Methods of contraception during lactation. Contraceptives while breastfeeding. Male and female sterilization

Many women after childbirth ask questions: "How to avoid new pregnancy? What methods of contraception are best for nursing mothers to choose?" Answers to these questions should be sought in the office of a gynecologist. Often, experts suggest that nursing mothers use safe oral contraceptives that effectively cope with their main task- they do not allow sperm to enter the uterus. These funds include pills "Laktinet", "Charozetta", "Microlut". Today we will learn how to take these pills correctly, what contraindications they have, and also find out how women themselves speak of these drugs.

Description of the tool "Laktinet"

This medication is a contraceptive drug. Active ingredient means progestogen causes inhibition of ovulation. In addition, when taking these pills, the cervical mucus becomes more viscous, which means that the sperm must work very hard to get into the uterine cavity.

This medicine can be used by those women who, for some reason, cannot take contraceptives containing estrogen. Among such representatives of the weaker sex are those girls who feed the baby with their own milk. Contraceptive pills for breastfeeding"Laktinet" have an effective degree of protection comparable to contraceptive pills, in which several hormones are combined.

This tool is produced in blisters, 28 tablets each.

How to take Lactinet dragee for a nursing mother?

These pills should be taken every day at the same time. Important: the interval between taking the tablets should be a day. The first pill should be swallowed on the first day of menstruation. Then you need to continue to take 1 tablet per day, regardless of possible bleeding. A new blister should be used only after the pills from the previous package have run out.

Since sexual life should be restored no earlier than 6 weeks after childbirth, then these pills should be taken from this period.

Some women do not have a period while breastfeeding their babies. However, this does not mean that the girl is not able to get pregnant again. In this case, you should also take care of contraception. And contraceptive pills for breastfeeding "Laktinet" will help with this. If there is no menstruation, then you should start taking pills after 6 weeks from the moment the baby is born. However, before taking any medicine, including Lactinet tablets, you should always consult with a gynecologist. Although this remedy is safe for the baby and effective for his mother, he, like any other medication, has its own contraindications.

Contraceptive pills after childbirth during breastfeeding "Laktinet" do not affect the taste of milk, as well as its quantity. It is a safe and effective remedy for unwanted pregnancy.

Reviews about the tool "Laktinet"

What kind birth control pills can breastfeeding help mothers? These are already well-known tablets "Lactinet". Many women choose this tool because it is convenient. There are 28 tablets in one blister, and not 21, as is often the case in oral contraceptives. Therefore, you should not take a 7-day break, after which very often women forget to start taking pills on time. And the Lactinet tablets seem to be made for mothers who, due to their employment, caring for a child, may not even remember when they should take the dragee. And since no 7-day break is needed, the task is also made easier: you need to drink these pills every day so as not to get pregnant.

As for the safety of this contraceptive for the baby, absolutely all reviews of nursing mothers are positive. Girls note that no negative impact pills are not given to their crumbs.

The effectiveness of the drug "Laktinet" is also proven. Not a single response about this remedy was negative, that is, pregnancy was not observed after using these pills. It turns out that Lactinet tablets are a really effective contraceptive.

These birth control pills for breastfeeding, the reviews of which we reviewed, receive mostly positive ratings. Women note such good moments pill use:

Improving the condition of the skin of the face. She stops being dry.
Body weight does not change.
There are no allotments.
Excellent value for money and quality.

The drug "Charozetta" and its effect on the baby

This is another safe and effective contraceptive that can be used while breastfeeding your baby. At the time of admission this tool quality, quantity and composition mother's milk do not change. However, women should be aware that a small dose of the main component of the drug will enter the child's body. But this value is so small that it does not pose any danger to the baby.

Composition, form of release of the drug "Charozetta"

These tablets, which are coated with a special shell, contain the following components: the main substance is desogestrel, auxiliary elements are colloidal silicon anhydride, lactose monohydrate, corn starch, stearic acid, povidone, talc, titanium dioxide.

Pills "Charozetta" in the amount of 28 pieces are packed in a blister. One box contains 1 or 3 blisters.

Proper taking of tablets "Charozetta"

These contraceptives while feeding should be taken 1 pill every day for 28 days at the same time. It is impossible to stop taking an oral contraceptive. The tablets should be taken with a glass of water.

If the interval between taking pills turned out to be more than 36 hours, then women should know that in this case the effect of the medication is significantly reduced. Then you should immediately take the tablet that was missed, and then do everything according to the instructions. Also during this period, it is better to protect yourself and use other methods of contraception to exclude the possibility of becoming pregnant.

After childbirth, you need to start drinking birth control pills while breastfeeding "Charosetta" on the 21st or 28th day after natural childbirth or caesarean section.

Side effects

Charozetta tablets can cause such undesirable moments after their use:

headache, dizziness, weakness, nausea, mood changes;
weight gain;
sensitivity of the mammary glands, their swelling;
the occurrence of irregular bleeding;
the appearance of a rash on the body.

Contraindications to the use of drugs "Laktinet" and "Charozetta" by lactating women

Although the above contraceptive pills are safe and effective during feeding, however, there are cases when these oral contraceptives cannot be used. And this:

Confirmed or suspected pregnancy.
hormone dependent tumors.
Vaginal bleeding of unknown origin.
Violations of the liver, as well as the presence of blood clots.
Lactose intolerance in a woman.
Reaction to the components of the drug.

