addition, spermicides have destructive effect also on some microbes that cause sexual infections (gonorrhea, chlamydia, herpes, trichomoniasis). In addition, these medicines additionally moisturize the vagina, which makes sexual intercourse more enjoyable.

Spermicides - contraceptives local impact with a short duration

Disadvantages of the method

The disadvantages of local contraceptives include:

Not very high protection against unwanted pregnancy (75-90%): therefore, it is better to combine spermicides with other means.
The exposure time of suppositories, tampons, creams, tablets is from 1 to 6 hours.
Inconvenient is the moment that you need to inject the drug into the vagina immediately before sexual contact (5-15 minutes before).
Chemicals are destroyed under the influence of a soapy solution, so the hygiene of the genital organs should be carried out only with water.
There are frequent cases of manifestations of an allergic reaction to spermicides, and in both partners.
Some experts believe that local chemical contraceptives do not have the best effect on the vaginal mucosa.

Intrauterine contraceptives during lactation

A reliable means of contraception is the intrauterine device (efficiency 98-100%). And this method is quite suitable for nursing mothers, because it does not have any effect on the production of breast milk.

The spiral is installed for several years (up to 7 years, depending on its type). You can do this six weeks after the birth (of course, if they went without complications). After caesarean section have to wait from three months up to six months: permission to use the spiral is given only by a doctor after assessing the state of health of a woman.

The disadvantages of intrauterine contraceptives include the fact that they do not protect against genital infections, often provoke painful menstruation(V rare cases periods may even stop altogether.

Modern spirals look like the letter T. When the doctor inserts it into the vagina, the antennae are pressed against the base, while inside the uterus they straighten. The remedy is removed using nylon threads attached at the bottom (again, only a gynecologist does this).

Installation and removal intrauterine device only gynecologist

The introduction of the IUD is usually accompanied by discomfort. This nagging pain(it should not be sharp and sharp), which lasts only a few minutes. However, during the day after the procedure, a woman may experience discomfort and dull pain in the lower abdomen (for some it lasts even a week).

These sensations are quite understandable: a foreign body was placed in the uterus, and now the body is slowly adapting to this stressful situation.

The mechanism of action of the helix is based on the mechanical blocking of the advancement of the egg. In addition, active metal ions negatively affect the activity of spermatozoa.

Modern medicine offers different kinds metal in the composition of the Navy:

copper (due to this metal, the uterus and fallopian tubes begin to produce a special fluid that is detrimental to spermatozoa);
silver (it is known for its anti-inflammatory properties);
gold (the metal is best biocompatible with human body, unlike silver and copper does not provoke allergic reactions).

In addition, there are IUDs containing synthetic hormones (for example, Mirena contains levonorgestrel, which belongs to the group of gestagens). These substances, gradually released into the uterus, change the structure of the endometrium, reduce the activity fallopian tubes and thicken cervical mucus. Spermatozoa will not be able to overcome the barrier, and the egg will not be able to attach in the uterus. Note that such medical coils, in addition to those mentioned earlier side effects, sometimes cause mood swings and depression in a woman (especially in the first three months after installation).

Modern medicine offers another means of internal contraception - contraceptive ring NuvaRing (it is placed deep in the vagina). This is a thin translucent bezel with a diameter of about six centimeters. It is made of a special synthetic material (many medical implants are made from it). The ring is flexible, elastic and hypoallergenic. The product contains the synthetic hormones ethinylestradiol and etonogestrel: daily they are released from the pores of the material in a strictly defined amount. Through the vessels, which are rich in the vagina, substances enter the woman's blood.

A contraceptive ring that releases hormones is placed deep in the vagina

Thus, this mechanism is identical to the reception of combined oral medications with the difference that the drug enters the blood through the vaginal route, and not through the gastrointestinal tract. And therefore NuvaRing is an unacceptable option for a nursing woman: the composition of the ring negatively affects lactation, reducing the quantity and quality of milk produced.

Barrier Methods

Some women are negative about hormonal chemicals, as well as the introduction into your body foreign bodies. In this case, traditional condoms, as well as diaphragms in the vagina, will become an alternative. Of course, they do not affect lactation in any way (besides, they rarely cause allergies, condoms provide high efficiency protection against pregnancy and sexually transmitted infections). However, not everyone is ready to accept reduced sensitivity during intercourse using condoms. In addition, these tools (like the diaphragm) should always be at hand.

