11 Contraception Choices For Post Birth

contraceptionAfter baby arrives, it’s time to think about contraception. Family Planning New Zealand (familyplanning.org.nz) shares info on your options – talk to your LMC or GP about what’s right for you.

 

Barriers

 

Male condom

What is it?

A thin rubber barrier. Best used with lubricant (water based)

How does it work?

Fits over erect penis and catches sperm when the man ejaculates.

Chance of getting pregnant
  • Typically 15% but 2% if used perfectly every time
  • DO NOT USE oil-based lubricant or some anti-thrush creams
Health concerns

None known

Advantages
  • Easy to use, easy to carry
  • Used only when needed
  • Helps protect against STIs
  • Available from Family Planning clinics and other healthcare providers
  • Can buy from pubs, clubs, pharmacies and many shops
  • Cheaper on prescription
Disadvantages
  • Some people are allergic to rubber
  • Must be put on when penis is erect and before sexual intercourse
  • Some people say it reduces sexual feeling
  • Can slip off or break

 

Female condom

What is it?

A thin polyurethane barrier

How does it work?

Goes into the vagina and prevents sperm entering the woman’s body

Chance of getting pregnant

Typically 21% but 5% if used perfectly

Health concerns

None known

Advantages
  • Helps protect against STIs
  • Women can use it
  • Easy to use

Disadvantages

  • Relatively expensive
  • Can be noisy
  • Can get them from the internet
  • Need to insert every time

 

Hormonal contraception

 

Combined pill

What is it?

Pill made of two hormones, oestrogen and progestogen

How does it work?

Stops ovaries from releasing an egg each month

Chance of getting pregnant

Typically 8% but less that 1% if used perfectly

Health concerns
  • Very small chance of blood clots, heart attacks and strokes. More likely in women over 35 who smoke, are obese or have a family history of the above conditions
  • Very slight increased risk of cervical cancer
Advantages
  • Simple and easy to take
  • Doesn’t interfere with sexual intercourse
  • Periods usually regular, shorter, lighter and less painful
  • Less chance of cancer of lining of the womb or ovaries
  • Can be taken up to menopause if a health non-smoker
Disadvantages
  • Should not be used by women over 35 who smoke
  • Must remember to take it daily
  • May have irregular bleeding

 

Progestogen-only pill

What is it?

Pill made of one hormone – progestogen

How does it work?

By thickening mucus in cervix and may stop ovaries from releasing an egg each month

Chance of getting pregnant

Typically 8% but less than 1% if used perfectly

Health concerns

No serious risk

Advantages
  • Doesn’t interfere with sexual intercourse
  • Can be used at any age
  • Can be used by breastfeeding women
  • Useful for women who can’t take combine pill
Disadvantages

May have irregular bleeding

 

Vaginal ring

What is it?

NuvaRing contains two hormones, oestrogen and progestogen. Sits inside vagina

How does it work?

Stops ovaries from releasing an egg each month

Chance of getting pregnant

Typically 8% but less than 1% if used perfectly

Health concerns

Very small chance of blood clots, heart attacks and strokes. More likely in women over 35 who smoke, are obese or have a family history of the above conditions.

Advantages
  • Lasts for 3-4 weeks
  • Useful for those who forget pills
Disadvantages

Should not be used by women over 35 who smoke

 

Depo Provera

What is it?

An injection of progestogen

How does it work?

Stops ovaries from releasing an egg each month

Chance of getting pregnant

Typically 3% but less than 1% if next injection given on time

Health concerns

No serious concerns

Advantages
  • One injection lasts 12 weeks
  • Doesn’t interfere with sexual intercourse
  • Usually no periods
  • Useful for women who can’t take combined pill
Disadvantages
  • Irregular bleeding, no periods or occasional heavy bleeding
  • Periods and fertility take an average of 6 months to return after stopping the injection

 

Long-acting reversible contraception

 

Implant

What is it?

Progestogen is released from 1 or 2 implanted under the skin of the arm

How does it work?

By thickening mucus in the cervix and may stop ovaries from releasing an egg each month

Chance of getting pregnant

Less than 1%

Health concerns

Very small chance of pelvic infection when IUD put in

Advantages
  • Can stay in place for 5 years or more – fit and forget
  • Useful for women who can’t take combined pill
  • Useful for those who forget pills or injection appointments
Disadvantages

Irregular bleeding often gets better with time and can be controlled with medication

 

Intra-uterine device (IUD)

What is it?

Put inside the womb. Copper IUD or progestogen releasing Mirena (IUS)

How does it work?

Stops sperm reaching an egg

Chance of getting pregnant

IUD and Mirena – less that 1%

Health concerns

Very small chance of pelvic infection when IUD put in

Advantages
  • Can stay in place for 5 years or more – fit and forget
  • Doesn’t interfere with sexual intercourse
  • IUS – lighter periods or no period at all, – suitable for women with heavy periods
Disadvantages
  • Needs to be inserted by an experienced doctor or nurse
  • IUD may cause heavier periods or cramping
  • IUS may cause irregular bleeding in the first few months

 

Other methods

 

Fertility Awareness

What is it?

Women checks body temperature, cervical mucus and periods. These body signs show when you are more likely to get pregnant

Chance of getting pregnant

Typically 25% but can be 3% if used perfectly

Health concerns

None

Advantages
  • After learning method, no further costs of visits to health professionals required
  • Helps you understand how your body works
Disadvantages
  • Expert instruction needed to learn method
  • No sexual intercourse during fertile time
  • Must chart temperature and cervical mucus daily
  • Body signs can be difficult to recognise and may vary

 

Emergency contraception

What is it?

Emergency Contraceptive Pills (ECP) or copper IUD used after unprotected sexual intercourse

How does it work?

Delays ovulation or stops sperm reaching an egg

Chance of getting pregnant
  • ECP – 2% for women of average weight, 6% if overweight
  • IUD – less than 1%
Health concerns
  • ECP – none known
  • IUD – risk of pelvic infection of STI present
Advantages
  • Reduces chance of pregnancy after unprotected sexual intercourse
  • ECP – can be used up to 72 hours after unprotected sexual intercourse
  • Can have ECP at home for future use
  • Can be used if other method fails, eg broken condom or missed pill
  • Can buy from pharmacies
Disadvantages
  • ECP should be started within 72 hours of unprotected sexual intercourse
  • ECP may not be effective for heavier women
  • IUD needs to be fitted by an experienced doctor or nurse and can be uncomfortable

 

Permanent Contraception

 

Vasectomy and tubal ligation

What is it?

Permanent contraception. An operation

How does it work?
  • Vasectomy – male tubes cut to stop sperm getting to the penis
  • Tubal ligation – clips put on female tubes to stop the egg getting to the uterus
Chance of getting pregnant

Less than 1%

Health concerns
  • Vasectomy – rare possibility of long-term scrotal pain
  • Tubal ligation – very slight risk from reaction to anaesthetic or damage to internal organs
Advantages
  • Once only
  • Permanent
Disadvantages
  • Not easily reversible
  • Requires an operation
  • May have short term side effects, eg pain, bruising

 

BUMP&baby
BUMP&baby
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