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Contraception while breast-feeding

Friday, December 31, 2004
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When breastfeeding, many types of contraception are safe. A good discussion with your doctor will cover the reliability of each method and the safety aspects for you and your baby. Your doctor will also be able to discuss current research with you, which will assist you in making an informed decision.

Suitable methods for breastfeeding women are:

Abstinence

  • The woman is able to decide whether/when she is ready to resume having sexual intercourse

Condoms

  • A barrier form of contraception
  • Can be used as soon as the woman feels comfortable enough having intercourse
  • If used correctly is effective 95 percent to 97 percent of the time

Mini-Pill

  • A progesterone-only Pill, which is taken at the same time every day
  • Can be started immediately but best to wait until any bleeding has settled, so three to six weeks post-delivery is often recommended
  • Is effective after three pills are taken (48 hours)
  • Efficacy rate is 96 percent to 99 percent

Depo Provera

  • An intramuscular injection taken every 12 weeks.
  • Best to be started six weeks post-delivery to reduce bleeding problems.
  • Is effective in seven days.
  • Efficacy rate is 99 percent or greater.

Implanon

  • A progesterone-only implant. The implant is approximately the size of a matchstick and is inserted in the inner upper arm. It releases progesterone slowly for up to three years (it can be removed before that, if required).
  • Can be started six weeks post-delivery.
  • Is effective after seven days.
  • Efficacy rate is greater than 99 percent.
  • Milk volumes are not reduced and hormonal transfer to the milk is very low when using the above three contraceptive methods.

IUD: copper and Mirena™
Copper

  • The copper IUD is an intrauterine device placed in the uterus during a minor procedure. It works to inactivate the sperm and provide a changed intrauterine environment that prevents implantation of a fertilised egg.
  • It can be placed in the uterus four to six weeks after a normal vaginal delivery and 12 weeks after a Caesarean section delivery.
  • It is effective immediately.
  • A copper IUD lasts for five to ten years and can be removed before this, if required.
  • The efficacy rate is greater than 99 percent.

Mirena™

  • The Mirena™ IUD is an intrauterine device placed in the uterus during a minor procedure. The shaft of the Mirena™ has a progesterone hormone-infused section that releases progesterone slowly over five years. This acts to reduce bleeding which can sometimes be a problem for copper IUD users. The Mirena™ changes the intrauterine environment, thus preventing the implantation of the fertilised egg.
  • It can be placed six to ten weeks after a normal vaginal delivery and 12 weeks after a Caesarian section delivery. The Mirena™ IUS lasts for five years but can be removed before this, if required.
  • It will be effective immediately.
  • The efficacy rate is greater than 99 percent.

Diaphragm

  • A dome-shaped rubber cap with a flexible ring that fits into the vagina and covers the cervix. It acts as a barrier preventing sperm from entering the cervix.
  • It can be used as soon after delivery as is comfortable, but as the birth canal has been stretched for delivery, a fitting is best done at least six weeks after delivery. If a diaphragm were used before pregnancy, a refitting must be done because the shape of the vagina will have changed.
  • Efficacy rate is 85 percent to 95 percent.

Cervical cap

  • A dome-shaped rubber cap that fits directly onto the cervix. It acts as a barrier preventing sperm entering the cervix.
  • It can be used as soon after delivery as is comfortable. The cervix should return to normal state within six weeks after delivery
  • The efficacy rate is 80 percent to 98 percent.

A full discussion with your doctor or local Family Planning clinic will help you to make a decision.

Information kindly provided by Family Planning Victoria.


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