Contraception and Postnatal Support

Condoms and diaphragms are both barrier methods of contraception. Condoms are readily available and also protect against sexually transmitted infections. They are more effective when used with a water based lubricant to reduce the risk of breakage.

A Diaphragm is a soft rubber cap which is inserted to cover the cervix prior to intercourse and left in place for at least 6 hours afterwards. If you wish to use this as a method of contraception we can advise you of where you can access it.

The Copper and Multiload IUDs are non-hormonal forms of contraception that are inserted into the uterus. They last 10 and 5 years respectively. Some women experience heavier and more painful periods with these devices. They are easy to remove with a quick return to fertility after removal. They can be inserted in the clinic. They are safe with breastfeeding and can be inserted from 12 weeks after delivery.

• Marie Stopes
• Shine SA

Depo Provera is an intramuscular injection of progesterone which is repeated every 12 weeks. Some women experience amenorrhoea (no bleeding) with depo injections. It is associated with a slower return to fertility once stopped and is not recommended in younger women or women approaching menopause as it can reduce bone density. The injections are usually administered by the clinic nurse. It is safe to use with breastfeeding and can be administered once bleeding has stopped after giving birth.

For more information see the below links:

• The Women’s
• RANZCOG
• Shine SA

Implanon is a progesterone-only contraceptive implant that is inserted in your upper arm. Like the Mirena, it is a LARC (long acting reversible contraception), which can be removed at any time. Insertion is a simple process under local anaesthetic in the clinic and the implant is contraceptive for 3 years. Dr Smith and Dr Andrew are both trained in Implanon insertion. Some women experience irregular bleeding on the Implanon and there may be other side effects which your doctor will discuss with you prior to insertion. It is safe to use the Implanon any time after giving birth, even with breastfeeding.

For more information see the below links:

• Shine SA
• Family Planning Victoria
• Family Planning NSW

If your baby is less than 6 months old AND you are exclusively breastfeeding your baby (ie no supplementary food or fluids) AND you haven’t had a period, you have a method of contraception which is 98% effective. It is important to have “back up” contraception on hand in case any of these criteria change.

For more information see:

• Australian Breastfeeding Association
• World Alliance for Breastfeeding Action

A Mirena or Kyleena IUD is a device that gets placed into your uterus. It is one of the most reliable forms of contraception, lasts for 5 years, has a low side effect profile, is easy to remove, has quick return to fertility once removed and is able to be inserted in the clinic rooms (in most cases). Kyleena, which is new to Australia, is smaller than a Mirena and is reported to have even fewer hormonal side effects. Mirena has also shown to be helpful for pelvic pain and troublesome periods. Both are safe to use while breastfeeding, although it is generally best to not insert it until 3 months after delivery. Dr Smith, Dr Andrew, Dr Hadgraft and Dr Frost are all skilled in IUD insertions.

HOW TO PREPARE FOR YOUR IUD INSERTION

For more information see the below links:

• Shine SA
• Family Planning NSW
• Mirena Website
• Family Planning Victoria

Nuva ring is a combined hormonal contraceptive which comes in the form of a soft plastic ring which is self-inserted into the vagina for 3 weeks at a time. It is not covered by the PBS so it is a more expensive option, but does suit some women. Like the OCP, it can be commenced 6 weeks after giving birth, although it may affect breastmilk supply in some women.

• Family Planning NSW
• Family Planning Victoria
• Nuva Ring Website

The OCP remains a population form of contraception due to ease of use and predictability of periods. It is a combination of oestrogen and progesterone. It is essential that is taken everyday and there are several different brands available (ie it is not “one size fits all”). There are cases where the OCP is unsafe, so it is important that a thorough medical check is performed before the OCP is commenced. The OCP can be started 6 weeks after delivery, although in some women it may decrease milk supply.

For more information see the below links:

• Shine SA
• Family Planning NSW

The traditional POP or mini pill is a daily tablet, which needs to be taken at the same time each day (within the same 3 hour window). It works by changing cervical mucus and thinning the lining of the uterus (endometrium). It is a popular contraceptive option during breastfeeding. It may cause irregular bleeding in some women. It is not as effective as other forms of contraception.

There is a new progesterone only pill that came on the Australian market in 2021. This pill is called drosperidone or Slinda. Slinda is also taken daily but prevents ovulation as well as having the effects on the uterine lining and cervical mucus. It has more flexibility in timing of dosage and is less likely to cause irregular bleeding versus the traditional POP. It is a good choice for breastfeeding women, however is not subsidised by the PBS and costs about $25-$30 per month, depending on your pharmacy. It is also a good option for women for which the combined pill is not recommended, for example if previous blood clot or migraine with aura.

• Shine SA
• Family Planning Victoria
• Family Planning NSW