Contraception and Postnatal Support

POSTNATAL SUPPORT AND CONTRACEPTION SUMMARY

Dr Andrew and Dr Smith are passionate about postnatal care, during this exciting and sometimes confusing time for your family. We are skilled in assessing and helping with any mother-baby pair issues. We can conduct thorough newborn examinations, weigh and measure your baby, as well as administer their immunisations (along with our practice nurses). We are able to discuss contraceptive options as well as provide IUD (Mirena) and Implanon insertion and removal.

Below is a summary of contraceptive options:

BARRIER METHODS

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, Dr Smith or Dr Andrew can advise you of where you can access it.

COPPER/MULTILOAD IUD

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.

DEPO PROVERA

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:

IMPLANON

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:

LACTATIONAL AMENORRHOEA

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:

MIRENA IUD

A Mirena 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). It has also shown to be helpful for pelvic pain and troublesome periods. It is safe to use while breastfeeding, although it is generally best to not insert it until 3 months after delivery. Dr Smith and Dr Andrew are both skilled in Mirena insertions.

HOW TO PREPARE FOR YOUR IUD INSERTION

For more information see the below links:

NUVA RING

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.

ORAL CONTRACEPTIVE PILL

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:

PROGESTERONE ONLY PILL

The 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 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.

RETURNING TO WORK

When it is time for you to return to work, you may have many questions about how to maintain your breastmilk supply, when and how to express at work, how to store the milk and how to encourage baby to take a bottle.

Dr Smith and Dr Andrew are more than happy to help you navigate this road as we have both been there before!

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