Discussing birth control methods with your provider is important, especially if you recently gave birth. Rapid repeat pregnancy (pregnancy occurring <1 year from prior delivery) is associated with an increased risk of pre-term delivery and other complications.

Things to consider

When choosing a birth control method it is important to discuss your medical history with your provider. Some women with certain medical conditions cannot take methods that contain estrogen (included in the pill, patch and ring). Some medications will interact with hormonal birth control methods and lower their efficacy. Discussing your menstrual cycle is also important as many methods can be used to improve bleeding, cramping and other period symptoms such as premenstrual syndrome, acne or cycle irregularities.

There are a variety of methods to choose from, and every woman is different in what method is best for their lifestyle and future reproductive health planning.

Method	How to Use It	Effectiveness	Benefits	When to Start After Delivery
Barrier Methods (condoms, diaphragms, cervical caps)	Worn over penis or inserted into vagina as a barrier to sperm	79-98%*	Only methods providing protection from sexually transmitted infections	Immediately postpartum
Oral contraceptive (“The pill”)	Take one pill daily	91-99.7%*	Improved periods; cycle predictability	6 weeks postpartum
Progestin-only pill (“mini pill”)	Take one pill daily	91-99.7%*	Improved cramping; period suppression over time	Immediately postpartum
Birth control patch	Apply one patch to your skin weekly	91-99.7%*	Improved periods; cycle predictability	6 weeks postpartum
Vaginal ring	Insert the ring into the vagina once a month	91-99.7%*	Improved periods; cycle predictability	6 weeks postpartum
Shot/injection	Shot given every 3 months in the buttocks or arm	94-99.8%*	Improved periods; period suppression over time	Immediately postpartum
Implant	Health care provider places under skin of upper arm; lasts for 3 years	99.9%	Long-term protection; improved cramping	Immediately postpartum or at postpartum visit
Intrauterine Device (IUD)	Health care provider inserts into the uterus; lasts 3-10 years depending on type (copper or progestin)	99.2-99.8%	Long-term protection; period suppression over time (for progestin containing IUDs); non-hormonal option (for copper IUD)	Immediately postpartum or at postpartum visit
Tubal ligation (“getting tubes tied”)	Health care provider removes or surgically blocks the fallopian tubes	99.5%	Permanent birth control; no effect on periods	During time of C-section, after vaginal delivery or 6 weeks from delivery
Vasectomy	Health care provider surgically blocks passage of sperm	99.9%	Permanent birth control; male option	Consultation with a urologist can be scheduled at any time

*First percentage refers to “typical use” and the second percentage refers to “perfect use”.

LARCs

Long acting reversible contraceptives (LARCs) are very safe and the most effective reversible birth control methods. These methods include intrauterine devices (IUD) and subdermal implants. IUDs can be placed at the time of C-section or immediately after a vaginal delivery depending on insurance coverage. Implants can also be placed while in the hospital postpartum. Alternatively placement can be done at the postpartum visit in the clinic 6 weeks following delivery.

Permanent Sterilization

Tubal ligation is permanent sterilization for women not desiring further pregnancies. Some insurances will require paperwork completed 30 days prior to this procedure. This procedure can be done at the time of C-section or following a vaginal delivery. If done after a vaginal delivery a small incision is made below the belly button. If this procedure is done 6 weeks after delivery, it is performed laparoscopically.

Males can have a vasectomy performed as an outpatient procedure with a urologist. To contact Marshall Urology, call 304-691-1900.