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What hormonal pills can be taken by a nursing mother. Safe and effective birth control pills while breastfeeding. Contraindications to the use of drugs "Laktinet" and "Charozetta" by lactating women

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What is the catch of lactational amenorrhea

The effectiveness of lactational amenorrhea reaches 99%. But only on condition that a woman and at least 6-10 times a day. For fidelity, the interval between feedings should be no more than 4 hours. And, of course, this method "works" only until menstruation begins.

What's the catch? First of all, when the intervals between feedings become longer, the risk of becoming pregnant increases significantly. Even if it's one longer interval at night. And the mother believes that she is still under reliable protection, and does not resort to additional methods of contraception.

Secondly, the first ovulation after childbirth in a woman will happen before the first (about 2 weeks). It turns out that all this time she will hope for a method of contraception that no longer works. So relying only on this method of contraception is not worth it.

How to insure? And than it is possible to be protected further, continuing to feed the child with a breast? Here are 6 possible options.

1. Condoms: the most important rules

The most, very reliable, including protection against STIs (sexually transmitted infections),. Although, it is worth recognizing that protection against STIs is irrelevant for many couples during lactation). Condoms are male and female. At the same time, their differences are only external, and the principle of action is the same - to create a mechanical barrier, to prevent the meeting of the sperm and the egg.

The most important rule of this: only correct and constant use will help to avoid unwanted. After each sexual intercourse, the condom must be changed. And you should not “for fidelity” use both male and female products at the same time. The probability of getting pregnant with a male condom is 2-18%, with a female condom - 6-12%.

2. Diaphragm/Cap: Treat with spermicidal cream before use

In fact, the diaphragm and the cap are different methods of contraception, but the protection mechanism (barrier) and the principle of operation are the same for them. To achieve an acceptable level of reliability, the diaphragm or cap should be treated with a spermicidal cream prior to use.

Diaphragms and caps come in different sizes, so it’s best to choose the right one with your gynecologist. You can use one product for several years. But after the birth of a child, still consult a doctor before hoping for the same cap as before pregnancy. Most likely, you will have to purchase a new, larger one.

Of the benefits: you can set the diaphragm in advance, and during intercourse, it does not require additional attention from the woman. Of the minuses: diaphragms and caps practically do not protect against STIs. and, moreover, are not sold in every pharmacy. The probability of pregnancy when used together with spermicides is 6-12%.

3. Progestin oral contraceptives (tablets): can be taken as early as one month after delivery

Purely progestin oral contraceptives (POCs) suppress ovulation, increase the viscosity of cervical mucus (it is more difficult for sperm to pass into the uterine cavity), disrupt the growth of the endometrium (which means that implantation of a fertilized egg is impossible if ovulation and fertilization still occurred).

Periods often disappear when using POCs, especially if a woman started taking them after giving birth. It is not harmful to health.

4. Injectable contraceptives: one injection for 3 months

How it works? Exactly the same as ChPOKi. However, medroxyprogesterone, which is part of the injection, enters the bloodstream after an injection into the buttock or shoulder (a certain “depot” is created, from where the drug is released within three months). During this time, medroxyprogesterone will suppress ovulation. Then the injection must be repeated.

The probability of getting pregnant with this method of contraception is quite low (0.2-6%). But most importantly, injections do not affect either the quality of mother's milk or the development of the baby. You can start taking POCs even on the day of delivery, but it is better to wait at least a month to avoid thromboembolic complications.

Because of the injections, a woman can lose her periods, as is the case with pills. If you notice any side effects after injections, contact your gynecologist immediately.

5. Contraceptive implant: the most effective way

It resembles a piece of the core of a fountain pen. A 4 cm long implant is inserted under the skin from the inside of the shoulder using a special syringe. The procedure is performed under local anesthesia. Cu-helix causes aseptic inflammation in the uterus (without the participation of microorganisms). As a result, spermatozoa become less mobile. Also, the drugs in the composition of the spiral disrupt the function of the endometrium and interfere with the implantation of a fertilized egg. The efficiency of the method is 99.2-99.4%.

The LN-coil works in much the same way as pure progestin contraceptives.. But the probability of pregnancy with her is only 0.2%.

The drugs that make up the spirals pass into breast milk in safe doses for the baby. They do not affect either the quantity or the quality of lactation. You can install the spiral immediately after childbirth. However, if the baby was born by caesarean section, you will have to wait at least 6 weeks (LN coil) or 8 to 12 weeks (Cu coil).

Examinations may be required before installing the helix: examination on a gynecological chair (mandatory), as well as an analysis for sexually transmitted infections, and a Pap test.

