How to protect yourself while breastfeeding. Rules of effectiveness for lactational amenorrhea

Today, family planning is one of the priorities in gynecological practice especially if there is a family baby. Not all families are morally and financially ready for the birth of the weather, and abortion for a woman who has recently given birth to a child and is breastfeeding is also a negative impact on health. Therefore, contraception after childbirth against the background of breastfeeding, after the start intimate relationships between spouses becomes one of the most important tasks.

Contraception after childbirth

Today, there are many methods of protection against unwanted pregnancy, but their effectiveness varies, there are both relatively reliable and unreliable methods. Against the background of lactation after childbirth, it remains relatively a long period amenorrhea, lack of menstruation due to blocking the work of the ovaries for the maturation of the egg against the background of lactation. This phenomenon is used by many married couples by practicing the method of LAM prevention (method of lactational amenorrhea). In addition, there is a matrimonial calendar, this is a calculation safe days, as well as interrupted sexual intercourse, in which sperm does not enter the woman's vagina. There are also barrier means protection - condoms and vaginal caps and membranes, preparations for oral hormonal contraception and intrauterine devices. The most radical method of protection is the method of cutting or tying the fallopian tubes in a woman or the vas deferens in a man.

When to Consider Contraception

Actually, with the onset of intimacy, the question of contraception should already arise, since even with intensive breastfeeding, LLA may not work, since its effectiveness reaches 95-96%, that is, purely theoretically 4-5% of women may well become pregnant. That's why, starting from 8-10 weeks after birth, when the discharge has ended, or with the onset of regular menstruation, pregnancy is quite likely, and it is necessary to decide how to protect yourself. Each of the methods has its indisputable advantages and disadvantages, the most reliable and indisputable method is only abstinence.

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MLA while breastfeeding

LAM is a method of lactational amenorrhea practiced by many breastfeeding women. Subject to all the rules of this method, its efficiency reaches 96%, in connection with which it is convenient for many couples in the first time after childbirth.

The undoubted advantage is its naturalness, ease of use and free. A significant disadvantage is the degree of reliability, which significantly depends on the strict observance of the conditions for compliance with all the rules in breastfeeding.

A similar method can be practiced if breastfeeding does not allow pacifiers, supplementary feeding and drinking water, application strictly on demand, including at night, the child sucks actively and the mother does not have menstruation.

It is usually practiced before children when it already loses its effectiveness and degree of protection. Against the background of active and full breastfeeding without interruptions, there are usually no periods, ovulation is suppressed due to the active release of lactation hormones and conception does not occur. Usually this method is practiced by those couples who do not worry about the possible hit in 4-5% of those who can become pregnant.

Calendar method for HB

One of the methods natural protection from pregnancy is maintaining a marital calendar (often along with measurements of basal temperature). The effectiveness of the method for HB is low, since conception can often occur before the first menstruation, and with this method they are guided by the timing of menstruation.

note

Due hormonal changes ovulation days can shift, respectively, as well as "stray" and safe days.

Against the background of HB, it can only be used in the second year of feeding, when menstruation is already established, its terms are stable, and hormonal influences on reproductive functions are not so great. Efficiency ranges from 40 to 65%, depending on whether regular cycle or not.

The advantages of this method:

Free
Natural

Cons of this method:

Coitus interruptus with GV

Many couples practice PAP (pullout) as a method of preventing unwanted pregnancies. Its essence lies in the fact that a man before the onset of ejaculation during intimacy removes the penis from the woman's vagina, respectively, the sperm does not enter the vagina.

It is difficult to call this method reliable due to the fact that some of the active spermatozoa are contained in the secrets released before ejaculation, and sometimes a man in a fit of passion simply does not have time to "come out", which causes misfires.

The advantages of this method:

Free
Natural

Cons of this method:

Barrier methods of contraception for HB

Barrier contraception includes condoms that are put on a man's penis during intimate contact or caps (membranes) that are placed or put on a woman's vagina. Due to these products, sperm and, accordingly, male germ cells cannot enter the cervical region and the fallopian tubes where conception takes place. Caps and membranes have not received much distribution with HB, as well as with other intimate contacts, due to the difficulty with their use and low reliability. Therefore, we will discuss condoms as one of the most popular methods.

A condom is put on the penis in an erect state just before intimacy, and due to it, the sperm simply physically cannot get into the woman's hearth paths, remaining inside the condom. Efficiency similar method reaches 95-98% at correct selection and use.

Advantages of the method:

Simple, does not require special skills
Reliable when properly sized
Protects against STIs

Cons of the method:

The condom may fall off, tear, or not fit
May be allergenic (grease, latex)
Every intimate encounter requires a new condom, which is financially sensitive (quality products are expensive).

Ligation (cutting) of pipes during HB

Refers to radical methods contraception, in which, due to artificially created obstacles, conception in the fallopian tubes is impossible. It is used only for those women who have reached the age of 35, have 2 or more children, or medical indications pregnancy is dangerous for a woman. Efficiency reaches 99-100%.

Advantages of the method:

Free
Effective

Cons of the method:

Does not protect against STDs
Requires an operation if the dressing was not done in childbirth with.

Ligation (transection) of the vas deferens

It is similar to this method in women, but is performed in men. It is indicated when a man reaches 35 years of age and older and has 2 or more children. The method can be both reversible and radical. When ligating the cords or placing a special cork, fertility can be restored, when transected - only after the operation, and not always successfully.

