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Birth control after baby: What’s best for you?

Reversible postpartum contraceptive options


Barrier + withdrawal methods

This includes male condoms, female condoms, cervical cap/diaphragm, the vaginal sponge, spermicide and the withdrawal method. These contraceptive forms decrease the amount of or prevent sperm from entering a woman’s body or reaching the cervix.

Breastfeeding mamas, take note...

The most commonly used contraceptive options that may be used within three weeks of birth in breastfeeding women are the progestin-only injection and the progestin-only pill, since they do not diminish milk supply.

It is also possible to place the progestin-only implant (IUD) during this early postpartum period, but many patients wait until later. Combined hormonal contraceptive methods are delayed until six weeks postpartum if breastfeeding to allow an adequate milk supply to develop, or they may be delayed and another form of contraception used until she is no longer breastfeeding.

If a woman does not plan to breastfeed, any of the combined hormonal contraceptive options can be initiated three weeks after delivery.

Progestin-only injection

This is a progestin-only method that is given as a shot every three months. This is a valid option for many women who cannot use combined hormonal contraceptive methods. It may cause weight gain and irregular cycles in some women. In other women it may cause monthly menstrual cycles to cease.

Oral contraceptive pills

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Combined OCPs contain the hormones estrogen and progestin and are considered a combined hormonal contraceptive method. They are taken orally daily. If a woman decides to start combined OCPs, it is important to discuss the options with an OB-GYN. Combined OCPs are avoided for a period of time if a woman plans to breastfeed. They are also contraindicated in women with certain medical conditions, due to the estrogen component. As a result, it is essential to discuss all medical illnesses with an OB-GYN prior to starting combined OCPs. The “mini pill” is a progestin-only OCP that is often prescribed to women who cannot take combined OCPs due to the estrogen component or because they want to breastfeed.

Copper IUD

The copper IUD does not contain any hormones. It is also inserted in the office into the intrauterine cavity by an OB-GYN and can be left in place for up to 10 years. The copper IUD works by creating an unfavorable intrauterine environment so the sperm is unable to reach and fertilize the egg. It may also inhibit attachment of the egg to the uterine wall. It is a good option for women who cannot or don’t want to use combined hormonal forms of contraception.

The patch

The patch is worn on the skin and contains both estrogen and progestin (combined hormonal contraceptive method). A new patch is placed weekly for three weeks, and during the fourth week a patch is not worn to allow for a period.

Postpartum tubal ligation

There is an option for permanent postpartum sterilization immediately after delivery via postpartum tubal ligation. This can be performed after a vaginal delivery or during a cesarean section. If done after a vaginal delivery, a small incision is made under the belly button. If done during a cesarean section, the same incision that is made for the cesarean will allow access to the fallopian tubes for permanent sterilization.

Hysteroscopic bilateral tubal occlusion

The hysteroscopic bilateral tubal occlusion is a procedure that is performed vaginally and does not require an abdominal incision. This can be done after six weeks postpartum or anytime thereafter. With this procedure, coils are placed into the fallopian tubes via the uterus and cause scarring, thereby blocking the fallopian tubes. The laparoscopic tubal ligation is another procedure performed after the six-week postpartum period. It requires several small incisions on the abdomen. The fallopian tubes are then interrupted by burning, placing clips or placing rings over each tube.

Well, you just had a baby (congratulations!), so you’re probably not thinking of immediately getting pregnant again. In fact, a 1999 study by the Centers for Disease Control and Prevention suggests waiting 18 to 23 months after birth to get pregnant again to allow your body time to recover from childbirth and give your future children the best chance of a healthy pregnancy.

So... birth control.

We asked Dr. Shannon M. Clark, a double board certified obstetrician and gynecologist and maternal-fetal medicine specialist, about all birth control options to consider postpartum. Here’s what we learned.

Permanent postpartum sterilization

Natural family planning

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This method of contraception requires a woman to track her menstrual cycle and avoid sexual intercourse or use a barrier method during her fertility period when ovulation occurs. This method is not very reliable, with a failure rate of up to 25%.

Vaginal ring

This is a vaginal insert that contains both estrogen and progestin, thus it is considered a combined hormonal contraceptive method. It a flexible plastic (latex-free) ring that is placed high in the vaginal canal using a two-finger insertion method. It is left in place for three weeks and removed for one week to allow for a menstrual cycle, then another ring is placed.

