You’ve just had a baby, congratulations! The last thing on your mind right now is sex. But you will have sex again - and if you have sex you may get pregnant. It’s not too early to start thinking about contraception.

Most women resume sex around 6 weeks after giving birth. If you aren’t breastfeeding, chances are you will ovulate within 4 weeks after delivery. So if you have sex before your 6-week postpartum checkup, you could actually go to that visit only to learn that you’re pregnant again! Scary, huh?

Breastfeeding delays the return of ovulation and minimizes your risk of getting pregnant again so quickly after birth. However, for maximum protection you must be exclusively nursing the baby (no other foods or liquids for baby, including formula) and your period can’t have yet returned. Once it does, all bets are off - you’re potentially fertile again.

So how do you prevent pregnancy after birth? The easiest answer is to never have sex again - but that’s unlikely. Barrier methods (condoms, diaphragm, cervical cap) are good choices but both the diaphragm and cervical cap need to be fitted when your body has returned to normal, so typically not before your 6-week postpartum check-up. These methods need to be used each and every time you have sex. Taking chances is risking pregnancy.

Progestin-only pills (the mini-pill), and injections (Depo-Provera) are safe for use after birth yet most women wait until their 6-week post-delivery visit to start. Progestin-only contraceptives don’t interfere with breastfeeding. The progestin implant (Implanon) can be placed in your uterus directly after the placenta is delivered but some women choose to wait for about 4 weeks to reduce the risks of the device being expelled. If for some reason you can’t return in 4 weeks for the implant, ask to have it immediately placed post-delivery.

Combination hormone pills, patches and rings (what we typically call “birth control”) impacts breastfeeding and experts recommend that you delay these methods until breastfeeding is well established, usually at least 4 weeks, although many women won’t feel confident in their milk supply and feeding until up to 8 weeks postpartum.

Sterilization (having your tubes tied) is a permanent procedure that can be done postpartum (particularly if you’re undergoing a cesarean birth). This is permanent and decisions regarding having a tubal ligation should be made before you birth your baby. Most providers will not perform this immediately after birth “on demand.”

Talk to your healthcare provider, your female family members and friends and be sure to talk to your partner too. It took two of you to get you pregnant - and it takes two of you to prevent another pregnancy too soon.

Useful Tips

• Breastfeeding delays ovulation.
• Barrier methods like condoms are useful but must be used every time.
• Progestin-only pills and injections are safe for use after birth but most women wait to start.
• Birth control impacts breastfeeding and experts recommend you wait until breastfeeding is well established.
• Sterilization works but most providers will not perform this right after birth.