Advantages of the method:

Free
Effective

Cons of the method:

Radical, further conception is possible only after surgical intervention
Does not protect against STDs.

Contraceptive pills for nursing mothers

At breastfeeding only pure gestagenic contraceptives (mini-pills) are acceptable for use, since combined ones (COCs) lead to a violation of milk production, and also affect the child.

Taking a mini-pill gives correct application efficiency up to 98%, but requires pedantry in observing the timing of taking the pills.

Advantages of the method:

Effective
Does not affect the quality of milk
Used with early dates after childbirth, possible from 8-12 weeks after birth

There is a risk of becoming pregnant after childbirth while breastfeeding, so contraception for HB is important during this period. Because rapid pregnancy after childbirth is undesirable for a weakened woman's body. A number of doctors claim that after childbirth, when a woman is breastfeeding and menstruation does not occur, the body's natural defense against unwanted pregnancy occurs. Despite this, there were cases when women became pregnant even in the absence of menstruation, since ovulation still occurred. Therefore, it is also necessary to take care of contraception during the lactating period.

Criterias of choice

The best option- think about how to protect yourself while breastfeeding, even during pregnancy, after consulting your gynecologist. If this could not be done earlier, then you can always consult the women's department of the clinic.

Such measures are associated with the fact that a woman is breastfeeding. No action should be aimed at undermining the health of a growing baby. Often, during lactation, contraceptive methods are combined.

breastfeeding important not only for small child but also for his mother. It contributes quick recovery reproductive system women, as at the time of feeding there is a natural contraction of the uterus. In addition, breastfeeding is a natural contraception against pregnancy. Therefore, the question of conception arises in women whose child is on artificial feeding. And the choice of a method of contraception in this case is unprincipled.

Overview of contraceptive methods for breastfeeding

The following methods contraceptives suitable for breastfeeding:

abstinence(absolute sexual abstinence) - of course, this method is the most effective and does not harm breastfeeding in any way, but most couples do not practice it, but use it as an intermediate measure.
lactational amenorrhea(lack of menstruation while breastfeeding). In this case, we can say that nature itself took care of the safety of the mother and child in such a crucial period. Prolactin is a special hormone that is produced after childbirth, it promotes the formation of milk in mammary glands and inhibits the ovulation process.
The use of condoms. Using them, you can protect yourself not only from unwanted early pregnancy, but also from various pathologies that are sexually transmitted. This method will in no way affect the health of the mother and baby, as well as the production of breast milk. The disadvantages of condoms include allergic reaction rubber, but this is extremely rare.
Vaginal suppositories destroy spermatozoa after they enter the vagina. The active ingredients of suppositories cannot penetrate into milk and into bloodstream women. In addition, they are able to protect against certain types of genital infections.
Protection with an intrauterine device. The method is very efficient. You can install a spiral immediately after childbirth or after some time. The disadvantage of this method of contraception can be incorrect installed spiral, that leads to inflammatory processes. And also with diseases of the genital area, painful and heavy menstruation. When installing an intrauterine device, a woman needs to be examined every six months, since the spiral can move inside the uterus, which leads to further complications.
Subdermal implants during the lactation period, they have the same effect as birth control pills. The ampoule is sewn under the skin in the shoulder area. The calculation is taken over several years.
Interruption of sexual intercourse. The method is not always effective, but many couples use it, since it does not involve the use of chemicals for pregnancy.

oral contraception

How to protect yourself while breastfeeding with oral contraceptives?

There are 2 types birth control pills:

Containing progestogens, which do not affect the activity of the ovaries and, accordingly, the production of milk. Due to the low content of hormones in such tablets, they were nicknamed mini-drank among the people.
Means based on gestagens and estrogens. They are aimed at blocking ovulation by affecting the functioning of the ovaries. They are not used during lactation, as these drugs negatively affect the quantity and quality of milk produced.

Thus, in order not to harm yourself and your child, before choosing a contraceptive method with pills, you need to visit a gynecologist and consult with him. Preparations of the progesterone group create unfavorable conditions for the further advancement of spermatozoa.

IN vivo the cervix is covered with a small amount of mucus, this is necessary to protect against infections. When a woman takes contraceptives, the mucus becomes more viscous and thick. Spermatozoa cannot get through it and fertilize the egg.

The most commonly used drugs the following kind: Mercilon, Fermulen, Charosetta, etc. The hormone progestogen contained in these preparations is not able to penetrate into breast milk.

Other benefits of these birth control pills include:

Side effects rarely develop.
Milk does not change its taste.
The development of lactation is carried out as always.
Fight inflammation or provide preventive action in this direction.
The composition of the blood does not change, the production of platelets is normal.
unable to reduce sex drive women.
If you stop taking progesterone-type contraceptives, then the ability to conceive is quickly restored.

Contraindications and disadvantages of tablets

During lactation, pregnancy pills may be contraindicated due to the following reasons:

If breast cancer is diagnosed.
Liver diseases, such as oncology, chronic diseases in the acute stage, cirrhosis.
Cancers in the kidneys.
Diseases of the vessels of the brain.
Epilepsy and other ailments for which they are used anticonvulsants.
Bleeding from the genitals of a woman, caused by an unknown cause.

Even if all these pathologies are absent, you still cannot take pills against conception on your own without consulting a doctor.

Hormonal contraception during breastfeeding should be used in accordance with the following rules:

Tablets are used strictly according to the scheme, skipping admission is not allowed.
These drugs are prescribed no earlier than after 1.5-2 months, the first 2-3 weeks will have to be protected after childbirth in other ways.
You need to take the tablets at the same time.

