Today, gynecologists strongly advise young mothers to pay special attention contraception after childbirth. This is due to the fact that in order to fully restore the female body, it is necessary to wait at least 2 years between pregnancies. However, conventional contraceptives are not suitable for a nursing mother, because they can negatively affect the quantity and quality of milk, as well as the development of the baby. How to protect yourself after childbirth so as not to worry about repeat pregnancy.

When can a woman become pregnant?

The ability to conceive again after childbirth occurs individually for each mother. There are several main factors that influence the restoration of fertility. First of all, this is lactation. Breastfeeding is not a reliable method of contraception. Many women are confident that a new pregnancy is impossible during lactation. Doctors say that this theory holds true, but only when proper feeding baby.

The opportunity to become pregnant returns to the woman immediately before the arrival of her first period after childbirth. This period is also individual. Breastfeeding mothers will be able to get pregnant again much later than those who do not breastfeed. Ovulation on average occurs between 40 and 90 days after birth, but there are cases when this process occurs much earlier.

Pregnancy after childbirth is always a surprise. A woman may not even suspect fertilization, because there are no periods, which means everything is normal, they think. This is how children of the same age are born. In our country, such cases are far from uncommon and, according to experts, 90% of them are the result of a lack of basic knowledge and negligence of women. Such pregnancies often end in abortion, which has an extremely negative impact on the young mother’s still fragile body.

Lochia or menstruation

How to distinguish physiological postpartum hemorrhage from menstruation? Typically, all discharge that is observed in women during the first 2 months after childbirth is postpartum lochia. However, in the absence of breastfeeding, menstruation may resume earlier than this. Also, your period may come early due to individual characteristics body.

You need to see a doctor if: scant postpartum discharge suddenly became more profuse, bleeding resumed after the lochia stopped.

If there is any suspicion of the resumption of menstruation earlier than 2 months after childbirth, you should visit a gynecologist. The doctor will conduct an examination and determine the nature of the discharge.

Responsibility of contraception after childbirth

When to start using protection

Based on recommendations World Organization Health care, the mother should begin contraception 3 weeks after birth. Of course, the risk of pregnancy during this period is extremely low, but there are exceptions. If you are not planning a second pregnancy, it is better to protect yourself from accidents.

Lactation and pregnancy

Many women are confident that pregnancy cannot occur throughout breastfeeding. This opinion is wrong. Lactation can indeed delay the onset of ovulation, but only for 6 months and with strict adherence certain rules feeding. These rules include:

• Feeding on demand.
• Feeding at night.
• Avoid bottles and pacifiers.
• Refusal of complementary feeding.
• Refusal to supplement.

However, even if all the rules are followed, breast-feeding cannot be considered 100% contraceptive method in the postpartum period.

Choice of protection

Abstinence method. This method is a 100% guarantee of no fertilization. However, the period of compulsory sexual abstinence usually does not exceed 2 months after childbirth, and then it is necessary to think about protective methods of contraception. The most popular methods of contraception are barrier, oral and intrauterine.

Progestin-based oral contraceptives

Oral contraception is a common method of preventing pregnancy for many women. However, in the postpartum period, not all drugs may be suitable for a young mother. Today, after childbirth, it is recommended to choose pills containing a minimal amount of hormones. The active ingredients in such medications are progestins.

The action of the tablets is based on structural change uterine mucosa. The surface after taking the pills becomes viscous and impenetrable for sperm. These drugs have good efficiency provided that you are breastfeeding and taking pills regularly.

These medications are new generation drugs and do not affect the quality and quantity of milk in a nursing woman.

Also, the drugs do not cause harmful effects on the baby’s health.

Disadvantages of the method:

• The need for regular use.
• Possibility of cycle disruption.
• Decreased effect when taking a series medicines.
• The ability to conceive returns immediately after missing medications.

Combination oral drugs

These medicines contain 2 types of hormones - estrogen and progesterone. Such tablets have high efficiency and are often used as contraception women of our country. However, they are only good if you are not breastfeeding your baby.

Combined drugs reduce the functioning of the mammary glands and can penetrate into the milk, and therefore into the child’s body.

In vitro fertilization and what it is

Hormonal injections

As in the case of oral contraceptives, the action of injections is based on the introduction of certain hormones that prevent ovulation and fertilization. The effect of the injection can range from 12 weeks to five years, depending on the form and composition of the drug. For women who are breastfeeding, only progestin-only injections are suitable. The disadvantages of progestin-based injectable protection are the same as those of the pill.

Intrauterine method

Even with the availability of modern oral contraceptives, this method is still the most reliable. It is often recommended for use by women in the postpartum period. The spiral does not affect the secretion and quality of milk, reliably protects against conception and has long term services.

Disadvantages include heavier periods at first, as well as pulling sensations in the early postpartum period.

The spiral can be installed immediately after childbirth (if there are no contraindications), or 3-5 weeks after the birth of the baby.
The intrauterine device should only be inserted and removed by a doctor.

Barrier method

For many, the barrier method is the most convenient. It can really protect not only from pregnancy, but also from transmission infectious diseases. This method has absolutely no effect on the secretion and quality of milk and has almost 100% contraceptive effect. Barrier methods include condoms and diaphragms.

The disadvantages of condoms include the inconvenience of putting them on during sexual intercourse and the possibility of damage to the condom if the instructions are not followed.

