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This might not be a couple’s first thought immediately after having a baby, but here’s something to think about: it’s possible for some women to conceive again within three weeks of having a baby, even before their first postpartum menstruation.

For most women, however, the timing of their first menstrual period depends on whether or not they are breastfeeding. Women who are breastfeeding usually don’t menstruate for the first six months after giving birth, although this varies.

If you aren’t breastfeeding or aren’t breastfeeding exclusively, you can expect to resume your menstrual cycle within the first eight weeks postpartum. According to the Association of Reproductive Health Professionals, “The first ovulation in non-lactating women typically occurs 45 days postpartum but may occur earlier.”

Whether you’re breastfeeding or not, if you don’t want to conceive immediately, it’s a good idea to begin thinking about contraception before resuming sexual activity (which most couples report happens about 6 weeks postpartum). Despite a widespread belief, breastfeeding alone is not a reliable method of birth control—although it is an important part of the lactational amenorrhea method (LAM), which is reported to be 98 percent effective.

For LAM to be an effective method of contraception, these three criteria must be met:

  1. Your baby is less than six months old.
  2. Breastfeeding is the only method of feeding your baby; no consumption formula, milk, or any other foods.
  3. You have not resumed your menstrual cycle.

Postpartum contraception usually falls into one of the following categories (these will look familiar if you used contraception before conceiving!):

  • Barrier methods: male or female condoms, contraceptive sponge, diaphragm, cervical cap, cervical shield.
  • Hormonal methods: oral contraceptives (the pill), the patch, the shot, or a vaginal ring.
  • Implantable devices: intrauterine devices (IUDs), implantable rods.
  • Permanent methods: vasectomy or tubal litigation.

Women are at an elevated risk for forming blood clots after giving birth, so consult with your doctor before using birth control methods that contain estrogen (including the pill, the patch and the vaginal ring). These have been shown to increase your risk of blood clots.

Every woman should discuss her fertility plans with her obstetrician before delivery and then again immediately afterward.  An OB might make certain recommendations regarding timing of next pregnancy depending on the method of delivery as well as the level of complication of delivery.

Reviewed by Dr. Jen Lincoln, November 2018

Takeaways

  • It is possible to get pregnant as early as 3 weeks postpartum.
  • Breastfeeding exclusively often delays your menstrual cycle for the first six months.
  • Breastfeeding alone is not a reliable method of birth control.
  • Plan your method of birth control before you resume sexual activity.

References

  1. La Leche League International. The Breastfeeding Dyad and Contraception
  2. U.S. Department of Health and Human Services. Birth Control Methods Fact Sheet.
  3. Centers for Disease Control and Prevention. Pregnancy Planning.
  4. La Leche League International. Breastfeeding and Fertility.
  5. Association of Reproductive Health Professionals. Postpartum Counseling.
  6. National Institutes of Health. Birth Control and Family Planning.

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