Vasectomy

A vasectomy is a procedure performed on the male partner where the tube that transports sperm from the testes to the penis is cut.

Progestin-only intrauterine device (IUDs)

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This IUD contains progestin. The IUD is inserted in the gynecologist’s office into the intrauterine cavity. The IUD can be left in place for three or five years, depending on which progestin-only IUD is chosen. As with the progestin-only implant, the progestin-only IUD is a valid option for patients who want a long-term contraceptive method or who should not have estrogen-containing forms of contraception.

Think twice about making things permanent: Prior to having any permanent sterilization procedure, a woman should be very certain that she does not want to have any more children. If she changes her mind at a later date, tubal reanastomosis (“tubal reversal”) can be attempted, but it is a technically difficult procedure that does not have guaranteed success.

Shannon M. Clark, MD, is a double board certified OB-GYN and maternal-fetal medicine specialist focusing on the care of women with either maternal or fetal complications of pregnancy. Dr. Clark is also an associate professor at UTMB-Galveston and the founder of Babies After 35.

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Progestin-only implant

This is small rod containing only progestin that is placed under the skin of your non-dominant upper arm. It is the most effective form of contraception available. It may be left in place for three years or removed earlier if a woman decides to become pregnant. It is an excellent choice for a woman who wants a longer-term contraceptive option or has a health condition where estrogen-containing forms of contraception are contraindicated.

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Unstructured play is play without predetermined rules of the game. There are no organized teams, uniforms, coaches or trainers. It is spontaneous, often made-up on the spot, and changeable as the day goes on. It is the kind of play you see when puppies chase each other around a yard in endless circles or a group of kids play for hours in a fort they created out of old packing boxes.

Unstructured play is fun—no question about it—but research also tells us that it is critically important for the development of children's bodies and brains.

One of the best ways to encourage unstructured play in young children is by providing open-ended toys, or toys that can be used multiple ways. People Toy Company knows all about that. Since 1977, they've created toys and products designed to naturally encourage developmental milestones—but to kids, it all just feels like play.

Here are five reasons why unstructured play is crucial for your children—

1. It changes brain structure in important ways

In a recent interview on NPR's Morning Edition, Sergio Pellis, Ph.D., an expert on the neuroscience of play noted that play actually changes the structure of the developing brain in important ways, strengthening the connections of the neurons (nerve cells) in the prefrontal cortex, the area of the brain considered to be the executive control center responsible for solving problems, making plans and regulating emotions.

Because unstructured play involves trying out different strategies without particular goals or serious consequences, children and other animals get to practice different activities during play and see what happens. When Dr. Pellis compared rats who played as pups with rats that did not, he found that although the play-deprived rats could perform the same actions, the play-experienced rats were able to react to their circumstances in a more flexible, fluid and swift fashion.

Their brains seemed more "plastic" and better able to rewire as they encountered new experiences.

Hod Lipson, a computer scientist at Cornell sums it up by saying the gift of play is that it teaches us how to deal with the unexpected—a critically important skill in today's uncertain world.

2. Play activates the entire neocortex

We now know that gene expression (whether a gene is active or not) is affected by many different things in our lives, including our environment and the activities we participate in. Jaak Panksepp, Ph.D., a Professor at the University of Washington studied play in rats earning him the nickname of the "rat tickler."

He found that even a half hour of play affected the activity of many different genes and activated the outer part of the rats' brains known as the neocortex, the area of the brain used in higher functions such as thinking, language and spatial reasoning. We don't know for sure that this happens in humans, but some researchers believe that it probably does.

3. It teaches children to have positive interaction with others

It used to be thought that animal play was simply practice so that they could become more effective hunters. However, Dr. Panksepp's study of play in rats led him to the conclusion that play served an entirely different function: teaching young animals how to interact with others in positive ways. He believed that play helps build pro-social brains.

4. Children who play are often better students

The social skills acquired through play may help children become better students. Research has found that the best predictor of academic performance in the eighth grade was a child's social skills in the third grade. Dr. Pellis notes that "countries where they actually have more recess tend to have higher academic performance than countries where recess is less."