The diaphragm also has a number of disadvantages. So, for example, the size of the cap should be selected by the doctor. Should only be used in combination with substances that destroy sperm. Strict adherence to the instructions for inserting and removing the cap is necessary.

Use of spermicides

Spermicides include suppositories, intrauterine pills and creams that destroy sperm in the vagina. The method is quite effective and easy to use. Additional benefits include providing additional lubrication. One of the disadvantages is the cost of drugs.

What should be the basal temperature during pregnancy?

Interruption of sexual intercourse

According to research results, this method is not reliable. The fact is that sperm can enter the vagina not only during a man’s orgasm, but also before it occurs. This means that use this method is similar to playing Russian Roulette and is purely based on luck.

Calendar

Many women calculate according to the calendar dangerous days and thus can plan their sex life without worrying about pregnancy. However, in the postpartum period this method may fail.

After childbirth, there is no regularity of menstruation, and ovulation may not occur according to script.

As a result, fertilization can occur on any day, and the woman will invariably be faced with resolving the difficult issue of repeated births or termination of pregnancy.

Sterilization

This procedure is irreversible and provides a 100% guarantee of no pregnancy. Today doctors are conducting this operation only in case medical indications or women over 35 years old if she already has at least 2 children. The operation can be performed on both women and men. However, according to statistics, the male sex goes to this extreme measure much less often.

Before deciding on irreversible contraception, you must carefully weigh the pros and cons so as not to regret the lost function of childbearing.

Today, it is not uncommon for children to appear in a family due to the carelessness of their parents. According to experts, it is these families who most often encounter disagreements during a woman’s pregnancy and the postpartum period. Such couples are more likely to divorce. This is due to the couple’s unwillingness to become full-fledged parents. Accidental pregnancy can also be the root cause of the development postpartum pregnancy in a woman. Plan your family wisely, and then your children will be welcome and happy.

Unfortunately, or fortunately, situations when, soon after giving birth, a woman finds out about a new pregnancy are not so rare, judging by the numerous threads on various “mom” forums. This happens for the reason that many nursing mothers naively believe that pregnancy is impossible during lactation. And it is not at all necessary to use protection if you are breastfeeding. This is wrong. How to protect yourself after childbirth so that Kinder does not become a surprise?

Read in this article

Changes in a woman's body

During pregnancy, the body has one hormonal level, after childbirth - another. All systems of the female body begin to recover. And by six months (or even earlier), even if the new mother supports breastfeeding, the reproductive system is already capable of another conception.

A few weeks after birth (usually seven to eight), lining the inside of the uterus. After six weeks, nearly twenty percent of new mothers who are not breastfeeding and five percent of those who are breastfeeding experience their first postpartum ovulation. The egg is released from the ovary and the chances of getting pregnant again become high. At the same time, the presence of menstruation is a completely optional condition.

Help prolactin

The hope of the majority of women is based on faith in breastfeeding: during breastfeeding, prolactin is actively produced. A hormone that blocks the maturation of eggs in the ovaries. In order for this method to work 100%, certain requirements must be met. One of which is feeding more than fifteen times a day. Including at night. In a situation where feeding is replaced by drinking water, complementary foods, formula and other “surrogates”, the young mother cannot count on the help of lactation as a natural contraception. This is especially true for those mothers who, before pregnancy, faced irregular cycle or gynecological diseases.

Lactational amenorrhea is a completely “working” method, but, as practice shows, it is difficult to implement. Especially in our time, when mothers often refuse long-term breastfeeding in favor of bottles and formulas.

By the way, if you prefer this method of “contraception,” you should also think about the fact that it does not protect against sexually transmitted infections.

Contraception methods

What is the best way to protect yourself after childbirth? For breastfeeding mothers, the contraceptives familiar to many are prohibited for obvious reasons. There are several options left:

• barrier contraception;
• creams (spermicides);
• medications containing a minimum of hormones (tablets for nursing mothers, implants with low content hormones and injections).

Let’s make a reservation right away: you can’t do without a visit to the doctor. This is because you cannot know exactly when the cycle will resume. This means that you can become pregnant during lactation very unexpectedly. Moreover, do not guess about it. Considering that there was no menstruation.

We increase reliability

Barrier methods of contraception for women

Doctors advise all nursing mothers barrier contraception, as a means of better protection after childbirth. Condoms, cervical caps and diaphragms (female condoms) - this option is not the best for those who are not enthusiastic about “protected” sex, which, coupled with stretched vaginal muscles, “steals” all the pleasant sensations. In addition, in some cases, latex allergy has not been canceled.

“Female condoms” are selected at an appointment with a specialist. The diaphragm is placed for several weeks. The woman can insert the cap right in front sexual contact. This method of protection is very comfortable for women who are breastfeeding. During the first 6 months, caps and “prolactin” natural support may become in a great way protection.

If a woman used this method before the birth of her baby, she should definitely visit a doctor so that he can select new size cap. It is logical that after bearing a child and giving birth, the volume of the uterus became different.

A little about spermicides

How to protect yourself during lactation? There is plenty of room to wander around here. Vaginal suppositories, all kinds of gels, tablets and creams not only protect against unwanted pregnancy, but also do not penetrate into milk. Give preference to proven brands - Erotex, Pharmatex or Patentex Oval. They are based on benzalkonium hydrochloride molecules, which actively “decapitate” sperm.