The main disadvantages of such mini-pills are that they do not protect a woman from STDs and are not as reliable as progestogen and estrogenic drugs. If you are planning a quick pregnancy after childbirth, then you should stop taking birth control pills.

female sterilization

Most often, sterilization after childbirth or abortion is used according to indications. For example, if another pregnancy can threaten the health or even life of a woman. The method is carried out by ligation of the fallopian tubes.

A woman can independently express a desire to be sterilized. This is usually done if she already has children and is over 35 years old. But it is worth remembering that tribal activity no longer recover. Therefore, before using this method of contraception, you should consider your step.

Video

In our video, an obstetrician-gynecologist gives answers to the most FAQ about contraception after childbirth.

There is a fairly common belief that a woman cannot become pregnant while breastfeeding. In fact, this does not always happen. In this article, we will talk about the cases when breastfeeding can really serve as a method contraception.

A bit of physiology

The postpartum period is one of milestones woman's life. At this time, her body is restoring all the changes caused by pregnancy in the genitals, endocrine, nervous, cardiovascular and other systems. The risk of pregnancy increases by 6 months postpartum, whether a woman is breastfeeding or not. At the 7-8th week, the restoration of the uterine mucosa ends. As early as 6 weeks after birth, 15% of non-nursing and 5% of breastfeeding women have ovulation - the release of an egg from the ovary. Outside of pregnancy, ovulation occurs in the middle of each menstrual cycle.

The ovum matured in the ovary is released into abdominal cavity and then enters the fallopian tube. There she can meet with a spermatozoon - in this case will happen fertilization. That is, ovulation is one of the main points that determines the possibility of conception in a given menstrual cycle.

During pregnancy and several months after childbirth, ovulation does not occur. The most early ovulation registered on the 4th week after birth. Thus, by the 3rd month after childbirth, a woman is potentially able to become pregnant. By this time, the production of hormones is restored, providing cyclic changes in the woman's body during the menstrual cycle.

During pregnancy, the production of prolactin (it is produced by a gland located in the brain) increases, one of the hormones involved in blocking the maturation of an egg in the ovaries. Prolactin prepares the mammary glands for lactation. By the end of pregnancy, with the onset of childbirth, the level of the hormone oxytocin rises. Both of these hormones - prolactin and oxytocin - provide lactation (from Latin lacto "I feed with milk") - the formation of milk in the mammary glands and its periodic excretion. The mechanism of direct and feedback between the intensity and duration of breastfeeding and the production of prolactin and oxytocin. On the one side, a large number of prolactin ensures the formation of lactation, and on the other hand, the maintenance of lactation contributes to the preservation high level prolactin. As a result, in women who breastfeed on demand, conditions are created to suppress ovulation, lengthen the recovery period for menstruation. The period of breastfeeding and the absence of menstruation is called lactational amenorrhea.

How does MLA "work"?

The lactational amenorrhea method (LAM) is natural method pregnancy prevention, tk. breastfeeding is used to prevent pregnancy.

Breastfeeding is provided by lactation reflexes, which are regulated by the higher parts of the central nervous system. The nipple-areola complex (peripapillary circle) is supplied with a large number of nerve receptors, the sensitivity of which increases with the duration of pregnancy and reaches a maximum in the first days after childbirth. Irritation of these receptors during sucking triggers reflex mechanisms leading to the production of oxytocin and prolactin - hormones that regulate lactation.

The milk production reflex (prolactin reflex) is associated with the production of the hormone prolactin during breast suckling, and prolactin, in turn, stimulates the production of milk in the mammary gland. How longer baby breastfeeds, the more milk is produced. The production of prolactin has a certain circadian rhythm. Its highest level is recorded at night, 2-3 hours after falling asleep, the lowest - from 10 to 14 hours of the day. Therefore, breastfeeding should occur at least every 4 hours during the day and every 6 hours at night. Prolactin suppresses the activity of the ovaries, delaying ovulation, so breastfeeding at night and during the day protects against new pregnancy in 98% of cases. Through the prolactin reflex, the mammary gland produces enough milk for successful breastfeeding.

No less necessary for the satisfaction of the child is the oxytocin reflex, or the milk ejection reflex. In the process of sucking, in response to irritation of the nipple, the hormone oxytocin is produced in the posterior pituitary gland, causing milk to be released outward. Oxytocin is called the "hormone of love": a mother is happy when her milk flows well and her baby is satisfied. Full of love thoughts about the child, the sight of the child increase the reflex, and stress, pain, excitement suppress the oxytocin reflex. Breast milk contains substances (inhibitors) that reduce its production. If breast milk is removed from the mammary glands during sucking or pumping, these substances are also removed, and then the mammary gland produces more milk. Therefore, if the baby is temporarily not breastfeeding, milk must be expressed so that its production does not stop. Emptying the mammary gland is the strongest stimulator of its work.

In the early postpartum period, it is lactation reflexes that ensure the formation normal lactation Therefore, for subsequent successful breastfeeding, the first application is preferably carried out in the first hour after birth, when the reflexes of the child and the sensitivity of the nipple-areola complex are highest.

Only complete exclusive breastfeeding reduces the chance of pregnancy in the first 6 months after birth.

The more intensive breastfeeding (frequent, at the request of the child, attachment to the breast up to 10 times, feeding both day and night with night breaks of no more than 6 hours, feeding with both mammary glands), the longer the period of inability to fertilize and the less often pregnancy occurs before the onset of menstruation.

