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Which post-birth contraception is best?
I've recently given birth and want to start planning contraception, but I have no idea where to start! My partner and I both want something a more long term than the pill or condoms and I'm not keen on the injection. I have very little knowledge of IUDs or the implant in your arm.
I suffer with very irregular, heavy and painful periods so something that helps to make them a bit lighter would be a bonus. I'm not breast feeding so that isn't an issue.
Dr. Valerie Tagwira: Congratulations on the birth of your baby - it's great that you are thinking about effective contraceptive choices, particularly as you wish to avoid an unplanned pregnancy.
For you, I would recommend Long Acting Reversible Contraceptive Methods. These include the injection which lasts three months, the implant which lasts 3 years and intrauterine devices (coils) which last for 5 to 8 years, depending on the type.
Apart from their safety and effectiveness, these methods all have the added advantage of not interrupting sex. You won't have to worry about contraception all the time, and if you want to have another baby, they are readily reversible in general. The exception to the rule is the injection, which may be associated with a delay of return to normal fertility by several months. Coils can be fitted from 4 to 6 weeks following the birth of your baby. Because you have a history of heavy periods, the Mirena coil may be your best option. It is known to be good at reducing heavy menstrual flow in most women. It is licensed for this use, as well as for contraception. Up to a third of women do not have periods after 12 months of use. This is not harmful and may be a welcome change!
The copper coil is effective but it may cause heavy periods in some women. I would not recommend it as your first choice if you are already prone to heavy periods. The implant may be a suitable alternative for you. It can be inserted under the skin of your inner arm from day 21 after having your baby. Your pattern of bleeding can be altered, and some women do experience reduced menstrual loss.
The Depo Provera injection is also a highly effective method of contraceptive. It is similar in causing unpredictable bleeding, with a proportion of women having lighter bleeding or no periods.
If you prefer a permanent method, sterilisation is available as laparoscopic (key-hole) surgery. Partner vasectomy is a safer and quicker procedure with a lower failure rate. It can be done under local anaesthetic.
We provide a full range of all these methods at Marie Stopes Centres and you can find more information at www.mariestopes.org.uk
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