Reviews of women about the tool "Charozetta"

Many write about this contraceptive. Some women praise him in every possible way, while others, on the contrary, criticize him. However, those who speak unflatteringly about him still do not deny the fact that the pills are really effective. And they don't affect babies at all. But the fact that pills often cause side effects is a fact confirmed. Headaches, dizziness, change menstrual cycle, pain during menstruation - all these symptoms in women were caused precisely by contraceptive pills during breastfeeding "Charosetta". Also, many mothers do not like that these oral contraceptives are too expensive. Indeed, for 1 package of 28 pills, you need to pay about 900 rubles.

But still negative reviews less than positive. Mothers who breastfeed their babies speak well of the Charozetta remedy. They note that this is an excellent drug that does not cause any harm to children. After all, the dose of the hormone in the product is so small that it is completely safe for crumbs. Also, women note the convenience of using this contraceptive. The pack is comfortable, because the days of the week are written on it. Therefore, it is easier for a woman to use such pills, since the blister indicates when the young mother took the pill.

Description of the drug "Microlut"

This tool, like the first two, is also effective method against unwanted pregnancy. The release form of the drug is contraceptive pills. When breastfeeding, these pills can be taken because they are safe and do not cause any harm to the baby.

Special instructions when taking tablets "Microlut"

For women who have excess weight, the contraceptive effect of this drug is less effective. If, when taking these pills, the nursing mother did not have the expected menstruation within six weeks from the start of the previous discharge, then you should purchase a test and exclude the presence of pregnancy.

How to take Microlut mini-pills?

If someone asks what kind of birth control pills you can take while breastfeeding, then you can safely answer that this is Levonorgestrel. Another name for the drug is "Microlut". You need to take these pills orally for a long time, and every day, you can not interrupt the course. The first pill should be drunk on the first day of menstruation. The tablet is taken from the cell that corresponds current day weeks. The pill should be swallowed, not chewed, and be sure to drink a glass of some liquid. The woman chooses the time of the first dose of the drug herself, however, in the following days, the tablets should be taken at the same hour, since required time between doses should be at least 24 hours.

Release form of oral contraceptive "Microlut"

These birth control pills for breastfeeding contain 0.03 mg active component. Pills are sold in packs containing 35 pills. One blister is enough for 5 weeks of use.

Modern medicine creates all the conditions for a woman during the decree to be not only a good mother to her baby. The desire to remain a wife and mistress to her spouse makes women look for reliable birth control pills while breastfeeding. What contraceptives can be used during this crucial period?

Contraceptive methods while breastfeeding

Trends modern society are such that most women give birth to one, maximum two children. At the same time, few young mothers decide to have a second baby in the first year after the last birth. The weather demands a lot of strength and resources from a woman, so many families put off planning another child for a while.

A month and a half after the birth of the first child, the question arises about reliable contraception. If the baby is on artificial feeding usually no questions arise. by the most effective tool Combined oral contraceptives are recognized for protection against unwanted pregnancy. These drugs contain estrogen and progesterone in their composition in the lowest possible doses. Daily intake of oral contraceptives reliably protects a woman from the birth of an unplanned child.

During lactation, the situation becomes somewhat more complicated. If a woman is breastfeeding her baby, she cannot take combined oral contraceptives. Estrogen, which is part of their composition, reduces the amount of milk. What about a nursing mother who does not want to refrain from intimacy with her beloved man? What are the methods of contraception for women during lactation?

All contraceptives approved for use in nursing mothers can be divided into the following groups:

hormonal agents;
intrauterine contraceptives;
barrier methods;
chemicals;
natural methods of conception planning.

All these funds can be used during lactation 6 weeks after the birth of the baby. Let's take a closer look at each of the contraceptives.

Hormonal contraception

During lactation, to protect against unwanted pregnancy, you can use the following hormonal drugs:

progestogen contraceptives (mini-drank);
intrauterine device"Mirena";
subcutaneous implants.

Contraindicated during breastfeeding:

combined oral contraceptives;
vaginal ring "NovaRing".

Gestagen contraceptives

Representatives of this group include Laktinet and Charozetta. These products contain only progesterone. Unlike combined oral contraceptives, mini-pills suppress ovulation weakly. Only in 30% of women taking "Laktinet" or "Charosetta", the egg does not mature in due time. Most nursing mothers ovulate, and the contraceptive effect is achieved through other mechanisms.

The Pearl Index (contraceptive effect) for progestin preparations is 0.3-0.9. Mini-pills increase the viscosity of the mucus of the cervical canal and reduce the activity of the fallopian tubes, thereby complicating the passage of spermatozoa. In addition, progestin contraceptives change the structure of the endometrium (the inner lining of the uterus). Even if fertilization occurs, the embryo simply will not be able to attach to the uterine wall. At long-term use mini-pills cause reversible atrophy of the endometrium (reduction in its size).

Preparations "Laktinet" and "Charozetta" are analogues. Each of them contains 75 micrograms of desogestrel. The package contains 28 tablets, which should be taken once a day, daily. A break in taking the drug is not done.

Take the mini-pill at exactly the same time every day!

Progestin preparations can be started 6 weeks after birth. "Laktinet" does not affect the composition and volume breast milk. This tool is considered completely safe for the baby, so the entire period of breastfeeding can be used.

Laktinet causes the following side effects:

heavy and prolonged menstruation;

bloody issues between periods;

decreased mood;

decrease in sexual desire;

soreness of the mammary glands;

body weight gain.