When does the MLA stop working?

Although with a high frequency of exclusive breastfeeding, the ability to fertilize after menstrual bleeding still significantly suppressed, the appearance of menstruation remains the most reliable sign restoration of fertility.

As the number of months after childbirth increases, the risk of ovulation gradually increases until menstruation resumes. After six months, the use of only the lactational amenorrhea method as a contraceptive is unacceptable. The six-month milestone was also chosen because by this time mothers are recommended to feed the child. He begins to be weaned, which leads to an increase in the intervals between feedings, which means an increase in the risk of a new pregnancy.

LLA as a method of contraception differs in that its reliability can be discussed only under certain conditions: absence of menstruation, exclusive breastfeeding, the age of the child is less than 6 months. Pearl Index (number of unplanned pregnancies in 100 women using this method during the year) in this case is 2. For comparison: when using condoms, it is 14. Even with the use of a hormonal drug, a purely progestin "mini-pill", recommended in the postpartum period, the Pearl index is 5. If after using LLA for 6 months after childbirth, the woman remains amenorrhea and continues to breastfeed before each feeding, then it becomes possible to extend the LLA to 9-12 months. The Pearl Index in these cases is 3-6.

Disadvantages of the method

In the event that any of the three necessary conditions the use of LLA is not performed (there is a resumption of menstruation, breastfeeding is irregular or a child older than 6 months), it is necessary to timely switch to other methods of contraception that do not affect lactation and the development of the child.
The duration of protection is limited to 6 months.
There is no protection against sexually transmitted infections.
The reliability of the method depends on compliance with the rules of breastfeeding. Today, the socio-biological status of a woman has changed, her role in society, politics, and business has increased. The principles of exclusive breastfeeding are not always applicable if the mother is working or studying.

When can I resume sexual life?

During the first 6-8 weeks after childbirth, sex life should be limited, since at this time the woman's body is recovering after childbirth. In the uterus - in the area of \u200b\u200bthe site to which the placenta was attached, there is an extensive wound surface, so-called are allocated from the genital tract. The cervix, the body of the uterus are reduced gradually, do not immediately acquire prenatal dimensions. Immediately after childbirth, the cervix remains fairly short, the cervical canal leading to the uterine cavity is open. All these conditions are a predisposing factor for infection of the uterus in the postpartum period. Therefore, after the postpartum discharge stops (this happens just after 6-8 weeks), you need to consult a doctor. Only after the examination can you get permission to resume sexual activity.

Advantages of the method

The use of MLA is controlled by a woman, this method cannot be attributed to a typical medical procedure, it does not require medical supervision.
MLA is effective method contraception used after childbirth, which not only improves breastfeeding, but also provides a timely transition during lactation to the use of other contraceptives.
The method favorably affects the health of mother and child. Children who received exclusively breast milk are less likely to get sick in childhood, and in adulthood are less susceptible chronic diseases, cancer, blood diseases.
The mother has a reduced risk of postpartum inflammatory diseases uterus, lactation is a means of preventing breast cancer.

So, as we can see, the method of lactational amenorrhea can be used as a means of contraception only from the 1st to the 6th month of the postpartum period, with careful observance of the rules of breastfeeding "on demand". In other cases, it is necessary to use other methods of contraception.

Ludmila Petrova
Obstetrician-gynecologist of the highest category,
manager maternity department maternity hospital No. 16,
Saint Petersburg
Article from the magazine "9 months" No. 7 2006

Not every young mother plans right after giving birth next pregnancy. In addition, in the near future, pregnancy is undesirable for a woman's health. Therefore, the need for control of sexual life and contraception becomes obvious.

The need for contraception after childbirth

After the birth of a long-awaited baby, many mothers are completely immersed in the atmosphere of household chores and caring for the child, sometimes forgetting about contraception. But the onset of a new pregnancy in postpartum period young families most often do not plan. Yes, and gynecologists recommend to refrain from a new pregnancy for 2-3 years after childbirth. Only after this period the woman's body will fully recover and she will be able to easily endure the next pregnancy without getting any complications for herself or the fetus.

A young mother may not notice the onset of pregnancy, because there is no menstruation when breastfeeding. This is how weather children are born. According to experts, more than 85% of such pregnancies in Russia are the result of ignorance or careless attitude of the family to protection in the postpartum period.

Sometimes it happens that because of an unplanned pregnancy, a woman decides to have an abortion, which negatively affects her health. New parents should pay more attention to contraception after childbirth. However, not all contraceptives are suitable for a nursing mother, as some get into milk and affect its amount or can harm the baby.

lactational amenorrhea

Many mothers are sure that it is impossible to get pregnant during breastfeeding. However, gynecologists warn about the need for contraception when breastfeeding immediately after the onset of sexual activity. The body of each woman is individual. And, indeed, the lactational amenorrhea method works in 99% of cases in the first six months of breastfeeding.

The lactational amenorrhea method is natural way protection from pregnancy, which is based on the absence of ovulation in a woman during breastfeeding.

A 6-month-old baby begins to introduce complementary foods, which means that there are fewer and fewer breastfeedings. The level of hormones responsible for ovulation in a woman gradually increases, the chance of getting pregnant becomes several times greater. The lactational amenorrhea method is recommended to be used only until the child is 6–7 months old and subject to the following conditions:

refusal of supplementation and complementary foods;
breastfeeding at night;
feeding on demand;
absence of menstruation.

