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Resuming Sex and Pregnancy Prevention

Sex is an important way to communicate. Many factors drive sexual desire. Your body may feel ready for sex, but your feelings may need more time. There are many other ways to show love and affection to your partner. Talk clearly about those feelings and your relationship will stay strong.

Can We have Sex too Soon?

Sex while the woman is still bleeding can put her at risk for infection. Sex can be uncomfortable if she had an episiotomy or an incision from a C-section. Try to avoid direct pressure on these areas. Use different positions to help increase enjoyment. Vaginal dryness is normal after giving birth and many mothers find that using a water based lubricant can help. The hormones of orgasm can also cause breastmilk to flow, so do not be surprised if you need a towel. Some women may be self-conscious about their bodies after giving birth. Breastfeeding your baby prior to sex, placing a towel over your breasts or wearing a bra with breast pads can be helpful. It is important for dad to be supportive if mom is feeling uncertain about her body.

What about Birth Control?

Mom can ovulate any time after giving birth, even if she is breastfeeding. Discuss birth control choices with your partner and your health-care provider after having your baby. Until you see your health-care provider use condoms and lubricant. The following list of choices for birth control can help you choose the method that suits you best.

Condoms

green condomThese are a common choice for sex after childbirth. It works best if you remember to:

  • Check the expiry date.
  • Handle carefully.
  • Pinch off the end to allow a space for the semen.
  • Use a bit of water based lubricant inside the tip, to improve sensation.
  • Hold the condom to withdraw, so the contents do not spill into the vagina.

Lactational Amenorrhea Method (LAM)

LAM is a temporary family planning method. It is only effective when babe is under 6 months; mom is breast­feeding on demand day and night, not feeding her baby other foods or liquids; and mom’s menstrual period has not returned since birth. When one of the above conditions change, this method is no longer effective .

Hormonal Contraceptives

Birth Control Pill

package of birth control pillsMost birth control pills contains two hormones called estrogen and progestin. Taking combined hormonal contraceptives decrease breastmilk supply for most women. Alternatively, women can try taking a progestin-only contraceptive that is less likely to reduce milk supply. The pill works best if it taken as the same time every day. When she stops taking the pill, ovulation will start again. She should stop the pill at least three months before her next pregnancy.

The Patch “Evra”

The patch contains the same two hormones as the birth control pill does (estrogen and progestin). Mom applies one patch every week for three weeks. Then she has a “patch-free” week. This is helpful for women who find it hard to remember to take the pill every day. The hormones absorb through the skin into the bloodstream. The patch works the same way the pill does. It gives you good protection against pregnancy. The directions for starting this method are the same as for the pill. When mom stops using the patch, ovulation will start again. She should stop the patch at least three months before her next pregnancy. The patch can decrease breastmilk supply.

NuvaRing

The NuvaRing is a flexible ring that contains female hormones. It is placed in the vagina for three weeks and then removed for seven days. The hormones are absorbed directly from the ring into your blood. They have the same effect on your body as the birth control pill. The NuvaRing is very effective. It has a simpler schedule to follow than either the pill or patch. When you stop using the NuvaRing, ovulation will start again. You should stop the NuvaRing at least three months before the next pregnancy. The Nuva Ring can also decrease breastmilk supply.

Intrauterine System “Mirena”

The Mirena is a soft, flexible plastic T shaped device. It is placed directly into her uterus by her doctor. It releases a small amount of the hormone levonorgestrel  into the uterus. This makes her period lighter and shorter. Mirena should not be fitted until six weeks after mom gives birth. It gives very good pregnancy protection for five years. If you want to become pregnant before that, simply ask your doctor to remove it.

Sterilization

Sterilization is a simple, safe, effective, and cheap birth control option. Sterilization should be considered permanent.
Women: The procedure is called a tubal ligation. The surgeon cuts or mechanically blocks the fallopian tubes to prevent the sperm and egg from uniting. You need a general anaesthetic.
Men: The procedure is called a vasectomy. The surgeon blocks or cuts the vas deferens so that the sperm cannot get into the semen. You might have local anesthetic (freezing) or general anesthetic.

Emergency Contraception (Plan B)®

Plan B is taken after you have had unprotected sex, had a condom break or missed two consecutive birth control pills. Mom takes a tablet of progestin up to 120 hours (5 days) after sex. The earlier Plan B is taken the more effective it will be. Plan B prevents the sperm from reaching and fertilizing the egg. Plan B does not cause an abortion if you are already pregnant. Most people don’t have any side effects from taking Plan B. Mom can start a more reliable method of birth control the next day. This might be the birth control pill, Evra patch or NuvaRing. Plan B is not intended as a method of birth control.  It is for emergency use only.

References:

Middlesex-London Health Unit (online), 2016
Sexuality and U (online), 2015

Remember talking and sharing remain the keys to keeping your relationship strong.