Habitual condoms do not affect the lactation process in any way

As for the selection of the diaphragm, this is initially done by the gynecologist (after that, the woman simply buys a cap right size at the pharmacy). Moreover, it is necessary to take into account the fact that after childbirth, the cervix often changes its size.

To use "female" funds, skill is needed, as well as preliminary planning of sexual intercourse.

Video: methods of contraception during lactation

Modern medicine offers a nursing mother various methods contraception: from traditional condoms to hormonal pills that are safe for lactation. To choose suitable option, a woman should seek advice from her doctor, assess the state of her health. After all, some drugs have contraindications, cause unpleasant adverse reactions, and intrauterine devices should not be installed after complicated births and caesarean sections. The most important thing is to approach the problem responsibly and not rely on the natural mechanism of protection against pregnancy during lactation.

The question of choosing a method of protection in the postpartum period is relevant, since the newborn is still too small, and the woman's body did not have time to recover. When choosing suitable contraceptives, consider their effect on lactation and all possible side effects. Otherwise, there is a risk of disruption of milk production, it is possible allergic reaction, the wrong remedy can harm the baby.

There are many methods of protection, the most natural of them is lactational amenorrhea. In addition, lactating women use barrier, intrauterine, hormonal and other methods of contraception. The gynecologist will pick up suitable way protection against unwanted pregnancy for women with breastfeeding.

Woman in the postpartum period

The body of a lactating woman requires restoration: weakened immunity, hormonal changes, energy consumption for lactation. Not all mothers have perfect health and can become pregnant 3–5 months after giving birth. It is possible, but dangerous to health. For full recovery women during lactation she needs at least 2 years.

Balance of hormones during prenatal development adjusted within 9 months. After the birth of a child, the woman's body is rebuilt again, the hormonal background changes. As a result, a woman becomes impressionable, distracted, quick-tempered. Approximately 3 months the body needs to regulate the production the right hormones. A new pregnancy will only aggravate the already unstable condition of the woman.

After unprotected intimacy use an emergency contraceptive drug, for example, Postinor. This hormonal remedy should be taken with caution if a woman is breastfeeding. The drug did not pass medical research, and therefore its effect on lactation and the newborn is not fully known. breastfeeding allowed only 36 hours after taking Postinor. The degree of protection of the drug is not higher than 98%.

Spermicidal contraception

Spermicidal preparations (Patentex Oval, Pharmatex, etc.) have low level reliability. Spermicides are available in the form of suppositories (vaginal suppositories), foams, jelly, creams, etc. The drug envelops the vagina and uterine cavity, and the chemical components that make up its composition destroy spermatozoa.

Spermicidal drugs help fight atrophic vaginitis(drying of the vaginal mucosa), this problem is typical for women in the postpartum period. Gynecologists recommend using them in combination with barrier agents. The effectiveness of spermicidal contraception is from 59% to 96%.

Sterilization

Voluntary surgical sterilization- This cardinal method protection against unwanted pregnancy. This is an operation, as a result of which an artificial obstruction of the fallopian tubes is created, and the woman loses reproductive function. Efficiency this method equal to 99%, but the consequences surgical intervention are irreversible, and therefore, before making a decision, weigh the pros and cons. Entrust the operation to a professional, otherwise pregnancy is possible.

There are many more methods of contraception, among which you can choose the most suitable option. However, it should be remembered that hormonal drugs during breastfeeding are not recommended. Otherwise, there are side effects in the form of bleeding of varying intensity. Besides, hormonal agents negatively affect lactation and the body of the newborn. The gynecologist is engaged in the choice and appointment of a contraceptive.

Looking for approved birth control pills while breastfeeding? Not all types of contraception are allowed for breastfeeding mothers. As with any type of drug, there is a list of drugs that are allowed and prohibited for use by women on HB.

Which ones are better not to use while breastfeeding, and which ones can? How do birth control pills affect breastfeeding and babies? What are the rules for taking contraceptives? What are alternative methods contraception? Let's figure it out further.

Types of birth control pills

Among the contraceptive pills, given the constituent component, there are:

gestagenic, so-called. mini-drank;
combined preparations or COC.

Mini-pills are one-component products, they contain gestagen or progestogen. Efficiency is based on the ability of progestogens to act on the mucus that covers the uterus, making it thicker, creating a barrier to spermatozoa for the fertilization process.

The baby is transmitted with breast milk specific gravity hormones and it does not harm the baby. Such contraceptive pills are safe during breastfeeding, because they do not have any effect on the functioning of the mammary gland. The body tolerates them normally, they do not contain a wide list of side effects, they rarely have a negative effect.