The effectiveness of these contraceptive substances is not of concern. But when using them, you should adhere to the rules regulated by the manufacturer. Otherwise, there is a risk of “missing the moment.”

Rules for using spermicides:

• You can only wash yourself clean water. Attention: no soap!
• The cream or gel (suppository, tablet) must be administered strictly within the time specified by the manufacturer before contact. This is usually done five to ten minutes before intimacy.
• Remember: one tablet or candle is designed for only one contact.

IUDs as a method of contraception

During feeding, one of the most popular methods is the use of non-hormonal intrauterine device. The effectiveness of this method varies from 85 to 95 percent. However, there are contraindications for inserting an IUD, so before installing it, you should be examined after childbirth.

Hormonal drugs: pros and cons

The myth that it is forbidden to use traditional contraceptives during breastfeeding has long been debunked. The pills just have to be “correct” and not contain estrogen. It has been proven that female sex hormones affect the amount of milk. How to protect yourself after childbirth so that “one thing doesn’t interfere with the other”? The so-called “mini-pills” were invented a long time ago. Of course, they need to be selected with the help of a doctor. The tablets approved for young mothers are based on progestogen. It does not end up in “milk rivers” and perfectly protects against unexpected pregnancy. These drugs have one drawback - they should be taken literally in minutes.

What you need to do when choosing this method of contraception: set a reminder on your phone or set an alarm. This is the only way to be sure that precious minutes of your appointment are not missed.

In terms of effectiveness, these pills cannot be considered as reliable as regular ones. hormonal pills. Therefore, when using them, it is best to apply additional methods protection (for example, barrier). And as soon as breastfeeding is completed, switch to COCs (combined oral contraceptives).

Hormonal implants and injections

There are also hormonal implants that are sewn under the skin. Their peculiarity is that the action lasts about five years. There are no estrogens in the composition, which means this method is quite suitable for a new mother.

How does this happen? A capsule or plate containing hormones is sewn under the skin. Every day, a small amount of the drug is released into the blood, protecting against unwanted pregnancy.

Injections have a shorter effect - the effect lasts only up to three months. Similar measures are considered quite radical. After all, one injection, in fact, causes a “temporary menopause” in the body (with “bonuses” in the form of absence of menstruation and ovulation). How the reproductive system will react to such experiments is another question. In any case, these methods are prohibited until you plan to give birth again. IUD with hormones

This method of protection against unwanted pregnancy is not always allowed for breastfeeding women. Young mothers can take IUDs containing progesterone. Such as Mirena, for example.

Doctors usually advise waiting a couple of months after a natural birth and at least six months after a CS.

There is a stereotype that hormones artificial origin(tablets, spirals) will harm the baby. Allegedly, a “dose” of unwanted drugs still ends up in mother’s milk. However, modern obstetrics denies negative impact for a crumb.

Other ways

There are two more ways to answer the question of how to protect yourself for a nursing mother. This is coitus interruptus and sterilization of either one or the other partner. Of course, the second method is suitable only for those who seriously understand that they do not plan to have any more children. In this case, during a simple operation, the fallopian tubes are tied in women or spermatic cords in men. The biggest disadvantage of this method is that it is irreversible. Before making a fateful decision, you should weigh all the pros and cons.

Therefore, we would not advise taking it seriously. Otherwise, another baby can cause a lot of trouble with its appearance. The fact is that many simply do not have time to notice the pregnancy when caring for a baby, because menstruation has not yet arrived after childbirth. Therefore, in order to avoid an unwanted pregnancy, the mother should get advice on contraceptive methods from her gynecologist.

Elena Zhabinskaya

Hello friends! Lena Zhabinskaya is with you! All more young mothers turn to a specialist with a question about what protection should be like after childbirth while breastfeeding. There are several reasons for this: some believe that lactational amenorrhea is a panacea for unplanned pregnancy, and they want to make sure of this. Others are looking for drugs and products approved for breastfeeding.

Which one is right in the end? Let's figure it out.

Do I need to use protection after childbirth? Definitely yes, because an early second pregnancy is undesirable. And the point here is not only that the young mother simply cannot cope with the load that has piled up all at once. It’s just that her body is not yet ready for new feats and stress.

If you don't want to protect yourself

If all the listed difficulties are not for you and you dream of a second toddler for the company you already have, we can only congratulate you. In this case, be guided solely by medical side question.

If possible, wait at least 2-2.5 years from last birth. If you want it earlier, consult a competent specialist and start preparing your body for the next pregnancy in advance.

Do it in advance physical exercise, toning the whole body and internal organs to successfully carry a new pregnancy. And tune in only for the best!

Is it possible to have an abortion after childbirth?

If an unwanted pregnancy occurs, the mother’s problems increase, and not only because abortion is extremely stressful for the mother’s body. Restoring the uterus even after a natural, easy birth is a long process. Any outside interference is inappropriate here and can lead to the development of the most serious illnesses up to infertility.

After cesarean it is generally prohibited. The solution could be medical abortion, however, in reality it will also not pass without a trace for the body. Moreover, a nursing mother will have to give up breastfeeding because of it. Is neglecting contraception worth it?

I wrote about possible abortion more with the goal of scaring and forcing those who are not at all ready for the next baby to take a responsible approach to the issue of protection.