Even with all the rules, breastfeeding cannot be considered 100% contraceptive method in the postpartum period. His contraceptive effect getting smaller every month. The likelihood of pregnancy in the future depends on the characteristics of the body of each individual woman.

Methods of contraception after childbirth

The main rule when choosing contraceptives is that they should not penetrate into milk in large quantities and influence the child. Some of them are also unsafe for a woman's body that is not strong after childbirth. Acquainted yourself with various methods contraception, it is still worth consulting with a specialist. The gynecologist will help the nursing mother choose the option that will be safe for her, affordable and convenient.

Hormonal methods of contraception

Hormonal remedies for pregnancy act on endocrine system women, excluding the possibility of conception.

Subcutaneous implant

The contraceptive is inserted under the skin in the woman's upper arm. This manipulation is simple - it is carried out by the doctor within a few minutes. The size of the implant is approximately 4 cm. The hormonal implant works about three years and gives a guarantee of protection for 99-100%. Its action is based on the daily even injection of artificially created hormones into the woman's blood. They block the release of eggs from the ovaries. This contraceptive can be installed 3 weeks after the birth of the baby. If more time has passed after childbirth, then it is necessary to use other means of protection against pregnancy (uterine caps, suppositories) for seven days after the installation of a hormonal implant. The contraceptive does not negatively affect the quantity and quality of milk, therefore it is possible for use by nursing mothers.

The implant protects against unplanned pregnancy for about 3 years

Contraceptive injections

They begin their action after one injection. The effect continues for three months. Then the procedure must be repeated.

Most women in Russia have not yet encountered contraceptive injections, while abroad they have already gained great popularity. Over the past 15 years, more than 8 million people worldwide have taken advantage of such injections.

The action of injections is based on the introduction to a woman of a substance obtained from natural hormone progesterone. The hormone suppresses ovulation, causes the cervix to thicken and increase the amount of cervical mucus, which interferes with the movement of sperm. The injection has high efficiency and protects against unwanted pregnancy by 99-100%. A contraceptive injection is given to a woman in medical institution once every three months on the fifth day monthly cycle. The drug is injected intramuscularly into the buttock or shoulder. It does not contain estrogen, which means it does not negative impact for lactation.

Contraceptive injection should be given once every three months

Intrauterine device (IUD)

This is a small plastic device, T-shaped or otherwise, that contains hormones or copper. It inhibits the entry of spermatozoa to the egg and reduces its lifespan, and in case of fertilization, it prevents the zygote from attaching to the walls of the uterus.

The intrauterine device has abortive effect, that is, in many cases, fertilization occurs, but due to the presence of the spiral, the egg cannot be accommodated in the uterus and dies. IUD is installed only gynecologically healthy women with a regular menstrual cycle. Only a gynecologist can put or remove it. With absence adverse symptoms or discomfort in a woman, the spiral can perform its function from 5 to 7 years. For nursing mothers, the installation of such a contraceptive is possible 5-6 weeks after childbirth. For women who have undergone C-section, it is necessary to postpone the installation of the spiral until 6 months after childbirth. This method of protection against unwanted pregnancy does not affect lactation.

The intrauterine device can serve from 5 to 7 years

mini pili

Mini-pills are hormonal pills that contain a small amount of progestin (300–500 micrograms). Progestin also serves as an alternative to the progesterone produced by a woman's ovaries. However, mini-pills are different from combination pills. oral contraceptives(COC) small dose active substance and single component. They are more gentle on the body, do not contain estrogens. The active substance of the tablets in a small amount enters the child with breast milk, but does not have any effect on him. Also, such contraceptives do not affect the amount of milk produced.

The action of the mini-pill is based on the ability of the agent to change the consistency of the cervical mucus. The secretions become thicker and more viscous, thereby preventing the penetration of spermatozoa into the uterus. Also, the drug reduces the ability of the egg to move through the fallopian tubes towards the sperm. Substances contained in the mini-pili contribute to changes in the endometrium: even if fertilization has occurred, the zygote cannot attach to the walls of the uterus. But most often this effect is achieved only when taking a mini-pill for several months.

Mini-pills do not affect lactation

Mini pills include:

Combined oral contraceptives (COCs)

COCs, unlike mini-pills, contain estrogen. Their use after childbirth is permissible only in a few cases:

if there was no lactation initially;
if lactation has already been completed.

Combined contraceptives have a two-component composition and, in addition to protecting against conception, can treat any gynecological diseases women. You cannot make the decision to take COCs on your own. Must pass full examination, after which the doctor will be able to prescribe contraceptives that are right for you. When properly selected combined oral contraceptives are taken daily, following the instructions, a 99-100% contraceptive effect can be achieved.

Emergency contraception while breastfeeding

Emergency protection against unwanted pregnancy is used infrequently, as it contains a huge dose of hormones and has a strong effect on the body. Tablets can be used in for three days after sexual intercourse, when other methods of protection (candles, condoms, caps, etc.) were not used or did not help. During this time, it is advisable to consult a gynecologist.

Emergency contraception after sexual intercourse is contraindicated in women who are breastfeeding. This is due to the fact that such drugs contain a very large amount of substances that affect the quality of milk and get along with it to the baby. IN emergency situations Postinor 2 can be relatively safe for lactating women. However, after taking it, it is necessary to stop feeding for 10 hours.

According to studies conducted with breastfeeding mothers, it was found that maximum amount active ingredient Postinora 2 is achieved three hours after ingestion. The half-life shows different time: 10 to 48 hours.

