Birth-control Options

Contraception is something you will want to think about, whether you are pregnant, have just given birth or are planning to fall pregnant. Some of the options and how they work.

It may seem odd to think about contraception when you are pregnant, but having a plan in place gives one less to worry about when your world becomes crammed full, as you care for your newborn baby. There are new factors which will influence your choice of contraceptives immediately after childbirth. And if pregnancy is something you hope will be on the horizon, you need to know how these contraceptives might affect your return to fertility. Every woman is unique and needs a contraceptive method to suit her. Find a practitioner you feel comfortable with to discuss the options.

From this information, you should consider the following:

  • how effective will this method of contraception be?
  • how safe will it be?
  • will it suit my lifestyle?
  • will it be reversible?
  • will it prevent me from contracting sexually transmitted diseases?

Your practitioner will give you advice based on various factors such as your age, your weight, your blood pressure, whether you smoke, what medications you take and specific medical conditions. You could discuss risk factors and possible side effects. Based on this you – and your partner, if possible – will be able to make a choice that suits you best. The contraceptive choices you may want to consider include hormonal contraceptives (oral, injections, patches and intra-uterine devices or IUDs with hormones), barrier contraceptives (IUDs and male or female condoms, sterilization (male or female) and natural methods (the rhythm method and breastfeeding as a contraceptive option).

“Every woman is unique and needs a contraceptive method to suit her. Find a practitioner to discuss the options with…”

What if I want to fall pregnant?

The effects of most methods of contraception – excluding, of course, sterilisation – end soon after you stop using them. With oral contraceptives – the pill – the return to fertility is varied. It can be quite rapid (think of the stories of women who’ve missed a pill or two and fall pregnant) or can take up to 12 weeks. As for IUDs, whether you have been using an ordinary IUD or one which re eases hormones, the return to fertility after it is removed is virtually immediate.
However, with hormonal injections, there is a distinctly recognized delay of between two weeks and nine or so months, says Dr Margaret Moss, head of Contraceptive and Sexual Health Services at Groote Schuur Hospital, Cape Town.

What if I have just given birth?

The need for contraceptives depends on when sexual relations are resumed. This depends on your cultural traditions – and you. Quite frequently, a new mothers biggest desire is seep.
It is a myth that until you get your first period (after giving birth) you can’t fall pregnant,’ emphasizes Dr Moss. ‘You ovulate before your period, so you could get pregnant then. Contraception is a priority if you don’t want to fall pregnant right away.’

Is breastfeeding a contraceptive?

Breastfeeding can be used as a reliable method of contraception, under a specific set of circumstances. You need to be fully breastfeeding – that is, feeding your baby regularly day
and night and not using any supplementary feeds; you must not have had a period and your baby must be less than six months old. — every woman is unique and needs a contraceptive method to suit her. Find a practitioner to discuss the A options with — If these three criteria are met, says Dr Moss, then there is about a two percent contraceptive failure rate.

Do contraceptives affect breastfeeding?

Contraceptives that can affect breastfeeding are those containing oestrogen Hormonal contraceptives are either combination’s of progestogen (an artificial progesterone) and
oestrogen, or contain progestogen only. Four types of hormonal contraceptives are available: the pill, injections, patches and one sort of IUD. Oestrogen and progestogen together are found in combined contraceptive pills and patches, while all the others contain progestogen only. ‘In the case of breastfeeding mothers,’ says Dr Moss, ‘we prefer to avoid oestrogen because it can suppress lactation. Once lactation is well established, you can use a low-dose combined pill.’ If you do notice a decrease in milk supply after starting a hormonal   contraceptive, speak to your practitioner about it. It might be better in some instances to use oral contraceptives or patches in preference to injected contraceptives. With the injected ones, the hormones slay in your body for between eight and 12 weeks, depending on which injection you have been given. You can stop using oral contraceptives and patches more quickly. The IUD could also be taken out timeously by your physician. Generally women will be given hormonal contraceptives once they have gone through threir six-week  postpartum checkup, so if sexual relations have resumed before this time,it is worth considering other contraceptive methodsin the meanwhile.

What other contraceptive methods are there?

A much maligned but cheap and reliable contraceptive – if used correctly and consistently – is the male condom. ‘It should never be excluded as effective and additional protection says Dr Moss. There is no worry about artificially changing your hormone levels and, best of all, it prevents sexually transmitted diseases, including HIV. Condoms can be used in addition to other contraceptives: your contraceptive use can have bells and whistles, as Dr Moss puts it. And if there is some mistake, for example if the condom slips, then you can buy an emergency contraceptive pill. Natural lubrication in women may be reduced at this time, but lubricants are available at pharmacies. Another under-utilised contraceptive is the IUD. You also get lUDs which do not release hormones. Both types are small plastic devices a physician would place in your uterus, and these can be left in place for many years.


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