Pregnancy

Birth Control After Pregnancy

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Many women choose to begin regulating their reproductive health with birth control (contraception) after they have had a child or experienced a pregnancy. The reasons for doing so vary from person to person. From preventing an unintended pregnancy to major postpartum health complications, women have a variety of birth control options available to suit their health concerns.

Thanks to reproductive health developments over the last century, there are a variety of birth control options for women to participate in. Some prefer the convenience of an intrauterine device (IUD), while others prefer the regimen of daily pills. Women use birth control to prevent pregnancy, but they also use it to regulate their bodies as well.

Hormonal imbalances can cause a variety of uncomfortable reactions in the body such as depression, painful periods, acne and stimulated facial hair growth.

Many women experience fluctuating hormonal changes after having a child, which range in severity. Polycystic ovary syndrome (PCOS) is a condition that affects one in ten women in the United States.

Though the exact cause is still unknown, high levels of androgens and insulin are indicators of PCOS. Androgens are what control the development of male traits like facial hair or male-pattern baldness. So when women start growing extra hair on their face, chin and body, they often resort to birth control to regulate their androgen levels.

PCOS also presents itself in the form of multiple cysts on one or both ovaries, irregular periods that come too often, later than normal or not at all.

Wait, I’m not ready for another child!

Some women begin planning their birth control methods while they’re still pregnant. The reason for this is that pregnancy can occur very soon after having a baby. There are a few considerations to be mindful of with postpartum birth control.

The American College of Obstetricians and Gynecologists indicates most forms of birth control are safe to use while breastfeeding, with the exception of a few that can affect the milk supply. Some birth control methods can be started immediately after birth, but there are some that require some time in between. The sponge and cervical cap are not recommended as effective for women who have given birth to a baby.

Types of Birth Control

The Intrauterine Device

An IUD is a T-shaped device that a healthcare professional inserts into the patient’s uterus. It is one of the most convenient birth control methods because there is little-to-no maintenance required. According to Planned Parenthood, IUDs are 99% effective, with fewer than one in ten women becoming pregnant with the implant. Just remember, an IUD does not protect you from sexually transmitted diseases (STDs)

How it works
Any type of IUD can be implanted immediately after a cesarean or vaginal birth, or at a postpartum checkup. There are two types of IUDs available on the market: hormonal release and copper.

Hormonal Release IUD: no egg, no preg
The hormonal release IUD contains a small amount of the hormone progestin to regulate the communication between a sperm and an egg, thereby preventing pregnancy. The hormones work by thickening the mucus that lines the cervix and prevents the egg from ever leaving the ovaries (ovulation). This type of IUD can be left in the uterus for 3-5 years.

Copper IUD: Sperm-B-Gone
There is the option of having a copper IUD implanted as well. This IUD contains no hormones. Rather, it is constructed of a small amount of copper. Sperm has an aversion to copper which makes reaching the egg nearly impossible (boy bye). This type of IUD can be left in the uterus for up to 12 years.

IUD Brands (have the cutest names for being a badass birth control)

Hormonal:

  • Mirena
  • Kyleena
  • Liletta
  • Skyla

Copper:

  • ParaGard

Wait, what if I don’t like my IUD?

Some IUDs can cause side effects that are difficult to deal with. The good thing about an IUD is it can be removed at any time.

Commonly reported side effects are:

  • pain after insertion
  • cramping and backaches
  • Irregular periods during the first 3-6 months
  • Heavier periods and worsened cramps
  • Spotting

Major side effects:

  • Migration
  • Perforation of the uterus
  • pseudotumor cerebri (PTC), also known as idiopathic intracranial hypertension
    Infertility (in fact, apparently there are pseudotumor cerebri lawsuits being filed)

Injectable birth control: Home Depo

With a little more maintenance than the IUD, the birth control shot is injected into the arm or buttock of the patient every 3 months. The progestin in this method is called depot medroxyprogesterone acetate (DMPA), aka: Depo Provera, aka: Depo shot. This prevents ovulation from occurring (remember, no egg no preg). This is another birth control method that can be administered immediately after a cesarean or vaginal delivery.