The active substance of Postinor 2 is levonorgestrel. It has these features:

inhibits the growth of the endometrium, which does not allow the zygote to gain a foothold in the uterus;
contributes to the inhibition of ovulation, due to which the mature egg does not enter the fallopian tube;
promotes thickening cervical mucus which prevents sperm from reaching the egg.

The drug is not suitable for regular use. Frequent use Postinora 2 can provoke pain and bleeding in a woman. Also for drugs emergency contraception include:

As the main contraceptive, emergency contraceptives are not suitable, as they carry a large burden on the body. These medicines have an abortive effect, but the time to stop breastfeeding for each drug is different:

Escapel, according to some experts, is absolutely safe for infants. It contains levonorgestrol, which is rapidly excreted from the body. If you do not attach the child to the breast for 5-7 hours, the substance will enter into children's body in a safe amount. Escapelle is taken 1 tablet before the expiration of 3 days after unprotected intercourse.
Contraceptives Genale and Ginepriston are very strong hormonal preparations, the entry of which into the body of the baby can cause serious violations in the functioning of his body. Therefore, after taking such contraceptives, it is necessary to stop breastfeeding for 14 days.
When taking Miropristone, experts recommend abolishing breastfeeding for three days.

Photo gallery: emergency contraceptive drugs

The active substance of Ginepristone - mifepristone Escapel is quickly excreted from the body of a woman.
After taking Genale, it is necessary to stop breastfeeding for two weeks.
If you had to take Miropriston, then for the safety of the baby, lactation is recommended to be canceled for three days. After taking Postinor 2, it is recommended to stop breastfeeding for at least 10 hours

barrier method

Barrier methods of contraception include condoms and silicone caps. These means of protection against unwanted pregnancy mechanically prevent sperm from reaching the uterus, where fertilization can occur.

condoms

The condom is put on immediately before the actual sexual intercourse on the male genital organ in an erect state. He retains the male seed inside himself and does not allow him to get inside female body. The effectiveness of protection against unwanted pregnancy is 96–99%. Disadvantage - the possibility of rupture when strong impact on him. Unlike many other contraceptives, a condom protects both a woman and a man from various diseases sexually transmitted. The condom is the simplest and available method protection against pregnancy, which has no contraindications when used during breastfeeding.

Uterine cap

It is most often made of silicone or latex, has the shape of a cup or hemisphere. The cap is a reusable tool, the service life of which can reach from one to two years. The contraceptive cap is worn by a woman on her own on the cervix and closes the passage for spermatozoa. It does not protect against sexually transmitted infections. The effect in protecting against pregnancy of the cap depends on the correctness of its selection and introduction inside.

Contraceptive cap can be used repeatedly

Without harm to health, the contraceptive cap can be left inside for 35-45 hours, after this time an unpleasant odor may appear.

Before inserting the cap into the vagina, it is necessary to check it for cracks and tears, then wash your hands thoroughly. For the greatest effect it is recommended to use a spermicidal gel, which fills the cap a little less than half. The contraceptive is then inserted deep into the vagina, where it attaches to the cervix. It is most convenient to do this with medium or index finger squatting or lying on the bed.

The advantage of the cap is the possibility reusable. After intercourse, leave the cap inside for at least another six hours: a quick removal may allow the remaining sperm to enter the uterus. You also need to take out the cap with pre-washed hands, taking a position that is comfortable for you. After removing the contraceptive, rinse thoroughly and dry. The uterine cap has no contraindications for use during breastfeeding, does not adversely affect the condition of the mother and child. However, after childbirth, you should refrain from using such a remedy for at least 4 months, until the cervix takes a permanent shape.

It is necessary to insert and remove the cap with pre-washed hands.

Sterilization

Sterilization is a surgical, in 99% of cases, irreversible method of contraception. Its essence lies in mechanical action on the fallopian tubes, as a result of which their obstruction is created. Do this in one of four ways:

Removal of part of the fallopian tube.
Moxibustion fallopian tubes with the help of current, as a result of which scars appear in the tube, preventing the movement of the egg and sperm towards each other.
Tubal ligation - tying the tubes and fixing them with a clamp, which subsequently resolves on its own.
Clamping of pipes - overlapping of pipes with the help of clamps. The advantage of this method is that later such clamps can be removed.

With a properly performed operation, protection against pregnancy is 100% guaranteed. Since in most cases such an effect is irreversible, a woman needs to weigh the pros and cons of this procedure before using it. Typically, the operation is performed on women who already have and do not want to have more children. It is also indicated in cases where pregnancy can be harmful to health. A woman must be consulted about the methods of sterilization and given an explanation about the irreversibility of the method, after which she must sign documents on her consent to sterilization.

If necessary, using the operation, the clamp can be removed from the pipe

Conditions for sterilization:

complete examination of the physiological and psychological state women;
the absence of health contraindications for surgical intervention, for example, sexually transmitted diseases, oncology, psychological instability, etc.;
the woman is over 18 years of age;
a healthy woman should have at least one child;
the woman must not be pregnant;
written consent of the woman to the operation.

Natural family planning methods

The calendar method of family planning is the cheapest and most natural way to avoid unwanted pregnancies. It consists in controlling the menstrual cycle and calculating the days when the conception of a child is possible and when it is excluded. On days when a woman cannot become pregnant, it is possible to have unprotected sex. On the days of ovulation or the days closest to it, pregnancy can be avoided by excluding sexual intercourse, or by using contraception. This method of protection is not contraindicated for nursing mothers, but is only suitable for women who have regular and stable cycle, otherwise the calculations are not fertile days will be incorrect. For the correct calculation of safe days, an ovulation calendar will help.

