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Pregnancy is an amazing  journey and after the birth of your bundle of joy your body needs recovery time.  This period post delivery is also ripe for getting pregnant again be mindful of this ladies!! Factors like breastfeeding do play a role in the return of fertility. Ovulation occurs two weeks prior to the periods, therefore, one can ascertain that you might be fertile again before you know.  It is important to have  a consultation with your midwife and discuss  options available.

Contraception methods available

There are numerous ways one can prevent another pregnancy right after childbirth. These methods include lactational amenorrhea (LAM), rhythm or fertility awareness  methods, barrier methods, hormonal methods, intrauterine devices (IUDs) and surgical sterilization. While  these methods are highly efficacious  birth control alternatives, most of these do not provide protection against sexually transmitted diseases. There are some traditional herbal  remedies that have shown evidence of contraceptive properties, these have been used by our ancestors for time immemorial before the advent of modern medicine. 

Lactational Amenorrhea

Breastfeeding provides natural suppression of ovulation because of changing hormonal levels, therefore inducing lactational amenorrhea. It is considered 95-98% efficacious in providing natural contraception for the first six postpartum months. This may however vary from individual to individual with fertility returning earlier than the first six months, there have been reported occurrences in the first month. This phenomenon applies only to breastfeeding. If you bottle feed with formula milk  and not pumping the breast milk your fertility will quickly return therefore you will need other methods of contraception.

Fertility Awareness-based Methods

These methods are based on assessment of regular menstrual periods and then estimating the time of ovulation. The woman keeps a calendar after assessing 6-12 of her menstrual cycles. However, this method is extremely unreliable in case of fertility after childbirth, as ovulation occurs before the periods in a postpartum woman. Therefore it’s not recommended and consultation with your health consultant can help you in choosing better available options.

Hormonal Methods

While all sorts of hormonal methods are available for mothers who are not exclusively breastfeeding, progestin only pills are recommended for those who are breastfeeding. This is primarily due to the fact that researchers have raised some concerns regarding the effects of estrogen on breast milk. Hormonal methods are available in the form of oral contraceptive pills, vaginal rings, IUD such as Mirena-IUS, hormonal implants and protesting injectables. Progesterone based methods act by thickening cervical mucus, hence preventing sperms from reaching the egg. This might also at times prevent the release of eggs from ovaries.

Progestin only pills – These come in a pack of 28 tables and have to be taken everyday at the same time. It gets quickly cleared by the body, therefore it has to be taken within a three hour period every day. Missing the three hour period warrants caution, and refraining from intercourse or using barrier methods is recommended.

Progestin Intrauterine Device and Implantable – This provides reversible contraception for upto three to five years, depending on the type of device used. It prevents the sperm from reaching the ovaries and acts as a physical barrier. It has been reported to be 99% effective and provides constant protection. There might be other side effects such as displacement and inflammation if placed incorrectly. Implantable on the other hand is a flexible rod which is inserted under the skin, mostly in the upper arm. It releases progesterone hormones into the blood and is equally effective as an IUD.

Vaginal Ring and Injectable  – These are placed in vagina once a month, hence providing protection for one month. It releases hormones which show action same as the pill. It is removed after every three weeks to allow periods to occur and is placed again. Injectables have a duration of action for 3 months. The circulating levels of progesterone derivatives act the same way as a pill or a ring, while providing action for a longer time.

Barrier Methods

Barrier methods include using physical protection methods such as condoms, diaphragm, cervical cap and spermicides during sexual intercourse. These provide action by preventing the sperm from entering through the cervical canal. Condoms and other physical barriers provide an efficacy of up to 98% when used together with spermicides. These can be more appealing to those who do not want to deploy methods such as medication or devices. These are also potent at preventing transmission of sexually transmitted infections.

Non-hormonal Intrauterine Device

Most popularly employed non-hormonal IUD is Copper-IUD. It is inserted by a doctor in a proper office or a clinic. It interferes with the ability of sperm to reach the fallopian tubes and eventually the ovaries. As it maybe, if fertilization somehow occurs, it leads to failure to implant by causing inflammation in the endometrium. However as opposed to other methods, side effects such as bleeding and infection are more common with Cu-IUD. These have the advantage of providing protection for several years. Cu-IUD is among the most effective reversible methods for birth control. The device can also be safely taken out by a healthcare professional and one can resume  trying for a baby if that’s the plan.

Surgical Sterilization

This is the most absolute method of birth control and should only be considered once the couple is fully sure that their family is complete as this is irreversible. This is available for both males and females. For females, tubal ligation leads to irreversible blockage of fallopian tubes which prevents egg and sperms from fertilizing with each other. For males, vasectomy is offered which results in ligation and binding of the vas deferens. Vasectomy provides a permanent barrier for the sperms in reaching the ejaculate. The semen therefore doesn’t contain any sperm. 

Herbal Alternatives to Contraception

For centuries, different civilisations have resorted to herbs for different treatments, including birth control. These methods are still applied to date in some countries and settings. Wild Carrot seeds for instance has been widely used for its action in preventing implantation by disturbing the progesterone synthesis. The only side effect reported with the herb includes constipation and bloating however drinking plenty of water and a healthy diet which includes fruits and vegetables will cure this problem. Similarly, smartweed is also a common herb found all around the globe. It has ingredients like rutin and gallic acid which promote menstrual blood flow and prevent the embryo from implanting on to the uterine walls. Likewise, mostly used in South and Southeast Asia, papaya seeds act as male contraceptives. Papaya seeds act by effectively bringing down sperm count to a minimum. For a person, who is apprehensive of chemical and medical therapies, effective research and reading on herbal medicines can provide an alternative avenue.

It is very stressful and  overwhelming  news for a mother to become pregnant a few months after a childbirth. Thus essential to consult your midwife or Doctor before childbirth to discuss options available. Above all its important to know what’s going into our bodies  potential side effects and so forth,  being proactive in research is recommended ladies and gentleman.