Babies on the Coast 01-Nov-2010
When you have just had a baby, usually, the last thing on your mind is immediately having another one! So, to be sure this doesn’t happen again until you and your partner are ready, it’s important to consider the safe contraception options available to you, especially while you are breastfeeding.
Some of you may be thinking “What? Sex in the first few weeks or months after giving birth? Are you kidding?” For many women, intimacy is definitely not high (or even existent!) on their ‘to do’ list once their new baby arrives. A recovering body, sleep deprivation and juggling the needs of other family members usually means most new mums don’t have the time, desire or energy for postnatal sex.
But, for just as many new mums who don’t feel ‘in the mood’ there are many who do. There’s no right or wrong, but for mums who are ready to ‘take the plunge’ but aren’t keen on falling pregnant so soon after giving birth, it’s important to understand that even while you are breastfeeding it is possible to conceive. Thankfully, there are several methods of contraception that are not only effective, but are also considered safe for both mum and baby.
Lactation amenorrhea Method...
Continuous breastfeeding, or the Lactational Amenorrhea Method (LAM), is a popular choice for new mums who want to avoid pregnancy in the immediate months following childbirth. This is mainly because it’s convenient, natural, free, has no side effects and allows for greater sexual spontaneity.
The tricky or important thing to remember is there is an actual method and criteria to fulfil if you want to use breastfeeding as a form of birth control – it’s not, as many have believed, a matter of simply breastfeeding. Continuous and frequent feeding is the key to the likelihood of success.
What does this mean?
For LAM to be successful it’s important to exclusively breastfeed your baby on demand both day and night. This usually means a minimum of six long feeds every 24 hours and not leaving a gap of more than four hours during the day or six hours at night between feeds.
How effective is LAM?
The Australian Breastfeeding Association (ABA) says that exclusive breastfeeding is 98-99.5% effective in preventing pregnancy as long as the following conditions are met:
• Your baby is less than six months old • Your menstrual periods have not yet returned • Baby is breastfeeding on cue (both day and night), and gets nothing but breast milk or only token amounts of other food
How does it work?
Your baby’s suckling stimulates the hormones that suppress ovulation and, because during ovulation is your most fertile phase, your chances of becoming pregnant are significantly reduced. It’s not foolproof though...
The ABA adds that although breastfeeding is an excellent natural method of birth control, it’s not always enough on its own to prevent pregnancy, as was discovered by Coast mum of three, Jenny Manton.
When Jenny’s second child was four months old she discovered she was pregnant with number three, and although she wouldn’t change the circumstances it was definitely a shock to her and her husband.
“I think I was under a misconception because when my first was born, I didn’t take a mini pill and relied on breastfeeding as contraception...I didn’t fall pregnant with number two until later,” she says.
“Not falling pregnant so soon after my first I just assumed I wouldn’t conceive number three while I was breastfeeding.
“I knew there was a slight chance I could [fall pregnant while I was breastfeeding] but didn’t think it would happen because I followed the same breastfeeding routine after the birth of number two as I did for number one.”
Advantages of LAM...
- No side effects
- It’s convenient and free
- You don’t need a prescription
- It’s natural – doesn’t affect your hormone balance
- Breastfeeding has many benefits for mum and baby
Disadvantages of LAM...
- No protection from STDs
- Can only be relied upon for six months from baby’s birth
- Exclusive breastfeeding may be difficult to achieve – especially if mum goes back to work or has other commitments
Natural family planning...
If you like the idea of using your body’s natural rhythms and cycles to prevent pregnancy, another option is the Natural Family Planning (NFP) method. In this method, you track and record your body’s monthly cycle to determine when you are most fertile and when intercourse should be avoided.
It is possible to predict or calculate your fertile phase by a number of methods including the:
- Calendar method
- Temperature method
- Billing’s ovulation method or
- Symptothermal method.
“During the fertile days a couple need to abstain from sexual intercourse or use a barrier method,” the organisation says. “Depending on the individual, sex may need to be avoided for 7-14 days during each menstrual cycle.”
How effective is NFP?
FPQ goes on to say that the effectiveness of NFP relies on motivation, length of time using the method and the type of method used to prevent a pregnancy.
“If used correctly every time, these methods are 75-99% effective,” it says.
“This means if 100 women used these methods, between 1 and 25 could become pregnant in a year. It is more successful for couples who have undertaken training with NFP educators.”
Advantages of NFP...
It’s cost effective. You may have an initial outlay for medical consultations or devices – but once the method is learnt there are no ongoing expenses
It doesn’t interfere with your body’s hormones or menstrual cycle Knowing your body and understanding when you are most fertile can be used to both prevent and achieve a pregnancy
Coast mum Kristy Guest says she has used NFP in the past to achieve pregnancy rather than avoid it, but now that she knows her cycles and is confident when her most fertile times are she feels she can use the same method to prevent another pregnancy.
“At first there was a lot of information to take in and terminology to understand but my GP and friends were really helpful,” she says. “Once I got the hang of it, it was quite simple and worked really well for us.
“But now, (after baby number five!) I can confidently use the method to prevent another pregnancy...for now. It also means I don’t have to take any medication which is great.”
Other choices...
If the LAM or NFP methods don’t appeal to you there are still other options available. Some methods are more effective than others depending on your personal circumstances and health.
If you are considering any hormone based methods of contraception you need to be aware that some hormones will pass into the breast milk. Although the amount is minute, Queensland Health recommends that you discuss the risks and benefits with your doctor prior to implantation. The methods to consider are:
the contraceptive pill...
The combined contraceptive pill (contains both oestrogen and progestin) isn’t usually recommended to breastfeeding mums because it can decrease milk supply. However progesterone-only pills or mini pills are usually safe to use.
Condoms and diaphragms...
Are safe regardless of whether or not you are breastfeeding. They both act as barriers to prevent sperm from entering the cervix. An intra-uterine device (IUD) is another possibility but requires a minor procedure and works by changing the intra-uterine environment and prevents eggs from implanting.
Depo Provera injection...
Is an intramuscular injection that lasts for three months. It is recommended you receive this injection six weeks post delivery to reduce bleeding.
Implanon...
Is a progesterone only implant and is about the size of a matchstick. It’s usually inserted into the inner upper arm and works by slowly releasing progesterone for up to three years, and can be removed sooner if required.
For a more permanent option...
If this was your last planned baby, you may wish to consider a more permanent solution. You can have a tubal ligation (or commonly known as having your ‘tubes tied’) or your partner can opt for a vasectomy.
If you are unsure about the right choice for you and would like to know more about any method of contraception be sure to seek advice from your regular doctor or qualified health professional.
For more information
Australian Breastfeeding Association: www.breastfeeding.asn.au
Family Planning Queensland: www.fpq.com.au
Queensland Health: www.health.qld.gov.au
Medication Helpline: 13 HEALTH (13 432 584)