"Laktinet" has some advantages over combined contraceptives. It can be used by nursing mothers suffering from varicose disease and many heart diseases. Mini-pills are much less likely to cause blood clots and other serious complications.

Of the minuses of "Laktinet" it should be noted an increase in the risk ectopic pregnancy and the occurrence of ovarian cysts. This drug also causes frequent appearance acyclic bleeding outside of menstruation. These side effects do not make Lactinet too popular among nursing mothers, forcing them to look for other methods of contraception.

Intrauterine hormonal system "Mirena"

Mirena is an intrauterine device containing levonorgestrel. This drug belongs to the group of gestagens and is approved for use during breastfeeding. Mirena inhibits the development of the endometrium, leading to its temporary atrophy. Like mini-pills, the intrauterine device increases the viscosity of the cervical mucus and reduces the activity of the fallopian tubes.

Mirena is recommended for women who have given birth and have one sexual partner. Of the advantages, it should be noted high efficiency and convenience of the method. The spiral is installed in the uterine cavity for 5-7 years. A woman no longer needs to think about taking a pill every day or constantly buying new packs of condoms. The gynecologist is engaged in the installation and removal of the intrauterine device.

Do not delay your visit to the doctor after the expiration of Mirena!

The intrauterine device, like Laktinet, has a number of negative side effects:

mood changes, depression (first 3 months after installation);

uterine bleeding;

menstrual irregularities;

lack of menstruation (amenorrhea).

Barrier and chemical methods of contraception

Not all women are ready to take mini-pills or put a spiral during lactation. What other methods of contraception are allowed while breastfeeding?

Many breastfeeding mothers prefer condoms and diaphragms. These funds are completely safe for the baby and do not affect the composition and amount of breast milk. Of the minuses, it is worth noting the decrease in sensitivity during intercourse, as well as the need to keep condoms at hand all the time. AT rare cases It is possible to develop an allergy to latex. Contraceptive effect from 85 to 97%.

Chemicals (spermicides) are also allowed during lactation. Their efficiency ranges from 75 to 90%. Spermicides are recommended to be used together with barrier methods of contraception to increase their reliability. Contraceptive effect after application chemicals lasts from 1 to 6 hours.

Natural methods of contraception

During lactation, you can use not only hormonal and barrier contraceptives. The well-known method of lactational amenorrhea is very popular with nursing mothers. The contraceptive effect persists for 6 months when fed exclusively with breast milk. Supplementation with mixture and supplementation with water is not allowed. Even with all the recommendations, this method often fails young mothers. Pregnancy against the background of lactation can occur even before the arrival of the first menstruation. It is quite difficult to predict this moment, so many women, when using the lactational amenorrhea method, become mothers for the second time.

The natural fertility recognition method also applies to natural ways contraception. Its essence lies in calculating the moment of ovulation and calculating safe days for marital intimacy. This method should be used under the supervision of a recognition specialist. Otherwise, the risk of incorrect self-interpretation of the results and the occurrence of an unplanned pregnancy is too great.

Taking birth control pills while breastfeeding is decided by women who have previously used this way contraception. However, not all remedies are suitable for lactation. Features of protection during breastfeeding, effective and safe contraceptives - in the recommendations of obstetrician-gynecologists.

The onset of a new pregnancy within a short time after childbirth is possible, even if the woman is breastfeeding. Lactational aminorrhea, in which menstruation does not occur, does not provide reliable protection from conception. The absence of menstruation and their irregularity do not allow a woman to assume the probable timing of the release of a mature egg. In fact, pregnancy can occur any day. Therefore, gynecologists recommend starting to protect yourself not from the period of the arrival of menstruation, but from the moment you begin sexual activity, that is, from the sixth to eighth weeks after childbirth.

Demanded means of protection

In 2011, the magazine "My Child" conducted a sociological survey on the topic of contraception after childbirth. Almost two-thirds of the women surveyed answered that they pay high attention to contraception and use special means. More than half of them used a condom, just under thirty percent chose the pill. About ten percent of the mothers surveyed used barrier contraceptives (cap, vaginal ring). And almost eight percent trusted the calendar and cervical methods.

This survey showed that postpartum birth control pills and other hormonal contraceptives are not often used by young mothers. The reason for that - low level confidence because of the danger of reduced lactation, interference with hormonal background. In addition, to choose contraceptives, you should consult a doctor, which takes time. It is much easier to use "improvised" means that do not have a pronounced effect on the body.

But doctors warn of the risks of using them.