Combined contraceptives are prohibited during lactation.

Permitted tablets

A nursing mother believes that. But this is only half true. Only in the first six months, the risk of pregnancy is minimized.

Lactational amenorrhea is a natural contraception, it inhibits ovulation and gives 98% of the result.

Even strictly adhering to lactational amenorrhea, there is still a few percent risk. Each woman is an individual - the cycle of menstruation can begin in the second month of feeding. But ovulation occurs before the menstrual cycle. The likelihood of conception while feeding, even if the cycle has not yet begun, exists.

Oral medications are 99% effective. Previously breastfeeding mothers were not allowed to use similar method contraception. But with the development of medicine, drugs have appeared that are allowed for use by women with hepatitis B.

Birth control pills during lactation, a specialist prescribes taking into account physiological features body, because most do not even have an idea what birth control pills can be breastfed.

mini pili

Mini pills are allowed for use during breastfeeding.

Mini-drinks are suitable birth control pills after childbirth while breastfeeding.

They are progestogen-containing contraceptives. Do not affect lactation activity and the duration of feeding. There are no side effects or minimized. Their use reduces the risk of thrombosis, does not reduce libido. They are an excellent option for menstruation with painful sensations, mastopathy fibrocystic character, overgrowth endometrium.

The main side effect is a change in discharge during menstruation. The drug acts in such a way that 40% of the endometrial cells are inactive, their thickness also changes. The amount of discharge decreases, may disappear altogether. If the reception is stopped, the cycle is restored. The ability to become pregnant also resumes in as soon as possible. Manifestations of side effects in the form of pain in the head, nausea attacks occur first, after a while they disappear.

Even taking into account the fact that such contraception is allowed with HB, it is recommended to consult a specialist before using it.

The doctor will choose the appropriate contraceptive and the appropriate dose. It should be noted that there are drugs that are forbidden to use after artificial childbirth(cross-sections), when treated with antibiotics.

List of approved contraceptives for HB

Even approved contraceptive pills for nursing mothers are used strictly following the instructions. . The list of acceptable ones is listed below.

Lactinet

These contraceptive pills are widely used during breastfeeding. Lactinet is effective, while it contains small doses of progestogen. Its effect is aimed at curbing ovulation.

Studies have been conducted, according to which there was no difference between the mental and physical development of children whose mothers took Lactinet and the development of other children.

Charosetta

Released by prescription. Active substance- Desogestrel.

Charozetta contraceptive pills are similar in composition to Lactinet.

Charosetta is forbidden for problems with the liver, bleeding of the uterus, the occurrence of a tumor, venous thromboembolism, the formation of blood clots in deep veins, kidney dysfunction, individual inability to tolerate certain components. The effect of the drug is similar to most COCs.

If you choose Lactinet or Charozetta, it should be noted that the composition and action of the drugs are identical, but the price of Charozetta is twice as much.

Exluton

Released by prescription. The active substance is Linestrenol.

Exluton suppresses ovulation. Synthetic gestagen reduces the amount and viscosity of cervical mucus, reduces the penetrating ability of spermatozoa. Reduces transport capacity fallopian tubes.

Microlute

The main component of the contraceptive is levonorgestrel. Quantity active ingredient minimal, so it is excellently tolerated.

Suppresses ovulation. Reduces menstrual bleeding, eliminates menstrual pain. Microlute is not prescribed for liver diseases, uterine bleeding.

comparison table

If side effects are detected, the use is stopped, with the help of a specialist, you need to choose a different type of remedy or method of protection.

Forbidden pills

When breastfeeding, it is forbidden to drink combination drugs, no matter: one-, two- or three-phase. They increase the amount of estrogen. A large proportion of estrogen affects the physical development of the baby. COCs have many side effects.

The components of these drugs are excreted in breast milk, in addition, its amount may decrease.

List of prohibited birth control pills: Jess, Logest, Lindinet, Silest, Zoeli, Qlaira, Dimia, Miniziston, Novinet, Mercilon, Janine, Femoden, Demulen, Chloe, Tri-Merci, Microgynon, Silhouette, Marvelon, Miniziston, Rigevidon, Belara, Lindinet , Regulon, Triquilar, Non-Ovlon, Tri-Regol, Ovidon, Triseston.

8 rules for taking birth control pills during lactation

In order for the contraceptive to have a result and not harm, it is necessary to take birth control pills strictly following the instructions and recommendations.

