What a new mother’s body needs most after giving birth is recuperation. Getting pregnant again straight afterwards is a great physical strain. The myth that breastfeeding can prevent pregnancy persists, and some women don’t use contraceptives while nursing. But while it’s been demonstrated that prolactin, the hormone responsible for the production of milk, inhibits ovulation, this effect requires very regular breastfeeding, every four hours, for a specific period. Just one longer interval between feeds can lead to a reduction in prolactin levels and the resumption of ovulation. For this reason it’s safer to use additional contraception.
Mechanical methods such as condoms and diaphragms are a relatively good choice. Condoms are particularly suitable, as they can be used immediately after birth and don’t affect the mother’s milk. Diaphragms don’t have a detrimental effect on milk production either, although they must be adjusted by a doctor. Even if a particular diaphragm has been used before, the effects of giving birth on the body are likely to mean it no longer fits afterwards. It should be adjusted and used six weeks after birth at the earliest. A spiral is also suitable, but like a diaphragm shouldn’t be used immediately after giving birth. The uterus has to first involute (return to its prepregnancy size).
If you opt for hormonal contraception it’s important to check the ingredients. Most birth control pills have a combination of the hormones oestrogen and progestin. Oestrogen inhibits the production of milk. Contraceptive patches also use a combination of the two hormones. The alternative is a progestin-only contraceptive, for example mini-pills, hormone rods and hormone spirals.
Natural contraception such as the cervical mucous or temperature method is not appropriate immediately following childbirth. Because of hormonal changes it’s not possible to predict when the woman’s cycle will return to normal. While breastfeeding, most women will find their sleeping patterns are so seriously disrupted that their temperature in the morning is not a reliable enough guide.