If we touch on the moral and ethical side of abortion, then I personally have an extremely negative attitude towards abortion. This is an extreme measure, which is possible only when continuing the pregnancy threatens the woman’s life or the fetus has developmental defects that are incompatible with life.

With all this, I hope that women who have gone through pregnancy, childbirth, and have already held a newborn at their breasts, in the event of a new sudden pregnancy, will be happy about it and will never even think about killing their own little one just like that. tummy.

When to start having sex

Even after light natural birth It is not recommended to have sex in the first weeks. In practice, gynecologists advise women to abstain from it for the first two months.

In some cases, when there were complications after childbirth, this period can be extended to 4 months.

And all because of microcracks that cover the surface of the uterus and can easily become inflamed. When this time has passed, you should go to the doctor for an appointment, during which he will advise safe methods contraception.

Contraception for breastfeeding: features and advantages of different methods

It’s easier for mothers of artificial babies: they can take any medications and use any means to prevent pregnancy, which cannot be said about nursing mothers. They are prohibited from anything that could affect the taste and quantitative characteristics of milk. Meanwhile, there are options.

Lactational amenorrhea

This is exactly what the mother hopes for during breastfeeding, but very often in vain. Why? In order for this method to work, you need to feed the baby as required, including during bedtime, without supplementing with anything.

Then the body will produce a huge amount of progesterone, which prevents the onset of unwanted pregnancy. This can last up to a maximum of 6 months of age.

You shouldn’t rely entirely on this method, because the absence of menstruation does not mean that ovulation has not yet occurred, and with it a new pregnancy.

Hormonal contraceptives

They are among the most reliable methods of protection, the effectiveness of which is 98 - 99%, depending on the drug. Just a few years ago, none of them were suitable for young mothers, but quite recently everything has changed.

Today OK is recognized as one of the best ways protection against unwanted pregnancy during lactation. True, you cannot assign them to yourself. The thing is that they contain different hormones that can affect the duration of breastfeeding. In addition, many of them pass into milk and are passed on to the baby.

In order not to think about treating the consequences later, you need to use only OK:

• which contain exclusively progesterone;
• which contain gestogen. A striking example Such drugs are mini-pills.

These two groups of medications do not affect the child or the amount of breast milk. In general, they are absolutely safe, but they still have one drawback: they must be taken strictly at the same time. Delay is fraught not only with the arrival of a new child in the family, but also with serious hormonal imbalances.

Is there a way out of this situation? Yes, you can set a reminder on your phone to take the pill, or choose other ways to prevent unwanted pregnancy:

• injections - at a certain time (usually once every 8-12 weeks), a young mother is given an injection, thanks to which she can forget about birth control for this time;
• capsules - the principle of their action is almost identical. They are also injected under the skin, and then protect the woman from pregnancy, and for 5 years.

The effectiveness of these two methods is 99% and is explained by the gestogen they contain. Moreover, the principle of their reception is simplified. There is no need to remember them, like pills, every 24 hours.

With all its advantages, hormonal contraceptives still don't use it too much in great demand. This is due to their shortcomings:

• intermenstrual bleeding, which may occur;
• heavy discharge during menstruation;
• lack of a barrier to infections of the genitourinary system;
• V in rare cases the need to wait for the onset of a new pregnancy after their cancellation.

During lactation, some emergency oral contraceptives are also allowed, for example, Postinor. However, it is not recommended to constantly rely on them.

Intrauterine device

A long-term and inexpensive way to prevent unwanted pregnancy. It is installed once every few years, however, only after natural childbirth.

All necessary installation manipulations can be carried out within 6 weeks from the moment the baby is born.

The reliability of this method is high, provided that the spiral is installed correctly and the woman monitors that it has not moved. The latter is possible, for example, during violent sexual intercourse, intense physical activity etc.

Experienced obstetricians and gynecologists warn about the disadvantages of this method:

1. the need for control on the part of the woman over the correct position of the spiral;
2. the possibility of pregnancy if the spiral has shifted;
3. a foreign body in the uterus can cause inflammatory processes and become a source of infection;
4. Difficulties with conceiving are possible even after the IUD is removed, so it is recommended for those who do not plan to give birth again.

Barrier methods

What else can a nursing mother do to protect herself?

• condoms;
• caps;
• diaphragms;
• spermicides - suppositories, gels, creams.

Their main advantages are ease of use and permissibility during lactation. But do not forget that these are not the most reliable methods. Some of them will protect against infections, but not against unwanted pregnancy.

In addition, it is never possible to predict the reaction of the female body to the chemical components of spermicides.

Everyone chooses for themselves how best to protect themselves after childbirth. However, your choice in favor of one or another remedy should be made only after consultation with a specialist.

Don’t forget about this, and also subscribe to blog updates and save the article to your wall on social networks! It was Lena Zhabinskaya, bye-bye!

A miracle happened. The baby you've been waiting for for nine long months has finally arrived. Now you, parents, are completely immersed in caring for him. At first, both of you are terribly tired, night feedings are exhausting, and you can’t even think about resuming sexual relations. Yes and extra pounds appeared, the figure is not the same as before pregnancy. No, you need to wait a little, especially since the doctor recommends not having sex for the first 4-6 weeks... But nature takes its toll, and your sexual relations will soon resume. Contraception is probably the last thing on your mind right now. Is it worth taking care of her at all, isn’t breastfeeding enough?