Condom. The most popular type of contraception, and not only during breastfeeding, but also in ordinary life. For a woman during lactation, it is completely safe. Condoms are available, you can buy them at any pharmacy, at hormonal balance they have no effect. Their advantage is also protection against sexually transmitted infections, which is especially important in postpartum period, until the restoration of natural defense mechanisms uterus. The disadvantage of a condom is the need for strict adherence to the rules for its use. In addition, there is a psychological barrier associated with an insufficient level of sensations. Not all couples can overcome it.
barrier means. Barrier contraception during lactation is not too in demand. At the same time, gynecologists note its relevance for nursing mothers. The contraceptive cap or diaphragm does not interfere with the hormonal background, does not affect lactation and work reproductive system. They are chosen by women who have already used such contraceptives before pregnancy. After giving birth, the first acquaintance with them may be unsuccessful. Only a doctor can choose the right size, insert a diaphragm or a cap, for which you need to contact women's consultation.
Chemical means. These include suppositories, spermicidal ointments, vaginal tablets. These funds can be used as contraceptives during breastfeeding, so they act exclusively within the vagina, inhibiting sperm motility. Their effectiveness is up to 90%, the probability of conception increases if the requirements for use are not met.
natural contraception. It involves the use of three methods of self-control. First calendar. With him, a woman calculates the days possible conception through mathematical calculations. The most dangerous period is the middle of the cycle, when the likelihood of pregnancy increases. The second method is cervical, it involves controlling the volume and quality of mucous secretions from the vagina. By increasing their number, it can be assumed that ovulation has occurred. And the third method is symptothermal. A woman daily measures the temperature in the rectum and, if it rises, can draw a conclusion about dangerous days. The disadvantage of all these methods during lactation is the lack of an established cycle. In addition, self-discipline and experience are important.
lactational aminorrhea. Natural contraception while breastfeeding due to high level the hormone prolactin, which blocks ovulation. Its efficiency reaches 98%, but several conditions form it. It is necessary to feed the child only with breast milk, without supplementing with water, without the use of supplementary feeding. It is not allowed to offer the baby nipples, and breastfeeding should be as frequent as possible. Reduce the protective effect long breaks in feeding, for example, on night sleep. The method stops working if the baby is six months old or the mother starts menstruating.

Natural and barrier methods of protection against pregnancy are the safest for a woman's health. They act "superficially", do not interfere with the processes occurring in the body. But in terms of effectiveness, birth control pills for nursing mothers are more preferable. They provide elevated level protection from conception.

Hormonal drugs

Means that correct the hormonal background of a woman are represented by pills, spirals, implants. Not all of them are suitable for a young mother. Preparations containing the hormone estrogen negatively affect lactation, suppress the production of breast milk. Therefore, the use of traditional oral remedies during lactation is prohibited.

mini pili

Alternative to oral contraceptives. The composition of the preparations includes gestagens, which do not affect the production of breast milk. The principle of action of contraceptives during lactation is to disrupt the possibility of fertilization of the egg.

Gestagens cause the following reactions organism.

Change the quality of mucus on the cervix. Its structure becomes denser more dense. increased density makes it irresistible to spermatozoa.
Reduce the peristalsis of the fallopian tubes. A decrease in the productivity of the movement of the epithelium does not allow a mature, fertilized egg to reach the uterine cavity.
Exclude the fixation of the egg. In the case of fertilization of the egg, it is not fixed on the walls of the uterus, therefore it is rejected by the woman's body.

“Gestagens have a mild effect on a woman’s body,” comments obstetrician-gynecologist Olga Pankova. - They do not change the composition of breast milk, its taste, do not affect lactation. But their effectiveness depends on the woman's self-discipline. It is important to take the tablets daily, at the same time. A break of more than twelve hours reduces the protective effect.

Contraceptives for breastfeeding such as mini-pili are represented by the preparations "Charozetta", "Lactinet", "Femulen", "Exluton".

Disadvantages of drugs:

the penetration of small doses of hormones into breast milk;
change in the menstrual cycle - increased intensity, reduced cycle duration, intermenstrual bleeding;
skin deterioration, acne development;
risk of developing polycystic ovaries.

Despite the mild effect of drugs on the body, side effects means of mini-pill exist. Therefore, they should be prescribed by a doctor, taking into account the state of health of the woman. When adverse reactions a doctor's consultation is required. After discontinuation of drugs within two to three months, the woman's condition usually returns to normal without additional treatment.

Hormonal coils are more convenient than pills. Their action is always kept at the same level. Efficiency reaches 98%, the result is based on the suppression of the egg maturation process.

Doctors do not exclude the use of an intrauterine device as a solution to the issue of how to protect yourself during breastfeeding. But note the following features of its application.

Childbirth without complications. The introduction of a spiral is possible only for women who have not received ruptures and significant damage to the cervix during childbirth. In this case, the use of the IUD is allowed already six or eight weeks after the birth of the baby. If the birth was traumatic, the installation of the IUD will need to be postponed, sometimes for up to six months.
Risk of inflammation. The use of a spiral increases the likelihood of inflammatory diseases of the genital organs. Therefore, a woman should be regularly observed by a gynecologist.
Side effects. Like other hormonal-type drugs, the spiral can affect the frequency and nature of menstruation, and cause ectopic pregnancy.

It is important for a woman who has installed an IUD to consider the period of its validity. It ranges from several months to five years. Even if the spiral works for a long time, regular examinations by a gynecologist are necessary to control your own health.

implant

If a woman is not sure that she will be able to take birth control pills correctly after childbirth and is afraid of inflammation that is possible after the installation of the spiral, she may choose a subcutaneous implant. It is a thin rod 4 cm long. It is implanted subcutaneously, on inside shoulder. The procedure is fast, carried out under local anesthesia takes about three minutes.

The implant contains the hormone progestogen. It does not affect lactation, but blocks ovulation. Its duration is up to three years. A woman can have an implant inserted as early as six weeks after giving birth.

Subcutaneous implants do not bring harm to health. But when using them, spotting in the middle of the cycle is possible. For a warning negative reactions regular gynecological examinations are required.

emergency contraception

Funds emergency contraception when breastfeeding are used after unprotected intercourse, if there is high risk unwanted conception. Preparations of this group are hormonal, contain high doses of hormones, so they should be used carefully, only in case of urgent need.