Representatives of progesterone species are recommended to start taking after six months. Preparations with a gestagenic component are recommended to start using after a five-week period.
Full compliance with the instructions and recommendations of the specialist. Do not increase or decrease the dosage. Excess will lead to unwanted side effects, A small dose- won't work.
Observe the time of taking the drug.
Take before going to bed. Tablets can cause dizziness, temporary malaise.
If seen side effect, the tool is cancelled.
For the first couple of weeks, you need to insure yourself in additional ways.
When conception is diagnosed, the reception is stopped.
Do not use during antibiotic treatment.

The effect of contraceptives on the baby

The main goal, apart from protection, is not to harm the baby. It is important to determine which birth control pills can be taken with HB. The main rule: they should not have an active estrogen component. He not only carries out Negative influence on the process of lactation, but also on the baby, inhibiting development.

For nursing mothers, only gestogen-containing preparations - mini-pills are ideal. They do not affect breast milk, the process of lactation and the development of the baby.

Alternative methods of contraception

Eat individual reasons when a woman should not take contraceptive pills while breastfeeding. Experts advise choosing alternative contraceptives when breastfeeding.

Barrier Methods

Barrier methods are the use of condoms, diaphragms and caps. This contraception does not affect the functioning of the glands, which is very important for nursing mothers. They do not have any effect on the baby.

Before use, it is necessary to determine the size of the barrier women's funds because after the birth of the baby, the size of the vagina has changed. To improve the effect, the use of spermicides is allowed.

Contraceptive pills for HB may be inferior in effectiveness to barrier methods of contraception.

Contraceptive candles

The active substances of suppositories are not absorbed into the blood, do not penetrate into milk and do not affect the child. This method of protection has some drawbacks. They consist in chemical composition contraceptive. Contraceptive suppositories for HB during the period long-term use violate the microflora of the vagina.

Also, the sexual intercourse itself depends on the time of action of the drug - you have to wait until it works. And after intimacy, you need to wait a certain period for hygiene.

Despite the inconvenience, contraceptive suppositories during breastfeeding have an advantage over by oral means protection - they are used only when needed.

Intrauterine device

Specialists tend to use the IUD because it has a high degree of effectiveness. What is better to use: contraceptives during feeding or IUDs - it is up to the nursing mother to decide after consulting with a specialist.

There are spirals that have hormones. They are also used to treat endometriosis.

Install a spiral for several years. It does not have any effect on the baby and lactation. Spirals are not installed after an artificial birth (caesarean section).

In the absence of contraindications (delivery was normal), there is no suspicion of infection, it is allowed to use this method in postpartum period. It is recommended to install after eight weeks, the probability of falling out is reduced.

Intrauterine devices are not protection against infections.

calendar method

Using calendar method calculate the estimated date of ovulation and refrain from sexual intercourse on fertile days. This method is ineffective. Out of 100 women, 9-40 will get pregnant.

During breastfeeding, birth control pills are more effective.

When deciding on contraception, it is necessary to consult a specialist: is it possible to take contraceptives of this kind. The main attention is paid to the influence of the main active substance on the condition of a nursing woman and on the development of a child. The physiological specificity of a woman and the provision of side effects are taken into account.

It is wonderful and touching to watch how the weather kids play, but if the birth of a second child is not included in your immediate plans, special attention should be paid to protection after childbirth.

Why special? Because many of the usual methods can no longer be used. For example, classic birth control pills reduce the amount of milk and impair the development of the child. The method of contraception after childbirth should be both effective and safe for both - for both mother and baby.

When the ability to conceive is restored

In order for conception to occur, it is necessary that the menstrual cycle is restored, ovulation occurs and menstruation begins. The time for which the body of a young mother has time to do this is very individual and depends on many factors, such as complications of childbirth, breastfeeding, activity hormonal system. According to the latter, in those mothers who do not breastfeed after childbirth, the first ovulation most often occurs between 45 and 94 days. However, there are exceptions to the smaller side, up to 25 days.

In most cases, after the first ovulation, women do not become pregnant, but there are exceptions to this rule. After childbirth, the measurement of basal temperature is ineffective, and therefore it is possible to know that ovulation has occurred only after the onset of menstruation. But by that time, fertilization could already potentially occur. That's where the unexpected come from repeated pregnancies after childbirth, even before the onset of menstruation.

Breastfeeding delays ovulation and menstruation, thus protecting against pregnancy. However, to use this tool effectively, you need to follow a few important rules, which we will discuss below.

