Birth control information Contraception Ideally you would have at least 18 months in between pregnancies to give you time to heal, return to your normal pre-pregnancy weight, and breastfeed if you choose to do so. Part of ensuring this may include using contraception in between pregnancies. If you are done having children, you could consider permanent sterilization, which is a surgical procedure, or asking your partner have a vasectomy. If you desire permanent sterilization, you will need to sign a consent form prior to the delivery of your infant. Currently there are many choices available for contraception. You will need to talk to your doctor about what type is right for you. You should not take any estrogen containing birth control for at least three weeks postpartum due to increased risks of blood clots, and in reality, you should not initiate sexual intercourse until at least six weeks postpartum. If you are breastfeeding, a progesterone-only contraceptive is preferred. You need to take this type of birth control at the same time daily, and remember to take it, for it to work properly. If you are not breastfeeding or your milk supply is well established, and you do not have a contraindication to estrogen, you can take combined estrogen and progesterone oral-contraceptive pills or use the vaginal ring. LARC methods (long-acting reversible contraception) include intrauterine systems and devices and an implant in the arm. These are as effective as permanent sterilization but are reversible in that when they are removed, you return to normal fertility. These are the most highly recommended contraceptive choices due to the low failure rates and ease of use. To choose the right birth control method for you, consider the following: • How well it prevents pregnancy • How easy it is to use • Whether you need a prescription to get it • Whether it protects against sexually transmitted diseases (STDs) • Whether you have any health problems Please discuss your options with your physician. Most birth control methods will not prevent the transmission of STDs. 74
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