Bring on the birth control! That’s what many of us mamas are thinking after pushing out our screaming, crying bundles of joy — and you are right to want to take your time. Pregnancy and childbirth, especially if you had a cesarean, can do a number on our bodies; and rest and recuperation down there is a must. But if you’re breastfeeding, there is a lot to consider when it comes to postpartum birth control: namely, how much milk you make. Which is why you might not want to ask for a refill of the same old pill you took before baby.
Indeed, some birth control options can be detrimental to your milk supply, and doctors say it’s best to avoid them altogether. Any estrogen-containing contraceptive, like combination oral pills, the patch or the shot, are major no-nos. These methods can decrease your supply and cut your production time, according to Dr. Tamika Auguste, obstetrician and professor at Georgetown University Medical School.
It doesn’t mean you should give up on contraceptives entirely. Nor should you rely on breastfeeding alone. Many women swear that breastfeeding itself is a form of birth control, but Dr. Auguste says that relying solely on nursing can be hit or miss – where prescribed contraceptives have a proven effectiveness rate.
“If you consistently breastfeed, then it is a proven method of contraception, however, the qualifier ‘consistent’ is where it varies. Some women who breastfeed only, there’s no way they’re getting pregnant,” Dr. Auguste told Well Rounded. “In other women, it’s not as effective.”
So what’s a breastfeeding mama to do?
You want to focus on the non-estrogen containing methods.”According to Dr. Auguste, the progestin only pill – sometimes referred to as the mini pill – and non-systemic birth control options are great alternatives when breastfeeding.
Non-systemic options include IUDs, implants and rings and are always Auguste’s first suggestions to new moms. Since they don’t contain estrogen and are localized, they have minimal to no effect on milk supply, Auguste said. Plus, they’re long lasting, more convenient and don’t depend on your ability to remember to take them. After all, life with a new baby can be exhausting; and forgetting to take oral contraceptives is potentially just as easy as forgetting to eat anything until the clock hits 5 p.m.
Then there are the barrier methods of birth control: condoms, diaphragms and caps. Dr. Auguste says these are totally fine options when it comes to your supply, but aren’t necessarily as efficient since their reliability really depends on how consistent you are in using them.
“Some women think after a baby, it takes a little while to get going again, and that’s not true,” Dr. Auguste said. “Some women get pregnant the first month after giving birth.” Plus, if you do choose to stick with your previously used diaphragms and caps, you need to have them refitted after pregnancy because the position of your cervix can shift during delivery.
So what birth control should you favor if you are breastfeeding and don’t want to put your milk supply in jeopardy? The progestin pill, the IUD, implants, vaginal rings, condoms and diaphragms are all great options, while you may want to steer clear of estrogen-based and combined pills, shots and patches.
At the end of the day, you are your own boss and decide on the best birth control option for you — based on your preferences, concerns and comfort level. Just make sure to discuss your options and their pros and cons with your doctor before making your choice.