Bloody discharge after childbirth is normal. But how to distinguish them from menstruation? There is a rule that any discharge in the period up to 8 weeks is considered postpartum and does not apply to menstruation. If they appeared after this period, most likely, we have to talk about menstruation. If the mother does not breastfeed the baby, then the cycle can resume before 8 weeks. For some time after childbirth, periods may be irregular, so if you have any doubts or questions, you should contact your gynecologist.

When to start contraception after childbirth

WHO experts recommend starting contraception as early as 3 weeks after birth. Of course, such early attack pregnancy is unlikely, but minimal risk yet there is. Most non-breastfeeding women have their first ovulation as early as 6 weeks after giving birth, and contraception after this period is mandatory.

Does breastfeeding protect against pregnancy?

Breastfeeding can be used as a method of contraception (the so-called "lactational amenorrhea method"), but for its effectiveness, several important conditions must be met:

You need to start breastfeeding immediately after childbirth. If for some reason the young mother was separated from the child in the first days or weeks of his life and could not feed, then protection additional funds should start at common grounds, from three weeks.
Feeding should be completely breastfeeding, without complementary foods and supplementary foods. The introduction of a mixture or puree dramatically reduces the effectiveness of breastfeeding as a means of protection.
Feeding should be frequent, intervals between feedings should not exceed 4 hours, be sure to feed at least one, and preferably twice at night.
Absence of menses. If they started, then there is ovulation and the likelihood of becoming pregnant. It is necessary to be protected!
The age of the child is up to 6 months. Protective action GV lasts only until this period. After - there is a high probability of ovulation, and contraceptive effect GW is drastically reduced.

If at least one of these conditions is violated, the probability of pregnancy rises sharply, and it is necessary to apply additional methods contraception. If a new mother is not breastfeeding, she can in most cases return to her usual and tried method, for example combination tablets(), however, breastfeeding makes its own adjustments.

What methods of contraception are suitable for HB

condoms
Most universal method, at correct application its efficiency is quite high. It does not affect the mother and child, does not reduce the amount of milk and does not change its composition.
Flaws: subjective decreased sensation, discomfort, or latex allergy.

Candles
Suitable for both episodic and permanent application. Contain a substance (nonoxynol or benzalkonium chloride) that destroys spermatozoa. The active substance is not absorbed into the blood and does not pass into breast milk, which means it does not affect the baby. Candles are also effective against some genital infections, pathogenic bacteria and viruses, without disturbing the natural microflora.
Flaws:: possible burning sensation, allergy, destroyed by soap.

Intrauterine device
In some cases (discussed in advance with the doctor), it can be installed immediately after childbirth or caesarean section, but it is best to do this after 6 weeks. It has a high contraceptive activity, although pregnancy with installed spiral is not excluded. Installed only an experienced doctor gynecologist after examination.
Flaws: can severely irritate the uterus, cause discomfort and prolong bleeding time during menstruation.

Oral contraceptives(pills)
When breastfeeding, only monohormonal progestogen preparations can be used (). They contain one hormone - an analogue of progesterone in a minimal amount. the required dosage, so it does not pass into breast milk and has no harmful effect on the baby. The effectiveness of mini-pills is lower than that of classic estrogen tablets, so they are best combined with barrier methods. You can start taking the minipill from week 4 if you are not breastfeeding and from week 6 if you are breastfeeding.
Flaws: do not give full protection, must be taken on schedule, you can not skip a dose, can cause nausea and vomiting, change the cycle.

Hormonal injections and progestin implants
Sewn or injected under the skin of the shoulder. They contain one progestin hormone, which can usually be used during feeding. They have been operating for several years, the effectiveness is high.
Flaws: change the cycle, can cause prolonged bleeding, as well as inflammation at the injection site.

Sterilization(tubal ligation)
Suitable only for women who no longer plan to have children. After a difficult birth, it may seem to you that you will never want this again, but after sterilization, after a while you will begin to regret it. That is why it is performed for women only after 35 years of age or with at least two children. Sterilization can be combined with a caesarean section, but you should not make a decision about this hastily, and even more so under pressure from the outside.

What methods of contraception are not suitable for HB

Combined oral contraceptives
These are tablets containing two hormones - one from the estrogen group, the other - progesterone, in large doses. They have a high effect, but during breastfeeding they worsen the production of milk, and, in addition, they have a harmful effect on the child, causing a delay in mental and physical development. Suitable only if the child is fully on artificial feeding. In this case, they can be used no earlier than 3-4 weeks after childbirth (since they can cause thrombosis) and always as directed by a gynecologist.

calendar method
Not suitable after childbirth, because at this time there is no clearly established cycle. Ovulation can come at any time, especially after a break from breastfeeding. Measurement of basal temperature at this time does not give anything, because frequent awakenings at night for feeding change it. As a result, it is impossible to predict "safe days".