Tablets "Exapel", "Postinor" contain the hormone levonorgestrel. It is able to affect lactation, reduces milk production. However, due to the short-term course of these drugs (2 tablets per day), they are considered conditionally compatible with lactation.

There is currently a large number of means of protection against unwanted pregnancy. Many of them can be used as birth control while breastfeeding. It is allowed to use effective hormonal contraceptives in the form of a mini-pill, an IUD, an implant. The doctor will help you choose the right one, taking into account the state of health and the characteristics of the recovery of the body after childbirth.

Birth control pills while breastfeeding are considered the most common method of contraception. They help prevent pregnancy. Moreover, the hormonal background is not disturbed, and the weight does not begin to increase. For this reason, even nursing mothers choose for themselves just such a protection option. So that it does not affect the health of the baby, you should carefully study the types of pills and the features of their intake.

And now let's dwell on this in more detail.

Types of birth control pills

Such drugs are divided into combined oral contraceptives (abbreviated as COCs) and mini-pills. COCs contain synthetic analogues of hormones, namely estrogen.

This type of drugs is mono- and three-phase. In the first case, the level of hormones in tablets is always the same, and in the second case, it gradually decreases during the intake.

The mini-pill contains a synthetic progestogen. Such contraceptives are intended for nursing mothers while breastfeeding.

There is another classification hormonal contraceptives also used in breastfeeding. According to it, tablets are divided into 4 groups depending on the amount of hormones:

Microdosed. These include Mercilon, and. They are suitable for nulliparous young girls who are actively leading sexual life. Also, such drugs are prescribed to women who have not previously taken hormonal contraceptives.
Low dose. This is Charosetta, and Sileste. The preparations are intended for giving birth and older women.
Medium dosed. It's about about, Triquilar and Tri-regola. They are suitable for both women who have given birth and women of reproductive age.
Highly dosed. This category includes Ovidon and Non-ovlon. Most often they are appointed in the presence of hormonal diseases. In some cases, these drugs can be taken by women who have given birth.

What contraceptives can breastfeeding mothers take?

Many mothers do not even know whether it is possible to drink and how to take birth control pills while feeding.

According to many foreign studies, mini-pills do not have a negative impact on lactation and the health of the child.

List of birth control pills for nursing mothers:

Charosetta. These pills are suitable for women for whom their own safety and a small dose of hormones are very important. The drug is not prescribed for various diseases liver, uterine bleeding, the presence of tumors and intolerance to some components. The effectiveness of Charosetta is comparable to most COCs.
exoluton. It contains linestrenol. With the help of the drug, it is possible to establish the menstrual cycle and avoid unwanted pregnancy. Contraindications include uterine bleeding and liver disease.
Microlute. The main thing active substance is a gestagen. Its amount is minimal, so the drug is well tolerated. Contraindications are diseases of the biliary tract and liver, as well as uterine bleeding.

Mini-drank - perfect option for nursing mothers. There aren't many of these pills. side effects. Also, the drugs do not affect the production of milk. Moreover, they minimize the likelihood of thrombosis, do not affect libido and mood.

Mini-drank - the best option for breastfeeding moms!

Mini-pills are often prescribed for painful periods, and . When the remedy is canceled, the ability to conceive is restored in a short time.

Before you start taking it, you need to study the list of contraindications to the mini-pill. This includes various tumors, impaired functioning of the kidneys, uterine and vaginal bleeding of an unclear nature, epilepsy, exacerbation of hepatitis and damage to the vessels of the heart and brain.

Benefits of the mini-pill:

rarely cause any unwanted effects upon admission,
do not affect the quality and quantity of breast milk,
do not reduce the duration of breastfeeding,
their appointment is practiced in the treatment of inflammatory diseases of the female pelvic organs, as well as painful menstrual bleeding,
they reduce the risk of thrombosis.

The effect of contraceptives on the baby

When choosing contraceptives, it must be remembered that the composition of tablets intended for nursing should not contain estrogen. This hormone negatively affects lactation, and also slows down the development of the child. COCs can be taken only after the final completion of breastfeeding.

Breastfeeding birth control should not contain estrogen!

Nursing mothers should choose only mini-pills. According to studies and observations, these drugs are absolutely safe. During their intake, the quality and quantity of milk remains the same, and the development of the child occurs without delay.

Rules and application features

Tablets, which are presented, should be taken no earlier than 6-7 weeks after childbirth. In this case hormonal changes organism will pass naturally. Tablets with gestagen can be used after a month.

The drug should be taken in certain time . It is best to do this in the evenings. In order not to forget about the tablet, you can install on mobile phone reminder. If the next appointment was later by 3 hours, the effectiveness of the contraceptive is reduced.

After 12 hours, the likelihood of pregnancy increases significantly. Today, progestin tablets have appeared on sale. When taking them, the “lateness” can be a maximum of 12 hours. This will not affect the effectiveness of the tool.

It must be remembered that oral contraceptives are not able to protect against vaginal infections. Also, birth control pills should not be used with antibiotics, which are usually prescribed after a caesarean section.

Other methods of protection

If for some reason a nursing mother cannot take oral contraceptives, then she should choose one of the following ways protection.

Contraceptive candles

Along with the advantages, there are also disadvantages of using chemical method contraception. Long-term use contraceptive suppositories can disrupt the microflora of the vagina, which will certainly cause discomfort.

