Types of contraception
You can expect your first period from six weeks after giving birth. If you are breastfeeding, you may not have your period for much longer. Your fertile period is 2-3 weeks before menstruation, which means that you can get pregnant again as soon as two weeks after giving birth! If you do not want this, it is necessary to use contraception.
COMBINATION PIL
This is actually the "normal" pill. It contains 2 types of hormones: estrogen and progesterone which prevent ovulation. After 3 weeks of taking the pill, you will have a stop week during which you will have your period. If you wait for your first period after giving birth and start taking the pill on the first day of your period, you will be sufficiently protected against pregnancy after one week. If you are in doubt about the start of your period or if you just start taking the pill somewhere in the middle of your cycle, the entire first strip is not safe, and you should use a condom for extra protection. Only after the first stop week, at the beginning of the second strip, are you sufficiently protected.
If you are breastfeeding the combined pill is not recommended. Both hormones are given to your baby in small amounts through the breast milk. The oestrogen can also reduce the amount of food you eat.
MINIPIL
If you are breastfeeding and would still like to take the pill, then choose the minipill (Cerazette). Cerazette only contains progesterone. To keep the risk of pregnancy as low as possible, a minipill should be taken every day at around the same time. There is no stop week, so menstruation can sometimes be more irregular. When used correctly, Cerazette is just as reliable as a combined pill.
COPPER IUD
A copper IUD is placed in the uterus. Copper paralyses the sperm cells and makes them inactive. This prevents fertilisation of an egg. A copper IUD is ideal for women who prefer hormone-free contraception. The natural cycle is maintained, and you can have carefree sex. However, menstruation may be heavier. For most women, the menstrual pattern is back to normal a few months after placing a copper spiral.
A copper coil is safe to use during the breastfeeding period. A copper coil is less suitable for women who suffer from a lot of cramps or a lot of blood loss during the natural cycle.
You can have an IUD placed by our midwife at the IUD consultation. You can choose for the copper IUD T-Safe (10-year protection) or the copper IUD Ballerine (5-year protection).
HORMONE IUD
A hormone coil is inserted into the uterus where it releases a small amount of levonorgestrel hormone daily to prevent pregnancy. This causes a thicker and tougher mucus in the cervix. This makes it more difficult for sperm to enter the uterus. It also inhibits the buildup of the endometrium. This has the effect of making your periods lighter. The bleeding is shorter, less intense, or sometimes stops completely.
A hormone coil is a very reliable form of contraception. The hormone enters the blood only in very low quantities, which makes it perfectly suitable for use during breastfeeding.
You can have an IUD placed by our midwife at the IUD consultation. You can choose for the hormone IUD Mirena or the hormone IUD Kyleena. These both give 5 years protection.
CONDOM
The condom is a widely used method of contraception. However, it is slightly less reliable than the pill or an IUD. It is best to use condoms with a spermicide lubricant. If other methods of contraception are not suitable or not desirable for you, then the condom is a good alternative. It does not affect your natural cycle or breastfeeding in any way.
INJECTION PILL
With the injection pill you do not have to take anything orally, but you will get an injection with progesterone every 3 months. The advantage is that you do not have to take the pill every day. The disadvantage is that your menstruation, especially in the first months, will be very irregular. After stopping the injection pill, it can sometimes take up to six months before your own cycle starts up again. If you want to become pregnant again quickly, then the injection pill is not a good choice.
CONTRACEPTIVE RING (NUVARING)
This is a flexible plastic ring that you must insert into your vagina once a month. The ring contains the same hormones as the combined pill, and these are absorbed through the vaginal wall into the blood to inhibit ovulation. After 3 weeks you remove the ring and have your period. If you are breastfeeding, the contraceptive ring is not recommended for the same reasons as the combined pill.
THE CONTRACEPTIVE PATCH (EVRA)
It is applied to the skin and contains the same hormones as the pill. As with the pill, you use the contraceptive patch for 3 weeks followed by a stop week when you have your period. An Evra plaster works for 1 week, which means that you must use it three times per cycle on the same day of the week as the day you started. Evra is not suitable for use during breastfeeding.
THE CONTRACEPTIVE IMPLANT (IMPLANON NXT)
The contraceptive implant, called Implanon NXT, provides 3 years of protection against pregnancy. The implant is inserted into your upper arm by a doctor and is designed to continuously deliver a low hormone dose to your body. This can cause your period to be irregular, miss or be very long. Other side effects include headaches and sore or tight breasts. These usually go away within 3 months. Implanon is safe to use during the breastfeeding period.
STERILISATION
If your family is complete, or if you absolutely do not want any more children, sterilisation is a definitive form of contraception. A choice must be made as to which of the two will be sterilised: the man or the woman.
The way sterilisation is done varies greatly. In men, both vas deferens are interrupted and tied off under local anaesthesia. In women, during keyhole surgery, the fallopian tubes are blocked with a ring or a small clip.
Both forms of sterilization do not affect the menstrual cycle, the desire for sex, or the ability to have an orgasm. Those seeking sterilization will be referred to a gynaecologist or urologist through their GP.
OTHER NON-HORMONAL CONTRACEPTIVE METHODS
These include the diaphragm, periodic abstinence, coitus interruptus. These methods are much less reliable.