Coitus interruptus
As harmful as it is a common "method of contraception". Firstly, it is not at all effective in preventing pregnancy, since the most active spermatozoa can penetrate even before ejaculation. Secondly, the interrupt method renders negative impact on the psyche of both - both husband and wife, preventing the normal course of sexual intercourse. As a result, dissatisfaction, irritability, nervous breakdowns, and all this, coupled with lack of sleep and the stress of caring for a small child, contributes to discord in the family.

The birth of a desired child is long-awaited and happy event. Of course, in the first weeks, young parents do not think about resuming sexual contacts, and doctors recommend abstaining, but over time, everything returns to normal, and sex is the natural side of relationships.

You can often hear the opinion that if you are breastfeeding a baby, unwanted pregnancy will not come. But is it?

This statement is largely erroneous, since lactation cannot guarantee maximum protection. Contraceptives during breastfeeding are not only important, but also necessary. However, when choosing them, a woman should also think about the baby. Contraception during feeding has its own subtleties. It is important to choose the right means and methods of protection, because many of them can penetrate the milk and harm the baby. Often for lactating women who do not use contraceptives, the appearance of a new pregnancy comes as a surprise, and not always pleasant. Therefore, you need to think about protection immediately after childbirth.

Lactational amenorrhea and its effectiveness

Lactational amenorrhea is a condition in which ovulation does not occur during lactation and there is no menstruation. By itself, this method of contraception during lactation is highly effective (up to 96%), but requires the strictest observance of all conditions, namely:

breastfeeding should begin immediately after childbirth, which is not possible in the case of a caesarean section;
feeding the baby is carried out strictly by the hour;
the interval between feedings should not be more than 2 hours, even at night;
there should be no supplementary feeding;
do not give the child pacifiers and bottles;
you can not feed the baby without a schedule, at his request.

If all conditions are met in the first six months after childbirth, this method of contraception for HB can provide sufficient protection, but in the future it will still be necessary to select the optimal means of protection. Of course, not everyone can withstand such strict conditions without violation. modern woman Therefore, it is not worth counting on lactation as the only means of contraception.

Safe contraceptives while breastfeeding

Modern medicine offers a lot of contraceptives for nursing mothers, it remains only to choose the right one, without forgetting about the health of the baby. Most safe methods contraception during lactation are the following.

condoms . They can be used immediately after the resumption of sexual intercourse, since condoms do not affect lactation and milk composition and (with correct use) can provide up to 98% protection. Incorrect use may damage the condom or cause it to slip, in which case the protection effect will be nil.

Diaphragms and caps. Their use does not affect the composition of milk and is completely safe for the baby, but use this barrier contraception you can start only when the vagina and cervix return to normal and take on the same size, that is, about 6 weeks after birth. The effectiveness of the method reaches 85%, but if used simultaneously with special spermicidal agents, the effect increases to 97%.

Spermicides . This type of contraceptive during breastfeeding can be used as independent means, since the likelihood of conception during this period is reduced. Funds provide local action, work exclusively in the genital area, without affecting the composition of milk. But if lactation is small and feeding the baby is not regular, then it is better to use spermicides in a combined version - with barrier types of contraception.

Intrauterine devices . Can be inserted into the uterus 6 weeks after birth, but in this case, the risk of prolapse is significantly increased if internal organs not back to normal yet. The efficiency of the method is 98-99%. The device is installed, on average, for 5 years, while it can be removed at any time from fast recovery fertility. Does not affect lactation and its quality.

Injection methods and subcutaneous implants. They have a prolonged action. After childbirth, the first introduction of such drugs (or implants) can be carried out after a month and a half, and in the absence of lactation - after a month. The effectiveness of the methods is maximum, it is 99%. Injections can provide protection for up to 3 months, and implants for up to 5 years, while the capsule can be removed at any time. Harmful effects the baby is not given.

What can not be applied

This category includes all hormonal contraceptives oral use. Such drugs can cause not only changes hormonal background, a violation of the menstrual cycle, which is not established immediately after childbirth, but also change the composition of milk and its quality, which can harm the baby. The effectiveness of the method is high, about 99%, but it is not suitable as a contraceptive for nursing mothers. Apply after childbirth oral contraception necessary only after the end of lactation.