5. Unstructured play gets kids moving

We all worry that our kids are getting too little physical activity as they spend large chunks of their time glued to their electronic devices with only their thumbs getting any exercise. Unstructured play, whether running around in the yard, climbing trees or playing on commercial play structures in schools or public parks, means moving the whole body around.

Physical activity helps children maintain a healthy weight and combats the development of Type 2 diabetes—a condition all too common in American children—by increasing the body's sensitivity to the hormone insulin.

It is tempting in today's busy world for parents and kids to fill every minute of their day with structured activities—ranging from Spanish classes before school to soccer and basketball practice after and a full range of special classes and camps on the weekends and summer vacation. We don't remember to carve out time for unstructured play, time for kids to get together with absolutely nothing planned and no particular goals in mind except having fun.

The growing body of research on the benefits of unstructured play suggests that perhaps we should rethink our priorities.

Not sure where to get started? Here are four People Toy Company products that encourage hours of unstructured play.

1. People Blocks Zoo Animals

These colorful, magnetic building blocks are perfect for encouraging unstructured play in children one year and beyond. The small pieces fit easily in the hands of smaller children, and older children will love creating their own shapes and designs with the magnetic pieces.

People Blocks Zoo Animals 17 Piece Set, People Toy Company, $34.99

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This article was sponsored by People Toy Company. Thank you for supporting the brands that support Motherly and mamas.

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If you've got hamburger in your freezer you might want to check it before making dinner.

According to the United States Department of Agriculture, Cargill Meat Solutions is recalling approximately 132,606 pounds of ground beef products for possible Escherichia coli O26 (aka E.coli).

The beef was sold at various retailers, including Target, Meijer, Safeway and Sam's Club, as well as Save Mart in California. This comes after a previous recall involving ground beef sold at Publix.

The USDA's Food Safety and Inspection Service notes the recalls are the result of an investigation into 17 illnesses and one death in recent months, and that children under 5, older adults and people with weakened immune systems are the most at risk for a type of kidney failure common in people with E.coli infections.

"It is marked by easy bruising, pallor and decreased urine output. Persons who experience these symptoms should seek emergency medical care immediately," the agency notes.


Cargill has issued a statement on its website that reads, in part: "We were distressed to learn a fatality may be related to an E.coli contamination of one of our products. Our hearts go out to the families and individuals affected by this issue."

The recalled beef products were produced and packaged on June 21, 2018. They have a use or freeze by date of July 11.


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In the moments after we give birth, we desperately want to hear our baby cry. In the middle of the night a few months later it's no longer exactly music to our ears, but those cries aren't just telling us that baby needs a night feeding: They're also giving us a hint at what our children may sound like as kindergarteners, and adults.

New research published in the journal Biology Letters suggests the pitch of a 4-month-old's cry predicts the pitch they'll use to ask for more cookies at age five and maybe even later on as adults.

The study saw 2 to 5-month olds recorded while crying. Five years later, the researchers hit record again and chatted with the now speaking children. Their findings, combined with previous work on the subject, suggest it's possible to figure out what a baby's voice will sound like later in life, and that the pitch of our adult voices may be traceable back to the time we spend in utero. Further studies are needed, but scientists are very interested in how factors before birth can impact decades later.

"In utero, you have a lot of different things that can alter and impact your life — not only as a baby, but also at an adult stage," one of the authors of the study, Nicolas Mathevon, told the New York Times.

The New York Times also spoke with Carolyn Hodges, an assistant professor of anthropology at Boston University who was not involved in the study. According to Hodges, while voice pitch may not seem like a big deal, it impacts how we perceive people in very real ways.

Voice pitch is a factor in how attractive we think people are, how trustworthy. But why we find certain pitches more or less appealing isn't known. "There aren't many studies that address these questions, so that makes this research especially intriguing," Hodges said, adding that it "suggests that individual differences in voice pitch may have their origins very, very early in development."

So the pitch of that midnight cry may have been determined months ago, and it may determine part of your child's future, too. There are still so many things we don't know, but as parents we do know one thing: Our babies cries (as much as we don't want to hear them all the time) really are something special.

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To my firstborn baby,
We were overjoyed when we found out we were pregnant with your brother. We were so excited to give you a sibling to play with; someone to love and grow up with. Someone who will be your buddy for life.

But our excitement quickly turned to worry as we thought about how this would affect you. You were the only grandchild, on both sides. The only nephew, on both sides. Basically, the king of the castle. And you relished in that title.