Sexual intercourse is tied to a certain time when the candle will work, not all couples fit such a framework. The same applies to hygiene procedures: When using contraceptive suppositories, you must wait a certain time before you can go to the shower.

But, despite all the seemingly negative aspects of using this method of contraception, contraceptive candles during breastfeeding are very convenient and this makes them so popular.

Barrier Methods

The use of condoms and diaphragms is good because they do not affect lactation and the development of the baby. The size of the cap or diaphragm must be clarified, because due to childbirth, the vagina is stretched.

Barrier methods should be applied no earlier than 2 months after childbirth.

Intrauterine device

Doctors often recommend the IUD because of its effectiveness.

If the birth went without complications and the nursing mother has no contraindications, then the introduction of the spiral in the postpartum period is allowed.

If you install the IUD 6-8 weeks after birth, the risk of prolapse is significantly reduced.

If an infection is suspected, the introduction of a spiral is possible after the diagnosis is refuted or cured.

natural methods

This is about calendar method, measurement , and research cervical mucus. These methods can be used when the menstrual cycle is fully restored.

It is pointless to measure during breastfeeding, because in the morning it rises due to night feedings. In general, all the mentioned methods are considered ineffective.

Information about . Save your child from colic and allergies.
Find out how to treat a runny nose for a nursing mother. All about the treatment of colds while breastfeeding.

Male and female sterilization

This method is very effective, but irreversible. For this reason, it is worth carefully weighing the pros and cons.

Such decisions cannot be made under the influence of stress or certain circumstances. If there is any doubt, then it is worth refusing to sterilize.

Some couples choose to abstain while breastfeeding. In fact, this method is often difficult to bear, so abstinence should not be practiced for a long time.

Nursing mothers often opt for birth control pills. So that they do not affect the health of the baby, you must carefully choose the drug using an experienced doctor. You also need to follow the instructions, otherwise oral contraceptive will be ineffective.

Ruben Nerses

Head of the Center for Family Planning and Reproduction of the Eastern Administrative District of Moscow at the Spaso-Perovsky Peace and Mercy Hospital

Magazine "9 months"

№09 2001

The need for contraception

A miracle happened. The baby you've been waiting for for nine long months has finally arrived. Now you, parents, are immersed in worries about him. At first, both are terribly tired, night feedings are exhausting, there is nothing to even think about resuming sexual relations. Yes and overweight appeared, the figure is not the same as before pregnancy. No, you have to wait a bit, especially since the doctor recommends not to have sex for the first 4-6 weeks ... But nature takes its toll, and your sexual relations are soon resumed. Contraception is probably the last thing on your mind right now. And is it worth taking care of her at all, isn't breastfeeding enough?

Worth it if you want to avoid an unplanned pregnancy in the first months after giving birth, because, contrary to popular belief, this is not such a rarity. Studies have shown that in women who are breastfeeding, menstruation resumes on average after 2-6 months, depending on the intensity of feeding, and in non-breastfeeding women, after 4-6 weeks after childbirth. If you are not lactating or you are breastfeeding irregularly, then ovulation, and, consequently, the ability to conceive, can resume as early as 25, and on average 45 days after childbirth. And since ovulation occurs 14 days before your period, you may already be fertile without knowing it.

Therefore, pregnancy can occur even before the first menstruation, so in order to start contraception, one should not expect the restoration of the menstrual cycle, the start of complementary feeding and the reduction in the frequency of breastfeeding.

According to polls, two-thirds of Russian women resume sexual relations within a month after giving birth, and almost all (98%) within 4-6 months. At the same time, physicians are more concerned about the fact that after 20-40% of sexually active Russian women do not use any methods of contraception. Meanwhile, the probability of pregnancy in the absence of reliable contraception in nursing mothers 6-8 months after birth reaches 10%, and in non-nursing - 50-60%. Thus, women who have recently given birth in Russia should be classified as high risk group for unplanned pregnancy.

And the onset of pregnancy during this period is generally extremely undesirable. Doctors believe that the minimum interval between births should be about 3 years. Why? Despite the fact that the involution of the organs of the reproductive system (their return to their previous state) ends 4-6 weeks after birth, full recovery the body takes at least 1.5-2 years. Breastfeeding is also a significant burden on a woman's body. But after that, a woman still needs to replenish the supply important trace elements, for example, iron, calcium, etc. Studies have shown that when pregnancy occurs earlier than 2 years after birth, the risk of developing pregnancy complications (preeclampsia, anemia, delayed prenatal development fetus), childbirth and the postpartum period.

Thus, we inevitably come to the conclusion that in the postpartum period and within 2 years after childbirth, a woman needs effective, reliable and safe contraception.

Choosing a method of contraception

Ideally, you should get advice and choose a suitable method of contraception after childbirth even during pregnancy. Did not have time before childbirth - consult a doctor maternity hospital. If you still could not decide on the method of contraception or you have doubts and questions, then before resuming sexual relations(even when breastfeeding) necessarily you should seek the advice of a gynecologist, such as an antenatal clinic or a family planning and reproduction center. The purpose of this article is to give general idea about methods of contraception in the postpartum period and how these methods are combined and how compatible they are with breastfeeding, however, it is necessary to determine which of these methods is right for you only in consultation with your doctor.

