MAKING THE RIGHT CHOICE
First things first, it does make sense to have a fair idea of how quickly you want your family to grow after having your first baby. While there doesn’t need to be a solid plan with certain terms, it would make your life much simpler if you and your partner are on the same page about how and when you’d like to expand your family. Once you’ve got that figured out, choosing a birth control method can become a lot easier and less messy. Dr Ghosh sheds some light on the various options available. She explains that contraception methods can be broadly categorised into two classes:
Barrier methods: This method prevents the sperm from reaching the egg and often do not interfere with your hormones, affect your lactation or have any signifi cant side effects. The most commonly used barrier methods are:
2. Cervical cap
Hormonal methods: These birth control measures use synthetic hormones to suppress ovulation, increase the viscosity of cervical fluid to prevent the sperm from reaching the egg and obstruct the implantation of the egg in the uterus. While these methods are highly effective and are available only on prescriptions, they do not provide any protection from STDs. These include:
1. Combined pill or the contraceptive patch
2. Contraceptive vaginal ring
3. Contraceptive implant
4. The birth control shot every three months
Apart from these options, intrauterine devices (IUDs) are also considered to be an effective method for long term protection. IUDs can be inserted immediately after vaginal or caesarean birth in about four to six weeks. Couples who have completed their family may decide for one of the partner to be sterilised. Tubal ligation (to cut and tie the fallopian tubes) is the most common method of sterilisation amongst women. Men can opt for a vasectomy, which involved cutting the tubes that carry the sperm from the testes, is cheaper, easier and safer than female sterilisation.
“While there is probably not one single gold standard when it comes to birth control after having your first baby and finding a reliable method is not always easy, using a long-term reversible contraception method such as intrauterine device or progesteroneonly pill are nowadays suggested by many doctors. Having protected sex using condoms is also something that most doctors would recommend. Also, oral contraceptives are most commonly used by young women in our country, whereas patches and implants are the methods that are not usually used in India,” adds Dr Ghosh.
BREASTFEEDING: A NATURAL CONTRACEPTIVE IN ITSELF?
While many mothers decide to nurse their child, others opt out. Breastfeeding is believed to offer some protection and is known to suppress fertility, and is often an appealing method of contraception in the first few months after delivery. They have a name for it as well; lactational amenorrhoea (LAM). “Breastfeeding can help to delay the fertility cycle when you start ovulating or having periods after the birth of your first child. However, if you want to follow the LAM method, you must be ready to breastfeed exclusively and regularly. LAM can be up to 98 per cent effective in preventing pregnancy, and the effectiveness lasts up to six months after the birth,” advises Dr Ghosh.
Nevertheless, be mindful of the fact that breastfeeding is but only a short-term option and becomes less reliable once your baby starts on solid foods. There’s another glitch as well—you’re not protected after you get your first postpregnancy period. However, since you wouldn’t know that you have ovulated until your period, there’s a huge possibility of you getting pregnant if you’re not using any other means of contraception. Another aspect to consider is the choice of contraceptives if you are breastfeeding your baby. Dr Ghosh explains that it is advisable for nursing mothers to refrain from hormonal methods such as combined pill, patch or the shot, since these routes involve the use of estrogen which can enter the milk as also decrease the production of breast milk.
WHEN IT COMES TO DECISIONS
While the availability of choices might seem overwhelming, asking yourself a few questions can simplify things. Often the simplest things make the most notable difference in deciding.
● Finances count: It’s inarguable that money matters and for most couples, cost has been a deciding factor since many forms of contraception may be out of budget. While most resort to condoms or pills because they are comparatively cheaper than IUDs or implants, they might eventually cost you more in long term. IUDs or implants do cost higher than condoms or pills, but the protection does last longer. Make sure you discuss all your options and doubts with your doctor before you decide.
● Feeding your baby: It’s best to stay away from estrogen-based methods if you are planning to nurse your baby. Certain types of oral contraception, such as the mini pill, as well as implants and IUDs are safe for breastfeeding, but combination pills are out.
● Family Planning: If you want to expand your family then you need to speak to your partner about it. In this case, if you are on barrier method, you’d need to make the necessary arrangements to be able to conceive again. Consider how long a method remains effective before you buy it— you wouldn’t want to pay for a pricey three-year method only to remove it a few months later.
Finally, don’t shy away from speaking to your doctor about the various options that you could consider after having the baby. Also, a little homework on your part will go a long way. Remember, it’s your decision and your choice. ■
Women often start ovulating in less than 25 days after having a baby, which implies that there is a solid chance of them conceiving again within a month after childbirth