When the happy moments of meeting a newborn baby are left behind, it is the turn of everyday life and the improvement of life. And contraception is one of the first places in a series of important and important things for a young mother in order to prevent unwanted pregnancy. What birth control pills can be taken while breastfeeding, we will discuss in this review.

After gestation, childbirth, and the subsequent feeding of the child, the woman's body requires some time to recover. Therefore, a second pregnancy will be inopportune. During this period, a woman should consider an effective method of contraception. Modern methods of protection against unwanted pregnancy are taking birth control pills.

Varieties of oral contraceptives

To oral contraceptives can be divided into two types:

The fact is that their action is aimed at blocking the normal functioning of the ovaries and ovulation in particular. These drugs will affect the taste and quality of breast milk, so nursing mothers should not drink such contraceptives.

What drugs will not harm when feeding

Preparations intended for lactating women after pregnancy should contain only progestogens.

It is this contraception that is suitable for women after childbirth with normal lactation and will prevent unwanted pregnancy. In this case, the production of breast milk and the normal functioning of the ovaries will not be affected, and it will be possible to apply the baby to the breast without fear.

There is no secret that before you start drinking any drug, you should consult your doctor.

A qualified specialist will select the most appropriate contraceptive pills that will be safe during feeding and at the same time effective for women from accidental pregnancy.

What modern drugs based on progestogen that can prevent pregnancy can be taken?

These are contraceptives, collectively called "mini-drank":

1. "Femulen";
2. "Exluton";
3. "Charosetta".

A woman after a recent birth can start drinking contraceptive pills containing progestogens, which do not have a clear effect on her hormonal levels. In this case, the process of ovulation proceeds in the same way as before taking contraceptives.

How do these drugs work?

Contraception in the form of tablets with progestogen in the body of a woman after childbirth contributes to the thickening of the mucus in the cervix, which subsequently makes it difficult for sperm to penetrate.

In addition, thanks to the progestogen, the egg slows down its activity and, accordingly, the uterine endometrium is subject to change.

And even in the event that the sperm has shown skill and penetrated the uterus, the expected fertilization with the egg will still not happen. And all thanks to the special effects of mini-pills, which will not allow the egg to attach, fully develop and continue to flow into pregnancy.

When are contraceptives for breastfeeding women appropriate?

Indications for women to use mini-drinks when feeding a child:

• an effective way to prevent unwanted pregnancy of a woman who is feeding a baby;

• during therapy for endometriosis or other hormonal diseases;
• reducing the negative effects of menstrual syndrome after pregnancy and during feeding;
• in the treatment of mastopathy during lactation.

What are the contraindications to the use of oral contraceptives

Each drug has its own contraindications. Contraceptives are no exception.

Oral contraceptives after childbirth and during subsequent feeding should not be used:

• with various benign and malignant tumors in the mammary glands and liver;
• with hepatitis;

• during therapy for kidney disease;
• with a diagnosis of cardiovascular disease;
• if there is a need to take anticonvulsants;
• with epilepsy;
• if there are signs of bleeding and diseases of the genitourinary system.

If there are no such ailments in a woman who feeds a baby, you should carefully study the instructions for contraceptives. Oral contraception implies strict adherence to the dosage and regimen prescribed by the doctor.

As a rule, contraceptives should be taken once a day, one tablet to prevent pregnancy. Moreover, it is recommended to do this every day at a certain time. For example, this should be done every morning at 09:00, when the first feeding of the baby took place. If the pill was taken late, then its effect will be reduced.

What is also very important - you can use mini-pills only after two months have passed from the date of birth. Such a period is not accidental. It is during this period that a woman’s body has time to return to normal after pregnancy and hormonally rebuild.

What can alert a woman when feeding after taking a mini-pill

While the female body gets used to the pills, in the first couple of months of taking the following signs may be observed:

• spotting of a smearing type at the peak of the cycle. Do not worry too much about this, such signs are quite normal and will soon cease to bother;
• or maybe vice versa, and menstruation will be completely absent for some time;
• change in the menstrual cycle as a whole, its duration, abundance of discharge;
• change in the sensitivity of the breast in the nipple area;
• and the most negative signs of taking contraceptives are the formation of functional cysts on the ovaries;
• change in skin type, the appearance of a greasy sheen on the face and a rash;
• rare cases of increased vegetation on the body.

But do not worry too much, as soon as a woman stops taking mini-pills, these signs will disappear on their own, without additional interventions.

It often happens that if earlier the discharge during menstruation was abundant, then the pregnancy and the subsequent intake of contraceptive pills will help reduce the volume of discharge. Yes, and pain in the first day after the start of the cycle may disappear. But such signs of taking a mini-pill can be called positive consequences, which will immediately be noticed by a nursing woman.