Non-nursing a woman should start using contraceptives from the moment of resuming sexual relations. At the same time, if there are no special contraindications, she can choose any of the modern arsenal contraceptives.

contraceptive method lactating women depends on the feeding regimen and the time elapsed after childbirth. In addition, the contraceptive should not adversely affect either the health of the child or the secretion of milk. With exclusive breastfeeding, the start of contraceptive use can be delayed by 6 months. With infrequent feeding or early start complementary foods (all this is typical for residents of developed countries), the method of contraception should be selected during the mandatory postpartum visit to the doctor no later than 6 weeks after birth.

One more thing important note: different methods of contraception, about which we will talk below, have different efficiency, some of them involve serious limitations in use, not all can be used in the first weeks after childbirth. Tune in in advance that in this important and responsible period of your life, when next pregnancy in any case, it is better to wait, various methods of contraception will often have to be combine, either by increasing the effectiveness of a tool that is ideally suited for you, but not sufficiently reliable, or by “hedging” in those circumstances when the effectiveness of a reliable method is reduced for some reason. And in determining the need and principles of combination various methods, as well as in the selection of the most suitable remedy for your couple, again, only a doctor will help.

Contraceptive methods

abstinence

Abstinence (sexual abstinence) has 100% contraceptive effectiveness, but most couples are not satisfied with this method even for a short time.

Lactational amenorrhea method (LAM)

Mechanism of action and characteristics. After childbirth, a woman's body produces a hormone prolactin, which stimulates the production of milk by the mammary glands and at the same time suppresses ovulation, resulting in lactational amenorrhea(lack of menstruation while breastfeeding). This action of prolactin on the woman's body determines the contraceptive effect of breastfeeding. Each act of suckling by the baby stimulates the secretion of prolactin, but if the interval between feedings is too long (more than 3-4 hours), the level of prolactin gradually drops. Breastfeeding, started immediately after birth, is an effective method of natural contraception and at the same time provides the child with the most good nutrition. In addition, sucking stimulates the production oxytocin- a hormone that contributes not only to the contraction of the muscles of the areola of the mammary gland (due to which milk is released from the nipples), but also to the contraction of the uterus, which leads to the speedy restoration of its size and shape after childbirth.

LAM involves exclusive or near-exclusive breastfeeding, both during the day and at night. The effectiveness of LAM is maximum if feeding occurs not according to the schedule, but at the first request of the child (even at night), sometimes several times per hour, on average from 12 to 20 times a day, of which 2-4 times at night. The break between feedings should not exceed 4 hours during the day and 6 at night. In this case, each time it is necessary to give the child a breast, and not to express milk. The contraceptive efficacy of LLA remains at an acceptable level if the proportion of complementary foods is no more than 15%.

Terms of application. The first 6 months after childbirth proper feeding breast.
Efficiency. 98%.

Advantages.

· Easy to use.

Gives a contraceptive effect immediately with the start of use.

· Does not affect sexual intercourse.

Promotes uterine contractions, reducing the risk postpartum complications(bleeding) and leading to a speedy recovery of the body.

Does not require medical supervision.

Beneficial for the baby (breastfeeding provides him with the most adequate nutrition, promotes the development of immunity, reduces the risk of infection).

Flaws.

Requires strict observance the above rules for breastfeeding.

· Unacceptable for working women.

Short-term use (6 months).

· Does not protect against sexually transmitted diseases.

Hormonal Methods

ORAL CONTRACEPTIVES (OK)
Progestin-only OCs (mini-pills)

The tablets contain progestins - synthetic hormones, the contraceptive effect of which is to reduce the amount and increase the viscosity of cervical mucus (which prevents sperm from passing into the uterus), change the structure of the mucous membrane of the uterine body (this prevents implantation of the embryo) and suppression of ovulation.
Start of application. Breastfeeding women can start taking pills 5-6 weeks after childbirth, non-nursing women - from the 4th week after childbirth or with the onset of menstruation.
Efficiency. 98% with correct and regular intake of tablets in combination with breastfeeding.
Advantages. Not rendered negative influence on the quantity, quality of milk and duration of lactation.
Flaws. In the first 2-3 cycles of administration, intermenstrual spotting is often noted, which is a consequence of the body's adaptation to the drug. Some women may experience menstrual irregularities up to amenorrhea.
Application features. OK prescribed by a doctor. They must be taken daily, without interruption, strictly at the same time. Violation of the time of taking or skipping pills, as well as the simultaneous use of certain antibiotics, anticonvulsants and hypnotics medicines, vomiting or diarrhea reduce contraceptive effect. The ability to conceive is usually restored immediately after discontinuation of the drug. After stopping feeding, you should switch to combined OK, which have a higher efficiency.

Combined OK

They contain hormones gestagen and estrogen that inhibit the growth and maturation of follicles and ovulation, as well as preventing implantation.
Start of application: After stopping breastfeeding, combined OCs are started to be taken with the resumption of menstruation. If you have not fed at all, this type of contraception can be used from the 4th week after childbirth.
Efficiency: With proper and regular intake, the effectiveness approaches 100%.
Advantages: After stopping the pills, the ability to conceive is quickly restored.
Flaws: it is undesirable to use when breastfeeding (estrogens reduce the secretion of milk and the duration of lactation).
Application features: similar to the use of OK, containing only progestins.

