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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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Parents in New Jersey will soon get more money and more time for parental leave after welcoming a baby.

This week New Jersey Governor Phil Murphy signed off on legislation that extends New Jersey's paid family leave from six weeks to 12.

It also increases the benefit cap from 53% of the average weekly wage to 70%, meaning the maximum benefit for a parent on family leave will be $860 a week, up from $650.

It might not seem like a huge difference, but by raising the benefit from two-thirds of a parent's pay to 85%, lawmakers in New Jersey are hoping to encourage more parents to actually take leave, which is good for the parents, their baby and their family. "Especially for that new mom and dad, we know that more time spent bonding with a child can lead to a better long-term outcome for that child," Murphy said at a press conference this week.

The law will also make it easier for people to take time off when a family member is sick.

Because NJ's paid leave is funded through payroll deductions, workers could see an increase in those deductions, but Murphy is betting that workers and businesses will see the benefits in increasing paid leave benefits. "Morale goes up, productivity goes up, and more money goes into the system," Murphy said. "And increasingly, companies big and small realize that a happy workforce and a secure workforce is a key ingredient to their success."

The new benefits will go into effect in July 2020 (making next Halloween a good time to get pregnant in the Garden State).

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Whether you just need to stock up on diapers or you've had your eye on a specific piece of baby gear, you might want to swing by your local Walmart this Saturday, February 23rd.

Walmart's big "Baby Savings Day" is happening from 10:30 a.m. to 4:30 p.m. at participating Walmarts (but more deals can be found online at Walmart.com already and the website deals are happening for the rest of the month).

About 3,000 of the 3,570 Supercenter locations are participating in the sale (check here to see if your local Walmart is).

The deals vary, but in general you can expect up to 30% off on items like cribs, strollers, car seats, wipes, diapers and formula.

Some items, like this Graco Modes 3 Lite Travel System have been marked down by more than $100. Other hot items include this Lille Baby Complete Carrier (It's usually $119, going for $99 during the sale) and the Graco 4Ever 4-in-1 Convertible Car Seat (for as low as $199).

So if you're in need of baby gear, you should check out this sale. Travel gear isn't the only category that's been marked down, there are some steep discounts on breast pumps, too.

Many of the Walmart locations will also be offering samples and expert demos of certain products on Saturday so it's worth checking out!

Motherly is your daily #momlife manual; we are here to help you easily find the best, most beautiful products for your life that actually work. We share what we love—and we may receive a commission if you choose to buy. You've got this.

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Any Schumer has not had an easy pregnancy. She intended to keep working, but if you follow her on social media you know she's been very sick through each trimester.

And now in her final trimester she's had to cancel her tour due to hyperemesis gravidarum, also known as HG. It's a rare but very serious form of extreme morning sickness, and on Friday evening Schumer announced she is canceling the rest of her tour because of it.

“I vomit every time [I] ride in a car even for 5 minutes," Schumer explained in an Instagram post.

Due to the constant vomiting she's not cleared to fly and just can't continue to the tour.

This is not the first time Schumer has had to make an announcement about HG. Back in November, just weeks after announcing her pregnancy, she had to cancel shows and again broke the news via Instagram.

She posted a photo of herself in a hospital bed with her little dog Tati, and spelled out the details of her health issues in the caption. "I have hyperemesis and it blows," Schumer wrote.

Poor Amy. Hyperemesis gravidarum is really tough.

Kate Middleton, Ayesha Curry and Motherly co-founder Elizabeth Tenety are among those who, like Schumer, have suffered from this form of severe morning sickness that can be totally debilitating.

As she previously wrote for Motherly, Tenety remembers becoming desperately ill, being confined to her apartment (mostly her bed) and never being far from a trash can, "I lost 10% of my body weight. I became severely dehydrated. I couldn't work. I couldn't even get out of bed. I could barely talk on the phone to tell my doctor how sick I was—begging them to please give me something, anything—to help."

Thankfully, she found relief through a prescription for Zofran, an anti-nausea drug.


Schumer probably knows all about that drug. It looks she is getting the medical help she obviously needs, and she was totally right to cancel the tour in order to stay as healthy as possible.

We're glad to see Schumer is getting help, and totally understand why she would have to cancel her shows. Any mama who has been through HG will tell you, that wouldn't be a show you'd want front row seats for anyway.

Get well soon, Amy!

[A version of this post was published November 15, 2018. It has been updated.]

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As a military spouse, Cydney Cooper is used to doing things alone. But when she delivered her twin daughters early after complications due to Influenza A, she was missing her husband Skylar more than ever.

Recovering from the flu and an emergency C-section, and trying to parent the couple's two older boys and be with her new infant daughters in the NICU, Cydney was exhausted and scared and just wanted her husband who was deployed in Kuwait with the Army and wasn't expected home for weeks.

Alone in the NICU 12 days after giving birth, Cydney was texting an update on the twins to her husband when he walked through the door to shoulder some of the massive burden this mama was carrying.

"I was typing up their summary as best I could and trying to remember every detail to tell him when I looked up and saw him standing there. Shock, relief, and the feeling that everything was just alright hit me at once. I just finally let go," she explains in a statement to Motherly.

The moment was captured on video thanks to a family member who was in on Skylar's surprise and the reunion has now gone viral, having been viewed millions of times. It's an incredible moment for the couple who hadn't seen each other since Skylar had a three-day pass in seven months earlier.

Cydney had been caring for the couple's two boys and progressing in her pregnancy when, just over a week before the viral video was taken, she tested positive for Influenza A and went into preterm labor. "My husband was gone, my babies were early, I had the flu, and I was terrified," she tells Motherly.

"Over the next 48 hours they were able to stop my labor and I was discharged from the hospital. It only lasted two days and I went right back up and was in full on labor that was too far to stop."

Cydney needed an emergency C-section due to the babies' positioning, and her medical team could not allow anyone who had previously been around her into the operating room because anyone close to Cydney had been exposed to the flu.

"So I went in alone. The nurses and doctors were wonderful and held my hand through the entire thing but at the same time, I felt very very alone and scared. [Skylar] had been present for our first two and he was my rock and I didn't have him when I wanted him the most. But I did it! He was messaging me the second they wheeled me to recovery. Little did I know he was already working on being on his way."

When he found out his baby girls were coming early Skylar did everything he could to get home, and seeing him walk into the NICU is a moment Cydney will hold in her heart and her memory forever. "I had been having to hop back and forth from our sons to our daughters and felt guilty constantly because I couldn't be with all of them especially with their dad gone. It was one of the most amazing moments of my life and I won't be forgetting it."

It's so hard for a military spouse to do everything alone after a baby comes, and the military does recognize this. Just last month the Army doubled the amount of leave qualifying secondary caregivers (most often dads) can take after a birth or adoption, from 10 days to 21 so that moms like Cydney don't have to do it all alone.

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