In addition to the ovulation calendar, body signals such as:

daily readings of body temperature increase by 0.4 - 0.6 degrees;
daily discharge from the vagina becomes very abundant, sometimes there may be a one-time slight selection blood;
increased libido;
pain lower abdomen;
prolapse and opening of the cervix;
breast tenderness.

It is important to be guided by both the ovulation calendar and the symptoms of the body so that the natural method of family planning works at 99 and 100%. Given the fact that people can make mistakes, be forgetful or inattentive, natural family planning provides only 75-80% protection against unwanted pregnancies.

PPA method, or coitus interruptus - another type natural contraception. Its essence lies in the fact that the man manages to get the penis from the woman's vagina before the moment of ejaculation. This method is unreliable. Doctors do not recommend using it, since often spermatozoa are in the secretions even before the moment of ejaculation, or the man may not have time to remove the penis. Of course, using such a method is better than not using any. However, it is worth knowing that in addition to the unreliability of contraception, it can bring psychological discomfort both partners and the fear that the man will not have time to get the penis before ejaculation.

Chemical contraception

TO chemicals protection against pregnancy include gels, suppositories, creams and aerosols. Such contraceptives, due to their active substance, destroy spermatozoa, bacteria and viruses. Chemical contraceptives are non-hormonal contraceptives, their action is based on the destruction of spermatozoa and an increase in the viscosity of cervical mucus, which prevents the passage of damaged spermatozoa into the uterus. Chemical contraceptives should only be used before intercourse. The introduction of suppositories or cream after sex does not make any sense, since the spermatozoa have already managed to penetrate into the uterus.

Chemical contraceptives include:

Erotex;
Benatex;
Evitex;
Pharmatex;
Gynecoteks.

Contraceptive suppositories and creams are not 100% protection against pregnancy. It is desirable to combine such contraceptives with other means of protection (condoms, caps). Using only chemical contraceptives provides protection against unwanted pregnancy by 75-90%. Therefore, women who are sexually active should choose other methods of protection.

Since contraceptive suppositories and creams are non-hormonal means, render local action and do not pass into breast milk, their use is possible during lactation. They are suitable for women in case of:

rare sexual intercourse, in the event that the installation of a spiral or reception hormonal pills doesn't make sense;
breastfeeding;
the presence of contraindications for the use of hormonal pills or the installation of a spiral;
perimenopause (the period before menopause, when the production of sex hormones gradually decreases);
additional protection when using a uterine cap or skipping a hormonal birth control pill.

To achieve 100% protection against pregnancy, contraceptive suppositories should be combined with other contraceptives.

It is necessary to introduce a candle 10-20 minutes before sexual intercourse in comfortable position(lying down or squatting). During this time, she will have time to melt, evenly distributed throughout the vagina and begin its action. Within 3 hours after using the candle, you should not wash yourself with soap, as soap can neutralize the spermicide and its action will be ineffective.

Contraceptive creams, gels and aerosols have the same properties and protection parameters as a candle. Their essential difference from each other is only in the form of release.

Most often, a tube with a special tip comes with the cream. It is also necessary to introduce the cream in advance - 10-15 minutes before sexual intercourse. With frequent use, it can cause vaginal dryness and lead to dysbacteriosis, so regular use of the cream is not recommended. Another disadvantage of the cream is that when interacting with water and soap, its protective properties are lost. Washing immediately after sexual intercourse or having sex in a pool can neutralize its effects.

Contraceptives Pharmatex are available in the form of a cream, tablets, suppositories.

The medical term "lactational amenorrhea" refers to the natural delay of the menstrual cycle during lactation, in the people this process is called "replacement".

What is lactational amenorrhea

When a woman breastfeeds her baby, the body intensively produces the hormone prolactin, which prevents the production of follicle-stimulating hormones. Consequently, the follicles do not mature and ovulation does not occur.

It is important to know! If for some reason the baby is fed exclusively with mixtures, the first menstruation should come no later than 8 weeks later. A delay of more than three months is a reason to contact women's consultation.

When wondering whether it is possible to get pregnant during lactation, women often face a variety of assumptions from friends and relatives. The period of lactational amenorrhea can be different: from 2 to 14 months.

Changes in the body can be caused by the influence of various factors, to avoid the sudden restoration of the menstrual cycle will help compliance with the rules for the effectiveness of lactational amenorrhea.

Rules of effectiveness for lactational amenorrhea

There are a number of rules to improve the effectiveness of lactational amenorrhea. clear understanding biological processes in the body will allow a woman to better control them.

Extend the replacement during lactation and minimize the chance of getting pregnant possible subject to simple rules, but each mother decides for herself whether to observe them:

feeding a newborn baby according to his every demand, and not according to the standard hourly schedule;
shorten intervals between feeding to the minimum, the night break should not exceed 5 - 6 hours;
refuse from introducing any complementary foods into the child's diet, it is also advisable to abandon the pacifier. Even drinking the baby is excluded.

Is it possible to get pregnant during lactation

Is it possible to get pregnant unplanned during lactation, or is it exceptional and rare cases, experts of women's consultation know firsthand. This question is shrouded in a mass of myths, for a complete understanding it is necessary to turn to scientific and medical data.