LONG-LASTING PROGESTAGENS
Highly effective means long-acting. These include, for example, injectable drug"Depo-Provera" and subcutaneous implant "Norplant".
Start of application. The first administration of the drug to lactating women not earlier than 6 weeks after childbirth, non-nursing - from the 4th week after childbirth.
Efficiency. 99%.
Advantages. They do not affect the quantity and quality of milk, the duration of lactation, do not harmful influence on a child. One injection of Depo-Provera provides contraception for 12 weeks. "Norplant" provides protection against unwanted pregnancy for a period of 5 years. Implant removal is possible at any time.
Flaws. Similar to the disadvantages of progestin-only OCs (frequent intermenstrual bleeding and the onset of amenorrhea).
Application features. Assigned and administered by a doctor. In the first 2 weeks after administration, additional contraceptives. It is necessary to strictly observe the intervals between the administration of the drug. "Norplant" must be removed after 5 years, since after this period the effectiveness of the method decreases sharply. After discontinuation of the drug, the restoration of a regular menstrual cycle and the ability to conceive usually occurs within 4-6 months.

Intrauterine contraceptives
(spirals)

Start of application. In uncomplicated childbirth and the absence of contraindications, an intrauterine device (IUD) can be inserted immediately after childbirth. This does not significantly increase the risk infectious complications, bleeding or perforation of the uterus. Optimal time introduction - 6 weeks after birth, while reducing the frequency of prolapse of the IUD.
Efficiency. 98%.
Advantages. Compatible with breastfeeding. Provides protection against pregnancy for up to 5 years. Gives a contraceptive effect immediately after administration. The IUD can be removed at any time. The restoration of the ability to conceive after the removal of the IUD occurs very quickly.
Flaws. Sometimes causes discomfort in the lower abdomen, resulting from uterine contraction during breastfeeding. Some women may have heavier and more painful periods than usual in the first months after insertion of the IUD. Sometimes there is a prolapse of the IUD.
Application features. The IUD is inserted by a doctor. Not recommended for women who have had inflammatory diseases uterus and appendages, both before pregnancy and in the postpartum period; as well as women who have multiple sexual partners, since in this case the risk of inflammatory diseases increases.

barrier methods of contraception

CONDOM

Start of application. With the resumption of sexual activity after childbirth.
Efficiency. On average 86%, but with correct use and good quality reaches 97%.
Advantages. The method is easily accessible and easy to use, does not affect lactation and the health of the child. AT to a large extent protects against sexually transmitted infections.
Flaws. At misuse the condom may slip or break. Application is associated with sexual intercourse.
Application features. Do not combine the use of a condom with the use of fatty lubricants that can cause the condom to break. Use a neutral lubricant with spermicides.

DIAPHRAGM (CAP)

Start of application. Not earlier than 4-5 weeks after childbirth - until the cervix and vagina are reduced to normal sizes.
Efficiency. Depends on correct application. During the period of breastfeeding, it increases to 85-97% due to a decrease in the ability to conceive at this time.
Advantages. Does not affect lactation and the health of the child. Provides partial protection against some sexually transmitted infections.
Flaws. Application is associated with sexual intercourse.
Application features. Choosing a diaphragm for a woman and teaching her how to use this method of contraception should medical worker. After childbirth, you need to clarify the size of the cap, it could change. It is used together with spermicides. The diaphragm should be removed no earlier than 6 hours after intercourse and no later than 24 hours after its insertion.

SPERMICIDES

This method of chemical contraception is local use creams, tablets, suppositories, gels containing spermicides- Substances that destroy cell membrane spermatozoa and leading to their death or impaired mobility.
Start of application. With the resumption of sexual activity after childbirth. Against the background of feeding, they can be used alone, in the absence of lactation, they should be combined with other means of contraception, in particular with a condom.
Efficiency. At correct application 75-94%. The contraceptive effect occurs within a few minutes after administration and lasts from 1 to 6 hours, depending on the type of drug.
Advantages. In addition to those described for a condom, it provides additional lubrication.

Sterilization

Sterilization is a method of irreversible contraception in which operational way ligation or imposition of clamps on the fallopian tubes (in women) or ligation of the vas deferens (in men) is performed.

FEMALE STERILIZATION

Start of application. It is carried out immediately after uncomplicated childbirth under local anesthesia by laparoscopic access or by minilaparotomy, as well as during a caesarean section.
Efficiency. 100%
Advantages. The effect occurs immediately after the operation.
Flaws. Irreversibility. small chance postoperative complications.
Application features. The method is acceptable only for those who are absolutely sure that they do not want to have more children. The decision to use the method should not be made under the pressure of circumstances or emotional stress.

MALE STERILIZATION (VASECTOMY)

Under local anesthesia, a small incision is made in the scrotum and the vas deferens are tied off (similar to fallopian tubes). sex drive, erection, ejaculation are not violated in any way, only the ejaculate does not contain spermatozoa.
Efficiency. 100% if you follow the rule: the first 3 months after the operation, you should use a condom. The absence of spermatozoa in the ejaculate, detected using a spermogram, can confirm the effectiveness of a vasectomy.
Disadvantages and features of the application. Similar to female sterilization.

Natural family planning methods

Based on abstinence from sexual intercourse on fertile days.
Start of application. Only after the establishment of a regular menstrual cycle.
Efficiency. No more than 50% subject to all rules.
Advantages. No side effects. The spouses are jointly responsible.
Flaws. To determine favorable and bad days requires special training for the couple by medical staff, careful record keeping, self-control and self-discipline. It is not recommended immediately after childbirth, as it is difficult to determine the timing of ovulation and the first menstruation.