It’s worth it if you want to avoid an unplanned pregnancy in the first months after giving birth, because, contrary to popular belief, this is not so uncommon. Studies have shown that in women who breastfeed, menstruation resumes on average after 2-6 months, depending on the intensity of feeding, and in non-breastfeeding women - 4-6 weeks after birth. If you do not have lactation or breastfeed irregularly, then ovulation, and therefore the ability to conceive, can resume as early as 25, and on average 45 days after birth. And since ovulation occurs 14 days before your period, you may already be fertile without knowing it.

Consequently, pregnancy can occur even before the first menstruation appears, therefore, in order to begin to protect yourself, you should not wait for the restoration of the menstrual cycle, the start of complementary feeding and a reduction in the frequency of breastfeeding.

According to surveys, two-thirds of Russian women resume sexual relations within a month after childbirth, and within 4-6 months - almost all (98%). At the same time, doctors are greatly alarmed by the fact that after giving birth, 20-40% of sexually active Russian women do not use any methods of contraception. Meanwhile, the probability of pregnancy in the absence of reliable contraception in nursing mothers 6-8 months after birth it reaches 10%, and in non-breastfeeding mothers it reaches 50-60%. Thus, women who have recently given birth in Russia should be classified as high risk upon the occurrence of an unplanned pregnancy.

And pregnancy during this period is generally extremely undesirable. Doctors believe that the minimum interval between births should be about 3 years. Why? Despite the fact that organ involution reproductive system(returning them to their previous state) ends 4-6 weeks after birth, full recovery the body takes at least 1.5-2 years. Breastfeeding also places a significant burden on a woman’s body. But after this, a woman still needs to replenish her supply important microelements, for example, iron, calcium, etc. As studies have shown, when pregnancy occurs earlier than 2 years after birth, the risk of developing pregnancy complications (preeclampsia, anemia, intrauterine growth retardation), childbirth and postpartum period.

Thus, we inevitably come to the conclusion that in the postpartum period and for 2 years after childbirth, a woman needs effective, reliable and safe contraception.

Choosing a contraceptive method after childbirth

Ideally, you should get advice and choose a suitable method of contraception after childbirth during pregnancy. If you don’t have time before giving birth, consult a doctor at the maternity hospital. If you still cannot decide on a contraceptive method or you have doubts and questions, then before resuming sexual relations (even while breastfeeding), you should definitely seek advice from a gynecologist, for example antenatal clinic or a family planning and reproduction center. The purpose of this article is to give general idea about contraceptive methods during the postpartum period and how these methods are combined and how compatible they are with breastfeeding, however, you should only determine which of these methods is right for you in consultation with your doctor.

A non-breastfeeding woman should start using contraceptives from the moment she resumes sexual relations. Moreover, if not special contraindications, she can choose any of the modern arsenal of contraceptives.

The method of contraception for a nursing woman depends on the feeding regimen and the time elapsed after childbirth. In addition, the contraceptive should not adversely affect the child’s health or milk secretion. If you are exclusively breastfeeding, the start of contraception can be delayed by 6 months. If feeding is infrequent or early start complementary feeding (all this is typical for residents developed countries) a contraceptive method should be selected during a mandatory postpartum visit to the doctor no later than 6 weeks after birth.

And one more important note: the various methods of contraception, which we'll talk below, have different effectiveness, some of them involve serious restrictions in use, not all can be used in the first weeks after birth. Be prepared in advance for the fact that during this important and responsible period of your life, when it is better to postpone the next pregnancy in any case, different methods of contraception will often have to be combined, either by increasing the effectiveness of a method that is ideal for you, but not reliable enough, or by “ensuring yourself” in those circumstances when the effectiveness of a reliable method is reduced for some reason. And in determining the need and principles of combination various methods, as well as in selecting the most suitable remedy for your couple, again only a doctor will help.

Methods of contraception after childbirth

Abstinence

Abstinence ( sexual abstinence) has 100% contraceptive effectiveness, but most couples are not satisfied with this method even for a short time.

Lactational amenorrhea method (LAM)

Mechanism of action and characteristics. After childbirth, a woman’s body produces the hormone prolactin, which stimulates milk production by the mammary glands and at the same time suppresses ovulation, resulting in lactational amenorrhea (absence of menstruation during breastfeeding). This effect of prolactin on a woman’s body determines the contraceptive effect of breastfeeding. Each act of breastfeeding stimulates the secretion of prolactin, but if the break between feedings is too long (more than 3-4 hours), the level of prolactin gradually drops. Breastfeeding started immediately after birth is effective method natural contraception and at the same time provides the child with the most nutritious food. In addition, sucking stimulates the production of oxytocin, a hormone that promotes not only the contraction of the muscles of the areola of the mammary gland (due to which milk is released from the nipples), but also the contraction of the uterus, which leads to speedy recovery its size and shape after childbirth.

MLA involves exclusive or near-exclusive breastfeeding, both during the day and at night. The effectiveness of MLA is maximum if feeding does not occur according to a schedule, but at the child’s first request (even at night), sometimes several times an hour, on average from 12 to 20 times a day, of which 2-4 times at night. The break between feedings should not exceed 4 hours during the day and 6 at night. In this case, each time it is necessary to give the baby the breast, and not express milk. The contraceptive effectiveness of MLA remains at an acceptable level if the share of complementary feeding is no more than 15%.

Terms of application. The first 6 months after birth with proper breastfeeding.

