- When does fertility return after delivery?
- How soon can you get pregnant after giving birth?
- How long should you wait before getting pregnant again after delivery?
- What are the risks of getting pregnant soon after delivery?
- Contraceptives to decrease the chances of pregnancy after delivery
If you have given birth to a child recently, having another child is perhaps the last thing on your mind. In fact, you’d be eager to get your period back, just to make sure that you are not pregnant too soon.
The common belief is that the chances of getting pregnant soon after delivery are low. But it is simply not true. A woman can get pregnant as early as a couple of weeks after giving birth to a child, even before her first menstrual cycle after delivery.
When Does Fertility Return After Delivery?
Whether you deliver vaginally or via a Cesarean-section, fertility might return in the initial weeks after delivery. The ovulation period, however, may vary among different women.
The first postpartum menstrual cycle may occur without ovulation (which means you may bleed without an egg being released mid-cycle ovulation may happen without a luteal competency(wherein the uterine lining will not be able to support the implantation), or you may ovulate without bleeding at all. However, it is less likely for a woman to ovulate in the initial six weeks after delivery, if she is exclusively breastfeeding at the time. If not exclusively breastfeeding, you may be able to get pregnant.
How Soon Can You Get Pregnant After Giving Birth?
You can get pregnant as early as three weeks after delivery, even if you haven’t gotten your period. While it is typical for you to get your period five to six weeks after delivery your ability to get pregnant may also depend on how frequently you are breastfeeding your newborn as mentioned above(1).
[ Read: Periods After Cesarean Delivery ]
Breastfeeding And Fertility
Breastfeeding is a natural contraceptive. If you are exclusively breastfeeding, then the secretion of the luteinizing hormone that triggers ovulation is suppressed. So frequent exclusive breastfeeding can delay the onset of periods for the first six weeks to even six months after delivery (2).
Many women experience bleeding or spotting that later decreases at 2-3 weeks after delivery, indicating the healing of the site where the placenta was attached to the uterus. In others, periods might only return after weaning from breastfeeding, but may still be irregular.
Breastfeeding or not, you need to use contraceptives to prevent an unwanted pregnancy. Talk to your doctor to know how soon you can be on contraceptiion after delivery. There are multiple forms of birth control available and many that are compatible with breastfeeding.
How Long Should You Wait Before Getting Pregnant Again after delivery?
The American Congress of Obstetricians and Gynecologists (ACOG) recommends couples to wait for at least 18 months to five years to have the next baby. However, women over 35 years and those with fertility problems could benefit from a shorter interpregnancy interval (4). If you think you should get pregnant sooner than later, discuss your plans with your obstetrical care provider to determine the best timing.
Spacing the pregnancies right allows your uterus to recover sufficiently. Also, it gives the body enough time to replenish the lost nutrients that are needed to support the next pregnancy.
Getting pregnant before the recommended time, especially within six months post delivery, can give rise to various complications (5), especially if you delivered via Cesarean section.
What Are The Risks of Getting Pregnant Soon After Delivery?
The risks of getting pregnant soon after delivery include (6):
- Uterine rupture or dehiscence, especially in women attempting for vaginal delivery after a C-section.
- Preterm birth
- Low birth weight or small for gestational age infant
- Placental abruption
[ Read: When Is The Best Time To Get Pregnant ]
Contraceptives You Can Use After Pregnancy
Here is a list of contraceptives that can prevent the chances of conception soon after delivery:
1. Lactational Amenorrhea Method (LAM) (2)
Studies prove that breastfeeding is the most effective and natural method of contraception. However, this method can be effective if:
- Your menstruation cycle hasn’t returned
- Your baby is less than six months old
- You are exclusively breastfeeding the baby, without a long gap between each feed.
The failure rate for this method is 0.45% when the conditions are met.
2. Short-Acting contraceptives
If you plan to have another baby within a year after giving birth, then choose short-acting contraceptives such as:
i. Combined oral contraceptive pill (COCP)
This pill, which is a combination of progesterone and estrogen, prevents ovulation. It is considered safe since it has few side effects and also prevents heavy bleeding. A pack contains 21 pills, which should be taken every day at the same time as long as you do not want to conceive.You can regain your fertility after you stop taking the pills.
There are some contraindications to taking combined hormonal contraception. It is recommended that you have a discussion with your OB/GYN regarding whether hormonal contraception is right for you.
ii. Progestogen-only pill (POP)
This contraceptive pill contains only progesterone. The POP pill prevents conception by thickening the cervical mucus to stop the sperm from entering the female reproductive tract. Also, it decreases the chances of implantation by thinning the womb lining. If taken properly, this pill can be 99% effective (7).
These pills have to be taken every day at the same time, regardless of your sexual activity, and could cause irregular periods.
iii. Contraceptive patch
It comes in the form of a patch and is similar in composition to COCP. This transdermal patch, when applied to the skin, releases synthetic estrogen and progestin hormone into the body. Like contraceptive pills, the patch prevents conception by preventing ovulation, thickening the cervical mucus, and thinning the womb lining.
The contraceptive patch is more convenient than pills and is more than 99% effective when used properly (8).
[ Read: When Do Women Get Pregnant Easily? ]
iv. Barrier methods
Barrier methods could be male or female condoms that prevent the sperm from entering the uterus. They are safe to use and don’t affect fertility either. The only concern is that these contraceptives are not as reliable as the others.
2. Long-acting contraceptives
If you are planning not to have another child until your baby is some two to three years old then, go for these contraceptives.
i. Contraceptive injection
Contraceptive injections are progesterone injections that inhibit ovulation. This is also known as Depot Medroxyprogesterone Acetate depo shot, which is injected once in every 12 weeks.
If you want to conceive, stop taking the shot at least a few months (usually six months or one year), as the body needs a long time to come out of the effect of this contraceptive (9).
The injection can result in irregular periods and loss of bone density over time.
ii. Contraceptive implant
An implant is a small flexible tube that is inserted under the skin on your upper arm and slowly releases progesterone into the body to prevent ovulation. It also thickens the cervical mucus and causes thinning of the womb lining. The implant lasts for three years and is more than 99% effective if properly implanted (10).
The implantation must be done by a doctor, nurse or a trained professional. Getting irregular periods is one of its disadvantages.
iii. IUD (Intrauterine device)
An IUD is a T-shaped device inserted into the uterus to prevent the sperm from reaching the egg. If by any chance the sperm meets the egg, then this device will prevent the implantation of the egg on the uterine wall. An IUD can be a copper IUD or a hormonal IUD. This contraceptive method is about 99% effective and can be inserted six weeks after delivery (11). An IUD works for up to ten years.
Generally, the IUD comes with a small risk (about 1 %) of infection and also a risk to the uterus (about 1 in 1000 women). Copper IUD can cause heavy bleeding or rarely an allergic reaction, whereas a hormonal IUD can cause irregular or light bleeding.
You may stop using the contraceptives when you are ready for another pregnancy. Talk to your doctor to know the right time. Since the body goes through a lot of stress during delivery, it is important to give it some time to regain its stability and fertility.
[ Read: Tips To Improve Chances Of Pregnancy ]
If you want to have intercourse soon after the arrival of your baby, but without the risk of getting pregnant, use a birth control method that suits you.
Do you have any experience to share? Let us know in the comments section below.
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