Side effects and complications:

  • Nausea
  • Irregular bleeding
  • Headaches
  • Weight gain
  • Breast tenderness

Bone loss is a common side effect of injectable birth control. Some bone loss will return when injections are stopped. Those with cardiovascular disease should stay far away from injectable birth control.

Brands:

  • Depo-Provera®
  • Sayana Press®
  • Noristerat®

Pills, a vaginal ring or a patch are also very common birth control methods used by thousands of people across the country that help regulate the reproductive system. We’ll go ahead and break down how they work, side effects and brands.

Mommy needs her pills. No, not those, the others ones!

Birth control pills have been around since the 1960s and are still a very popular and affordable way to manage pregnancy and hormonal changes. They are taken on a daily basis to regulate the hormones. “The pill” as it’s known, comes in progestin-only form, or as a combination of progestin and estrogen.

The pill can be used three weeks after childbirth. There are many benefits to taking the pill, which is why so many women rely on it for reasons other than pregnancy. The progestin or combo pill can help relieve cramping, lighten periods or lower ectopic pregnancy (a pregnancy that occurs outside of the uterus and is very painful).

Other benefits include:

  • Cysts on the breasts or ovaries
  • Bone thinning
  • Iron deficiency (anemia)
  • Premenstrual syndrome (PMS)
  • Acne
  • Endometrial and ovarian cancer
  • Ovarian, fallopian tube or uterine infection
  • Pelvic inflammatory disease

However, there are some downfalls to taking the combination pill that should be taken into consideration.

  • Women who are breastfeeding can be affected by the pill, as the hormones can cause trouble with producing adequate milk supply.
  • There is an increased risk of developing deep vein thrombosis (DVT), a dangerous condition of developing blood clots in the deep regions of the body.
  • Women over 35 years old are at risk of heart attack and stroke, especially if they are smokers, have a history of high blood pressure or cardiac complications.

Stick it on

The Patch is another contraceptive device used to regulate hormone levels to prevent pregnancy or regulate other complications. It has a bit of an irregular schedule compared to a daily pill. The patch is worn for three weeks at a time (21 days), removed for one week, a new one is applied and the process begins all over again.

The only brand of contraceptive patches available in the United States are Xulane and Evra.

Ring it on

The vaginal ring (NuvaRing) is a latex-free device that releases hormones in the same manner as an IUD. No surprise here, it is shaped like a ring and nestles itself into the uterus. It follows the same regimen as the patch (inserted for 21 days, removed for 7). Some medicines have been known to interfere with the effectiveness of the ring’s hormonal flow.

  • Antibiotics (Rifampin, Rifampicin, Rifamate)
  • Antifungal (Griseofulvin)
  • HIV medication
  • Anti-seizure medicines
  • St. John’s Wort, an herbal supplement

Certain medical histories also pose a problem for experiencing side effects that can be dangerous and potentially fatal.

Those include:

  • Blood clots
  • Breast cancer
  • Migraine headaches
  • Angina, heart attack, stroke or other cardiac complications
  • Diabetes
  • Liver disease
  • Migraine headaches

Contraceptive methods vary from person to person. Whether it’s primarily birth control or other reproductive concerns, it’s important that a knowledgeable healthcare professional monitors and prescribes the most effective method of contraception.

Sources:

https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

https://www.cdc.gov/reproductivehealth/contraception/unintendedpregnancy/pdf/contraceptive_methods_508.pdf

https://www.plannedparenthood.org/learn/birth-control

https://www.fda.gov/ForConsumers/ByAudience/ForWomen/FreePublications/ucm522453.htm

https://www.advocacyforpatients.org/pseudotumor-cerebri-lawsuit/

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