Efficiency. 98%.

Advantages

• Easy to use.
• Gives a contraceptive effect immediately from the start of use.
• Does not affect sexual intercourse.
• Promotes uterine contractions, reducing the risk postpartum complications(bleeding) and leading to a speedy recovery of the body.
• Does not require medical supervision.
• Beneficial for the child (breastfeeding provides the child with the most adequate nutrition, promotes the development of immunity, and reduces the risk of infection).

Flaws

• Requires strict adherence the above breastfeeding rules.
• Not suitable for working women.
• Short-term use (6 months).
• Does not protect against sexually transmitted diseases.

Hormonal methods

ORAL CONTRACEPTIVES (OK)

OCs containing only progestins (“mini-pills”)

The tablets contain progestins - synthetic hormones, the contraceptive effect of which is to reduce the amount and increase the viscosity of cervical mucus (which prevents the passage of sperm into the uterus), change the structure of the mucous membrane of the uterine body (this prevents embryo implantation) and suppress ovulation.

Start of use. Breastfeeding women can start taking pills 5-6 weeks after birth, non-breastfeeding women - from the 4th week after birth or with the onset of menstruation.

Efficiency. 98% when taking the pills correctly and regularly in combination with breastfeeding.

Advantages. They do not provide negative influence on the quantity, quality of milk and duration of lactation.

Flaws. In the first 2-3 cycles of use, intermenstrual periods are often observed. spotting, which is a consequence of the body’s adaptation to the drug. Some women may experience menstrual irregularities, including amenorrhea.

Features of application. OK prescribed by the doctor. They must be taken daily, without breaks, strictly at the same time. Violation of the time of taking or skipping pills, as well as the simultaneous use of certain antibiotics, anticonvulsants and sleeping pills, vomiting or diarrhea reduce the contraceptive effect. The ability to conceive is usually restored immediately after stopping the drug. After stopping feeding, you should switch to combined OCs, which are more effective.

Combined OK

They contain gestagen and estrogens hormones that suppress the growth and maturation of follicles and ovulation, as well as preventing implantation.

Start of use. After stopping breastfeeding, combined OCs are started to be taken with the resumption of menstruation. If you have not breastfed at all, you can use this type of contraception from the 4th week after birth.

Efficiency. When taken correctly and regularly, the effectiveness approaches 100%.

Advantages. After stopping taking the pills, the ability to conceive is quickly restored.

Flaws. It is not advisable to use during breastfeeding (estrogens reduce milk secretion and the duration of lactation).

Features of application. Similar to the use of OCs containing only progestins.

LONG-ACTING PROGESTAGENS

Highly effective products long acting. These include, for example, injectable drug"Depo-Provera" and subcutaneous implant "Norplant".

Start of use. The first administration of the drug to nursing women is no earlier than 6 weeks after birth, to non-breastfeeding women - from the 4th week after birth.

Efficiency. 99%.

Advantages. Do not affect the quantity and quality of milk, the duration of lactation, do not have harmful influence per child. One injection of Depo-Provera provides contraception for 12 weeks. "Norplant" provides protection against unwanted pregnancy for a period of 5 years. Removal of the implant is possible at any time.

Flaws. The disadvantages of OCs containing only progestins are similar (frequent intermenstrual bleeding and the onset of amenorrhea).

Features of application. Prescribed and administered by a doctor. In the first 2 weeks after administration, additional contraceptives should be used. It is necessary to strictly observe the intervals between administration of the drug. “Norplant” must be removed after 5 years, since after this period the effectiveness of the method sharply decreases. After discontinuation of the drug, restoration of a regular menstrual cycle and the ability to conceive usually occurs within 4-6 months.

Intrauterine contraceptives (spirals)

Start of use. In case of uncomplicated labor and no contraindications, an intrauterine device (IUD) can be inserted immediately after birth. This does not significantly increase the risk infectious complications, bleeding or perforation of the uterus. Optimal time introduction - 6 weeks after birth, which reduces the incidence of IUD loss.

Efficiency. 98%.

Advantages. Compatible with breastfeeding. Provides protection from pregnancy for up to 5 years. Gives a contraceptive effect immediately after administration. The IUD can be removed at any time. Restoring the ability to conceive after removal of the IUD occurs very quickly.

Flaws. Sometimes it causes discomfort in the lower abdomen, resulting from contractions of the uterus during breastfeeding. For some women, in the first months after insertion of an IUD, menstruation may be heavier and more painful than usual. Sometimes the IUD comes out.

Features of application. The IUD is inserted by a doctor. Not recommended for women who have had inflammatory diseases uterus and appendages, both before pregnancy and in the postpartum period; as well as women who have multiple sexual partners, since in this case the risk of inflammatory diseases increases.

Barrier methods of contraception

CONDOM

Start of use. When resuming sexual activity after childbirth.

Efficiency. On average 86%, but with correct use And good quality reaches 97%.

Advantages. The method is easily accessible and easy to use, and does not affect lactation or the health of the child. Greatly protects against sexually transmitted infections.

Flaws. At misuse the condom may slip off or break. Use is associated with sexual intercourse.

Features of application. You should not combine the use of a condom with the use of fatty lubricants, which can cause the condom to rupture. Use a neutral lubricant with spermicide.

DIAPHRAGM (CAP)

Start of use. Not earlier than 4-5 weeks after birth - until the cervix and vagina shrink to normal sizes.

