(Updated July 2013)
Contraceptive Options for US Women in the Postpartum Period Table
| Contraceptive Options for US Women in the Postpartum Period | ||
| Method | Advantages | Consider |
| Most effective (99% or more effective) | ||
| Transcervical sterilization (Essure®) | Permanent. May be placed in an office setting. | Delayed efficacy. Follow-up procedure (hysterosalpingogram) required to confirm efficacy. Non-reversible. |
| Tubal ligation | Permanently eliminates concerns about birth control. Surgical procedure. | Non-reversible in most cases. Can be done laparoscopically. |
| Intrauterine contraception (Copper T IUD [ParaGard®] or LNG 52 IUS [Mirena®] or LNG 13.5 IUS [Skyla™]) | Copper T IUD lasts 10 -12 years. It can be used by nursing women.
LNG 13.5 IUS lasts up to 3 years |
Lower risk of expulsion if insertion delayed until 6 weeks postpartum. Not recommended for women currently at risk of STIs or pelvic inflammatory disease. |
| Very effective (91% – 99% effective) | ||
| Oral contraceptives (OCs): combination | Does not interfere with sexual activity. Helps ease menstrual cramps and regulate menstrual periods; may be used continuously to suppress periods. Reduces risk of ovarian and endometrial cancer. | Estrogen-containing OCs are not generally recommended for women who are breastfeeding. If not nursing, women can begin using 3-4 weeks postpartum. |
| Oral contraceptives: progestin-only | Suitable for breastfeeding women. Does not interfere with sexual activity. May cause irregular menstrual bleeding. | Breastfeeding women can initiate 6 weeks postpartum. |
| Injection (DMPA) | Contains synthetic progesterone. Suitable for nursing mothers. | Injections 4 times/year. Irregular menstrual cycles and weight gain possible. Fertility may take up to 1 year to return. |
| Patch | Provides 1 week of protection. Easy to apply. |
Contains estrogen and therefore not recommended for breastfeeding women. |
| Vaginal ring | Once-a-month vaginal insertion. Can be used continuously to suppress menstruation. | Small percentage of users report discomfort; some women are uncomfortable with vaginal method. |
| Effective (81% – 90% effective) | ||
| Condom | Lubricated condoms can ease pain with sex if vaginal dryness is a problem. Provide STI protection. Female condom allows woman to control use of barrier method. | Condoms may tear during intercourse. Some people are allergic to latex, in which case polyurethane condoms are recommended. |
| Diaphragm (with spermicide) | Good option for women who prefer a barrier method to hormones. | Refitting after childbirth required but should be delayed for 6 weeks postpartum. Not suitable for women allergic to latex. May increase risk of bladder infection. Should be refitted/replaced at least every 2 years. |
| Moderately effective (80% effective) | ||
| Cervical cap (with spermicide) | An option for women who prefer a barrier method to hormones. | Refitting after childbirth required but should be delayed for 6 weeks postpartum. Not suitable for women who are allergic to latex. Should be refitted/replaced every 2 years. |
| Spermicides | Non-hormonal contraception that is highly portable and discreet. Protection against some STIs. | Includes foam, creams, gels, vaginal suppositories, and film. Use with a condom boosts effectiveness. Spermicides do not protect against HIV. |
| Sponge | Non-hormonal contraception that provides a barrier to sperm and contains spermicide. | Delay use until 6 weeks postpartum to reduce risk of toxic shock syndrome. Does not protect against HIV. |