Is it possible to get pregnant during lactation - young mothers are often interested in this question

During lactational amenorrhea, fertilization of the egg is impossible, therefore there is a misconception that it is impossible to become pregnant while feeding a newborn. This fact cannot be denied, but there is still no absolute guarantee.

The essence of the phenomenon is quite simple: when a woman begins to introduce complementary foods or does not follow other rules of effectiveness in lactational amenorrhea, prolactin production decreases.

The menstrual cycle begins to recover and ovulation occurs. These changes are almost impossible to feel physically, but the body is already fully prepared for the next conception.

As you know, ovulation precedes the first menstruation in a short period of time. It is quite difficult to determine whether the replacement has stopped during lactation or not, and it is quite possible to become pregnant during this period.

After that, other processes begin to occur in the body, menstrual cycle again suspended for the duration of the gestation, which is mistakenly perceived as a continuation of lactational amenorrhea.

Is lactation compatible with menstruation

The arrival of menstruation during lactation is a common and natural phenomenon. As already mentioned, an increase in the intervals between feeding a child or the introduction of complementary foods leads to the production of ovarian hormones, which ends with ovulation and the arrival of the first menstruation.

Restoration of the cycle, as a rule, falls on the 6th - 7th month of lactation. Usually, by this time, various dry mixes are introduced into the baby's diet. But these are conditional terms, for each woman the process occurs individually, which is largely influenced by the level of effectiveness of lactational amenorrhea.

It is important to know! Contrary to conflicting opinions, the arrival of menstruation does not affect the taste and nutritional properties milk. According to scientists and doctors, menstruation is not a reason to stop breastfeeding.

Often the first menstruation is confused with postpartum discharge . There is nothing to worry about, the uterus is cleaned and restored within two months after childbirth. A common occurrence when bloody issues stop by week 7, but resume at the end of week 8 - this is how the uterus completes the cleansing.

It is these processes that women often confuse with menstruation, expecting their reappearance in a month. Misunderstanding the nature of discharge can lead to misunderstanding or fear about a health condition.

Symptoms of pregnancy during lactation

Bearing in mind that the first ovulation after childbirth comes almost unnoticed, it is useful to know the first signs of pregnancy during lactation. It happens that many women find out about the child already in the middle of the term, when the baby begins to move.

Getting pregnant during lactation is in the order of things, is it possible to find out about this by certain symptoms, will answer medical practice. Experts have identified a number of common symptoms.	The usual symptoms of pregnancy that are observed in women may also be present.
Changes in the consistency and taste of milk, if the child began to refuse feeding for no apparent reason	Nausea or morning sickness
A decrease in milk production also indicates that the body is conserving its resources due to pregnancy.	Frequent urination to the toilet
If uterine contractions become more intense and frequent	Loss of appetite, change in taste needs
Swelling on the chest, pain (if there are no injuries).	Lower back pain
—	Delayed menstruation

If a woman decides on an early pregnancy, feeding the first child should be stopped 1.5 - 2 months before the next birth.

Pregnancy immediately after childbirth - for or against?

Is it possible to get pregnant during lactation, how safe is it for the expectant mother - these are the key questions that a woman should ask after childbirth. If earlier few people thought about it, now everything has changed, and young parents have become more serious about having children.

Pregnancy after childbirth, more precisely, after the normalization of the menstrual cycle, is a complex issue that requires analysis. On the one side experts recommend taking a break and allowing the body to fully restore its strength. In addition, a newborn baby in the first months needs care, attention and timely care.

On the other hand, parents can take such a step quite consciously, due to age or other factors. Nature in this regard also does not set certain restrictions: it is enough to introduce complementary foods to the baby and hormonal background women will begin to change, and the menstrual cycle will begin to recover.

In addition to the enormous burden on all body systems, pregnancy after childbirth often becomes a serious stress for the mother - this must be taken into account.

In that difficult question more “against” than “for”, but the final word should be with the doctors of the antenatal clinic. If it is still possible to fight and overcome nervous loads, then the disadvantage physical health can lead to adverse consequences.

There is another myth that women are often afraid of: lactation provokes premature birth. This opinion has a fairly strong confirmation - at this time, the body produces the hormone oxytocin, which affects the production of milk. But according to the data medical practice,not a single case of miscarriage due to lactation was recorded.

Safe methods of protection during lactation

If emergency pregnancy is not included in the plans of parents, you need to turn to approved contraceptives. The period of lactation, although safe in this regard, does not give a full guarantee, therefore, lactational amenorrhea cannot be used as a reliable method of protection.

Many safe contraception options are available to breastfeeding women:

oral contraceptives, which do not include the hormone estrogen, for example, Charosetta;
condoms - the standard and simplest method of contraception against unwanted pregnancy;
intrauterine device;
various spermicides: creams, suppositories or tablets.

Usually, before the onset of sexual activity after childbirth, a young mother should visit a antenatal clinic and consult a doctor. He conducts an examination, determines whether the genitals have recovered and will definitely recommend suitable precautions. If the specialist does not certain tips, they should be clarified on their own initiative, because this moment is very serious.

We can summarize a little: pregnancy during lactation in the order of things, it has been proven since scientific point vision. A young mother can partially control this process, but one should not lose vigilance if another child is not included in the plans of young parents. It is worth noting that an early pregnancy after childbirth does not always entail serious problems with health.

Video about the likelihood of pregnancy during lactation

Pregnancy during lactation - features in this video:

For information on whether it is possible to get pregnant during lactation, see this video:

Is it possible to get pregnant while breastfeeding, see the answer from a professional here: