After birth—family planning decisions

Congratulations on the birth of your new baby.

This is an exciting, busy and tiring time. However, it is important to remember that a family planning decision needs to be made before resuming intercourse.

One factor to consider when making a decision regarding contraception is whether you are breastfeeding your baby or not. Many other issues may also influence this decision including maternal health, age, finances and ages of other children.

If you are breastfeeding

Breastfeeding is nature’s way of allowing you, the mother, to nourish your newborn baby in the best way possible before another pregnancy makes demands on you.

In simple terms, sucking on the breast sends signals to the brain which block the release of hormones which stimulate the ovary and cause ovulation. You are less likely to fall pregnant if you are fully breastfeeding, and your periods have not returned. If you wish to use breastfeeding alone as a method of family planning, we advise teaching and guidance by a trained Natural Fertility Consultant. For breastfeeding women, other family planning options include barrier methods (eg condoms), the mini-pill, Implanon, and Mirena.  The oral contraceptive pill is not recommended for breastfeeding women. Please talk to your GP about what method might be best for you.

If you are not fully breastfeeding, or are formula feeding

It is possible that a pregnancy could occur anytime after you resume intercourse, especially if you are not fully breastfeeding. 

If you wish to avoid a pregnancy then you need to consider your family planning options very soon after birth and use a reliable method from the time you resume intercourse. Family planning options include natural methods (with instruction available by Mater’s Natural Fertility Service), barrier methods (eg condoms), Implanon, Mirena, and the oral contraceptive pill (although advisable to wait until 6 weeks if choosing the contraceptive pill to reduce the risk of blood clots).  Please talk to your GP about what method might be best for you.   

Questions new parents often ask

Could I become pregnant before my first period?

If you are fully breastfeeding—it is much less likely for adequate ovulation to occur before the first bleed in the early months after birth. However the longer that the period is postponed by breastfeeding, the greater the possibility that adequate ovulation, and hence the chance of a pregnancy, will occur prior to the first period (statistically 2% at six months, 8–9% at 12 months).

If you are formula feeding—after resuming intercourse, it is possible to become pregnant before your first period if intercourse occurs without an effective method of family planning.

Will my cycles be regular after the first period?

With breast or formula feeding, the first few cycles may be shorter or longer than usual. Normal cycles have usually returned by the time you have had four to six cycles.

When is it appropriate to resume having intercourse?

This may depend on customs and culture. If you feel comfortable, you may choose to start having gentle intercourse after your heavy bleeding has eased. If you are sore or bruised, it may take some weeks or months for you to feel ready for intercourse. If medical problems are, or have been present, such as haemorrhage or infection, intercourse may need to be delayed. Please discuss any such issues with your doctor or midwife.

Remember:

• You need to be comfortable and experience no pain or you may be fearful the next time. Use a position which is comfortable for you. A pillow under your hips may be helpful.
• Looking after a new baby can be tiring so enjoying intercourse may be difficult.
• It is common for the natural lubricants produced by the vagina before intercourse to be lacking in the first few months after birth. Use of a water-based lubricant can be helpful.

Further information 

You can read more information about family planning options on the Queensland Government website. 

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