We took special care to wait as long as possible to tell you. We waited until 20 weeks when we knew you were going to be getting a brother. We felt it would be easier for you to wrap your head around and also shorter for you to wait for his arrival.

I still watch the video of you cutting into the gender reveal cake. You were SO excited to see blue—because that meant you were getting a brother. You were overjoyed with telling everyone the news because you were the first to know.

From there your love for him grew every day. YOU too had a baby in your belly. I was carrying YOUR baby. You told everyone who would listen that you were going to be a big brother. We wondered if your love for him would quickly fade when he was actually here. When you realized that you would have to share time and attention...

But we were wrong. Your heart grew a million times bigger the day your brother arrived.

You came to visit me in the hospital wearing your doctor uniform, to check on both of us. You made friends with the nurses. You wanted to make sure I was okay. You wanted to take care of me and were so proud to wear your "Big Brother" shirt your aunt made you.

You were such a trooper during his two-week stay in the NICU. You were too young to go in to visit him. So, for you, it meant you had this mysterious brother you could only see in pictures and videos.

You drew him cards and colored pictures for his isolette (which you so playfully called his aquarium). You told everyone at school you had a new brother and that he would be home soon—even though you didn't know when exactly. Your heart ached as much as ours did. You wanted him home as much, if not more, than we did. You wanted your new family of four.

Sometimes I feel like you are wise beyond your years. A little old man trapped in a pint-sized body.

You were the best helper for Mom and Dad in those first days and months of welcoming your baby brother into our family. You would tell everyone to use hand sanitizer, and check to see if anyone was sick before they walked through the door to our house.

You would tell everyone how to hold your baby. And then them the proper way. You would tell everyone to line up their shoes at the door. You just wanted to keep your brother healthy and safe, ever the protector.

I worried the honeymoon period would wear off, that you would wonder how long he was staying here.

But, I was wrong. It's almost a year later and you are still so in love with your brother. Truly in love. On your obligatory "first day of school sign" you listed your favorite things as: Star Wars, basketball and my brother.

You tell everyone that you love him more than anyone. The way you both laugh hysterically together during peek-a-boo in the back seat of the car literally makes my heart explode into a million pieces, in the best way possible. It is a joy and an admiration I never knew possible as I watch my two precious boys interact and love each other.

My wish is that you will always be best friends. That you always look out for each other. Continue to be each other's biggest fans. Root each other on, even when it's hard, or you don't want to. Because, my sweet, sweet boy, I want you to remember—your brother looks up to you. You are his role model for life. And I thank you for taking that role so seriously.

Love,
Your Mommy

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If there's anyone who needs a nice spa day, it's parents. But booking a day at the spa isn't so easy when you also have to find and pay a babysitter.

A business owner in Los Angeles came up with a solution: Trina Renea, the founder of Spa Lé La, added free childcare (by a CPR-certified nanny) to her spa's menu, offering the service to any parent who needs a massage or a facial, or any of the spa's other stress-busting services.

If you've got more than one child at home, the first child is free, and each one after is just $6 for the whole duration of mom or dad's spa visit, HuffPo reports.

Renea recognized that for a lot of parents, a quick 15 or 30 minute appointment for a wax or a manicure just wouldn't be worth all the effort it would take to get the kids ready and then into and out of the car, so she added 30 minutes of "lounge time" that parents can take before or after their appointment, so mama can just chill for a bit.

If lounge time isn't relaxing enough for you, you can also spend an extra $40 for another 25 minutes in a totally comfortable nap room.

This kind of parent paradise could only have been thought up by a fellow parent. Renea is a mother herself, and she understands that a lot of parents feel guilty about prioritizing their own self-care. That's why she added cool classes to the childcare component: Kids can participate in art, music or yoga sessions while mom or dad is away. There's nothing to feel guilty about at all. "If they feel like their child is getting a class, then it makes them feel more comfortable," she told HuffPo.

The spa also offers services for expecting parents, like prenatal massage, belly facials, and even labor stimulating massage for those 40-week mamas-to-be who are understandably over being pregnant and just want to meet their little one.

Whether you have a child on the way or a couple of them keeping you up at night, this spa's menu sounds like the perfect way for mama to enjoy some me time.

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