Contraception after pregnancy and while breastfeeding

Fertility can return surprisingly quickly after having a baby, sometimes before your periods come back, so contraception is worth sorting out earlier than many people expect. The good news is that there are safe options at every stage.

The main thing that changes with timing is whether the combined pill is suitable yet. This article runs through what is safe and when.

When you need contraception again

If you are not breastfeeding, you can become pregnant from about three weeks, day 21, after giving birth. From that point you need contraception if you do not want to conceive again straight away. If your assessment is after day 21 and you have already had unprotected sex, we will check that you are not already pregnant before starting anything.

If you are breastfeeding fully, fertility takes longer to return, but it is not switched off, so it is still worth having a plan in place rather than relying on chance.

Why the combined pill waits

The weeks after giving birth carry a naturally higher risk of blood clots, and oestrogen adds to that risk, so the combined pill is avoided in the early postpartum period. If you are not breastfeeding it is generally not used before three weeks, and longer if you have other clot risk factors. If you are breastfeeding it is avoided for the first six weeks. After those windows, and once any clot risk factors are accounted for, it can be considered.

The progestogen-only pill: safe from day one

The progestogen-only pill contains no oestrogen, so it can be started immediately after birth, including while breastfeeding. It does not affect milk supply. For most new parents who want a pill, this is the sensible starting point in the early weeks, and you can review later whether to move to a combined pill once it becomes suitable.

Breastfeeding and your own natural cover

Exclusive breastfeeding can itself provide contraception in the first six months, known as the lactational amenorrhoea method. It is around 98 percent effective, but only if all three things are true: your baby is under six months, you are breastfeeding fully day and night with no top-up feeds, and your periods have not returned. As soon as any one of those changes, the cover drops and you need another method.

If you want a long-acting method

The implant and the hormonal coil can be fitted very soon after birth and are popular postnatal choices, because they need no daily thought during a busy time. We do not fit these at LoveMyLife at launch, but the NHS and most GP surgeries fit them free, and the maternity team or your GP can often arrange it. If that appeals, it is worth asking about while you have the chance.

Emergency contraception after a baby

If you have had unprotected sex more than three weeks after birth and did not want to conceive, emergency contraception may be appropriate. The morning-after pill can be used while breastfeeding, though with one option, ulipristal, you would express and discard your milk for a week. We cover this in detail in our emergency contraception article.

What suits the early months

In practice, the early weeks after a baby tend to favour methods that are safe straight away and need little daily thought: the progestogen-only pill, the implant, or the injection. The combined pill comes into its own a bit later, once the higher clot risk of the postpartum period has passed and, if you are breastfeeding, once your milk supply is well established. There is no rush to land on a final answer. It is perfectly reasonable to start with a progestogen-only pill now and review your options at your postnatal check, or a few months down the line, once life has settled and you know how breastfeeding is going.

This may need more than a pill if...

If you had complications in pregnancy such as high blood pressure or a clot, your safe options will be narrower, and that is worth a careful conversation. If you are unsure whether you might already be pregnant again, we deal with that first. And if you know you want a long-acting method, you will be better served by a service that fits it.

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