(Updated July 2013)
Contraceptive Options for US Women in the Postpartum Period Table
|Contraceptive Options for US Women in the Postpartum Period|
|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.|