Efficiency. Depends on correct application. During breastfeeding, it increases to 85-97% due to a decrease in the ability to conceive at this time.

Advantages. Does not affect lactation and baby's health. Provides partial protection against some sexually transmitted infections.

Flaws. Use is associated with sexual intercourse.

Features of application. Select a diaphragm for a woman and teach her how to use this method of contraception medical worker. After giving birth, you need to clarify the size of the cap; it may have changed. Used together with spermicides. The diaphragm should be removed no earlier than 6 hours after sexual intercourse and no later than 24 hours after its insertion.

SPERMICIDES

This method of chemical contraception is the local use of creams, tablets, suppositories, gels containing spermicides - substances that destroy the cell membrane of sperm and lead to their death or impaired motility.

Start of use. When resuming sexual activity after childbirth. While breastfeeding, they can be used independently; in the absence of lactation, they should be combined with other means of contraception, in particular with a condom.

Efficiency. At correct use 75-94%. The contraceptive effect occurs a few minutes after administration and lasts from 1 to 6 hours depending on the type of drug.

Advantages. In addition to those described for the condom, it provides additional lubrication.

Sterilization

Sterilization is a method of irreversible contraception in which ligation or clamping of the fallopian tubes (in women) or ligation of the vas deferens (in men) is performed surgically.

FEMALE STERILIZATION

Start of use. Performed immediately after uncomplicated childbirth local anesthesia laparoscopic approach or by minilaparotomy, as well as during surgery caesarean section.

Efficiency. 100%

Advantages. The effect occurs immediately after the operation.

Flaws. Irreversibility. Low likelihood of postoperative complications.

Features of application. The method is acceptable only for those who are absolutely sure that they do not want to have more children. The decision to use the method should not be made under pressure from circumstances or emotional stress.

MALE STERILIZATION (VASECTOMY)

Under local anesthesia, a small incision is made in the scrotum and the vas deferens is ligated (similarly fallopian tubes). Sexual desire, erection and ejaculation are not disturbed in any way, only the ejaculate does not contain sperm.

Efficiency. 100% if you follow the rule: you should use a condom for the first 3 months after surgery. The effectiveness of vasectomy can be confirmed by the absence of sperm in the ejaculate, detected using a spermogram.

Disadvantages and application features. Similar to female sterilization.

Natural Family Planning Methods

Based on abstinence from sexual intercourse on days favorable for conception.

Start of use. Only after establishing a regular menstrual cycle.

Efficiency. No more than 50% if all rules are followed.

Advantages. Absence side effects. Spouses bear joint responsibility.

Flaws. To determine favorable and unfavorable days the couple requires special training by medical staff, careful record keeping, self-control and self-discipline. It is not recommended immediately after childbirth, as it is difficult to determine the timing of ovulation and first menstruation.

Is it possible to get pregnant immediately after giving birth? This question interests many young mothers. On the one hand, there is such a thing as lactational amenorrhea, which in principle excludes conception. On the other hand, families raising babies of the same age prove that pregnancy is quite likely soon after birth.

What is lactational amenorrhea?

Nature has decreed it in such a way that reproductive functions Women after the birth of a child recover gradually and not immediately. The fact is that when a baby is born, the female body intensively produces a hormone that promotes the production of breast milk and at the same time suppresses ovulation processes. The hormonal background of the young mother changes, which is accompanied by the absence of menstruation. Doctors call this condition lactational amenorrhea.

However, there are times when menstrual cycle in a young mother it returns to normal immediately after childbirth, and the first menstruation occurs within a month. If the spouses had intimate intimacy during the period, then the onset of pregnancy soon after childbirth is very likely!

Important! No doctor can guess the timing of normalization of the menstrual cycle in a young mother, since everything depends on the individual characteristics of the body. In some women, ovarian function remains suppressed for 2 years, while others can conceive already in the first weeks after the baby is born!

Gynecologists say that pregnancy can be prevented during breastfeeding if the time interval between feedings is no more than 6 hours. But even this method is not a 100% guarantee of protection against possible pregnancy!

If a young mother nevertheless decides to lead an unprotected intimate life during breastfeeding, she is recommended to follow the following rules:

1. Feed your baby regularly, without periodically replacing breast milk with artificial formula.
2. During feeding, place the baby directly on the breast. The method of expressing milk is not suitable for these purposes.
3. Strictly observe the time intervals between feedings (no more than 5–6 hours).
4. Try to feed your baby at night, because it is during these hours that prolactin is produced most intensively in the body.

Please note: With frequent and regular feeding, a woman’s ability to conceive is restored within 1-2 years. Otherwise, ovulation may occur several months after birth. If a woman's menstrual cycle has returned, breastfeeding as a method of contraception loses its effectiveness!

When does pregnancy occur with artificial feeding?

If a woman does not breastfeed her baby, the chances of becoming pregnant during the first weeks after birth are more than 95%! The fact is that the hormone prolactin, which suppresses ovulation processes, is produced exclusively during lactation. And if the baby is on artificial feeding, then the young mother’s menstrual cycle is restored, usually within 4 weeks.

Please note: If you are not breastfeeding, start using protection at the very first intimacy after childbirth!

Pregnancy during lactation

If a young mother is breastfeeding, then doctors do not recommend conception earlier than a year after the end of the lactation process. Breastfeeding consumes most of the resources of the female body, vitamins, microelements and nutrients. For this reason, when a new pregnancy occurs, even special vitamin and mineral complexes will not help to adequately provide the fetus with all the substances necessary for normal, full intrauterine development.

The woman herself, in most cases, suffers from vitamin deficiency, weakening immune system, which is very dangerous. New pregnancy, which occurs during breastfeeding, is difficult, accompanied by strong manifestations and high. In addition, during breastfeeding, stimulation of the nipples occurs, which increases and can cause premature termination of pregnancy.

It is for this reason that if a young mother becomes pregnant again, then to reduce possible risks, doctors recommend that she take it at least in the 5th–6th month of pregnancy. However, this is also an undesirable option. After all, breast milk is the best stimulant for a baby. And weaning from the mother’s breast will be a great psycho-emotional shock for a small child.

Important! If you become pregnant again, wean your baby off the breast smoothly and gradually so as not to injure the baby. A qualified specialist will tell you how to do this correctly, and what timing of cessation of lactation will be most relevant!

What are the dangers of early pregnancy after cesarean section?

According to gynecologists, pregnancy after artificial childbirth () is possible already in the first months after the birth of the baby. However, conception in such a situation is not only undesirable, but also extremely dangerous for a young mother. The fact is that after a difficult artificial labor process, the female body is especially weakened; the vaginal muscles and abdominal wall cannot yet hold the fetus in the correct position, which is fraught with the threat of miscarriage.

In addition, after a cesarean section, the woman in labor is required to have stitches, and with a rapid re-birth, the likelihood of the postoperative scar diverging is very high.

Why is pregnancy after childbirth undesirable?

Even if the first birth went well, according to experts, pregnancy during the first two years is extremely undesirable. Carrying a child and yourself birth process greatly weaken the female body and undermine its strength.

If a woman is not given the opportunity to fully recover after childbirth, then another pregnancy may be associated with the following risks:

Please note: If pregnancy occurs soon after childbirth, it is important that the woman pays special attention to her health and is under constant supervision of her doctor!

We must not forget about psychological aspect. According to psychologists, repeated postpartum pregnancy that occurs within two years is extremely severe and can cause the development of disorders mental nature! In addition, it will be extremely difficult for a young mother to manage two children of the same age, both physically and psychologically!

If pregnancy occurs

But what to do if a second pregnancy occurs much earlier than the recommended period? The opinion of experts on this issue is unanimous: give birth! Abortion can be recommended only in exceptional situations, in the presence of certain clinical indications.

A woman needs to pay special attention to her health, eat well and rationally, and take specialized vitamin and mineral complexes prescribed by her doctor.

A young mother expecting a new addition to the family should have a good rest and sleep. You cannot do this without the help of loved ones. Daily walks are also recommended. fresh air, which will be useful both for the baby and for the pregnant woman herself.

With insufficient tone of the vaginal muscles and muscle groups abdominal wall minimize risks possible interruption pregnancy is possible with the help of a special prenatal bandage, which is recommended to be worn regularly.

How can breastfeeding mothers protect themselves?

The issue of contraception among nursing mothers is quite acute. If a woman’s menstrual cycle has returned to normal, then it is simply necessary to take precautions to avoid early re-pregnancy. However, what contraceptive method will be effective and extremely safe?

Please note: application birth control pills hormonal nature is strictly contraindicated for nursing mothers!

A means of preventing unwanted pregnancy such as spermicidal vaginal suppositories (Patentex, Pharmatex and others) will be quite effective and safe for nursing mothers. According to statistics, protection in this case is about 90%, and at the same time, unlike condoms, the degree of sensitivity during intimate intercourse is practically not reduced.

The installation of an intrauterine device provides a good effect and maximum comfort. However, the IUD can be placed on young mothers only after prior consultation with a specialist.

Please note: Only an individual consultation with a gynecologist will help a woman choose the right contraception! This rule especially applies to breastfeeding mothers!

Signs of pregnancy after childbirth

Pregnancy that occurs shortly after childbirth has rather vague symptoms. Possible changes Women’s well-being and behavior are often attributed to the peculiarities of the postpartum period. However, gynecologists still point to a number of specific signs indicating the onset of a second pregnancy.

These include the following factors:

• Swelling or increased sensitivity mammary glands.
• Changed consistency of breast milk due to changes hormonal levels, which occur in the female body during pregnancy.
• Decreased breast milk supply.
• Absence critical days(if the young mother’s menstrual cycle has already stabilized).
• Soreness of the mammary glands, with a tendency to intensify during feeding.
• Increased fatigue.
• Increased body temperature.

In addition, the young mother has early stages pregnancy, all the signs characteristic of pregnancy may appear, namely: in the morning, changes in taste preferences, excessive sensitivity to odors, attacks, etc.

Important: When the above symptoms appear, a woman is recommended to consult a gynecologist to determine the timing of pregnancy and obtain specialist advice!

Is it possible to get pregnant immediately after giving birth? According to obstetricians and gynecologists, pregnancy can occur within the first month after the baby is born. However, plan next pregnancy It is recommended no earlier than 2-3 years after the birth of the first child, in order to give the opportunity female body fully recover. In case of imminent reconception, it is extremely important that the pregnancy takes place under the strict supervision of a specialist, in order to avoid the development possible complications and premature birth!