How to stop taking birth control pills

In the event that there is a desire to become pregnant again, then after taking the mini-pill, you need to stop drinking them. However, the following rules must be followed:

- you can not stop the selected method of contraception when feeding in the middle of the cycle;

- you need to complete the entire course, then wait for the start of the menstrual cycle, and only after that you can start planning a future pregnancy. If you follow all the recommendations, then there will be no reason to fear the effect of the mini-pill on conception.

It is worth dispelling the widespread myth that if a woman after childbirth regularly feeds her child, then within six months you can safely not use protection, and pregnancy allegedly will not occur. Conception can occur at this time, leading to pregnancy quite often. The egg can mature 21 days after birth. And menstruation appears about five weeks after labor.

As an alternative to oral contraceptives, vaginal-type contraception can come to the aid of young mothers after pregnancy. For example, when feeding a woman, you can pay attention to Farmateks, which manufacturers produce in the form of a cream, suppositories, tampons and capsules.

Content

Most women are sure that they cannot become pregnant during lactation. This is partly true. In the first six months of lactation, the risk of conception is minimized. This phenomenon is called lactational amenorrhea, which serves as a natural contraceptive that suppresses ovulation by 99%. It is necessary to use contraceptives during breastfeeding after six months from the moment of birth or earlier, if lactation is not established, menstruation has appeared (and it can begin as early as 2-4 months).

Methods of contraception while breastfeeding

Use contraceptives while breastfeeding with caution. For the first six months, lactational amenorrhea operates, and this continues until the child is completely breastfed. Other methods of protection are:

1. Condoms. They can be used from the first days after childbirth. This method is easy, affordable, does not affect the health of the baby. The degree of protection varies from 86 to 97% and depends on the quality of the product, the correct use of the technique.
2. Spermicides. Such funds are allowed for use immediately after childbirth. They are represented by ointments, suppositories and tablets, they have protection over 90%.
3. Intrauterine device. It is allowed one and a half months after childbirth and provided that they were without complications. The reliability of such a tool is 98-100%, the shelf life is 7 years. You can remove it at any time, but only a doctor is involved in setting and extracting.
4. Injection method using Depo-Provera. Such an intramuscular injection is given every three months. It is used 6 weeks after childbirth, does not affect the health of the mother or child, and is safe.
5. Oral contraceptives. Birth control pills while breastfeeding can be taken 6-8 weeks after the baby is born. They do not affect lactation, have no taste, are 98% reliable, but before use, you need to consult a doctor and take tests.

Contraceptive pills for nursing mothers

You can use contraceptives while breastfeeding if they are prescribed by a doctor. Among the popular contraceptives, gestagenic and combined preparations are distinguished. The latter are prohibited during lactation, because they increase the level of estrogen and adversely affect the well-being of the child and mother. Combined birth control pills are allowed six months after childbirth, but can lead to hormonal disruptions and depression.

Progestogen contraceptives (mini-pills) are drugs based on a progestogen, progestogen or progesterone. These include Lactinet, Charozetta and Exkluton. They do not contain estrogens, the active substances penetrate into breast milk in small quantities, do not affect the health of the baby and the amount of secretion of the mammary glands. Mini-pills are well tolerated and do not cause serious side effects, except for a slight increase in body weight. Some medicines are prohibited after a caesarean section or while taking antibiotics.

Lactinet

Contraceptive pills Lactinet (28 pieces cost 750 rubles) contain the hormone desogestrel. They are taken one at a time at the same time for 28 days. Immediately after the first, the second package begins. If you skip a pill, the contraceptive effect decreases. The action of the drug is based on inhibition of the ovulation process, the absence of an increase in the values ​​of luteotropic hormone and progesterone in the blood serum, an increase in the viscosity of the cervical mucus. This prevents the advancement of spermatozoa.

Contraceptive pills during lactation can lead to nausea, mood swings, chest pain, menstrual irregularities, weight gain and headaches. With caution, they are prescribed for chloasma (hyperpigmentation on the skin), diabetes mellitus, porphyria (liver dysfunction), herpes, systemic lupus erythematosus. Contraindications are:

• venous thromboembolism or predisposition to it;
• liver cancer;
• liver failure;
• malignant hormone-dependent tumors;
• prolonged immobilization;
• pregnancy;
• vaginal bleeding of unknown cause;
• hypersensitivity to the components of the composition, including lactose.

Charosetta

Charozetta contraceptive pills (the price of 28 pills is 1050 rubles) contain desogestrel, 1 piece is taken every day. The contraceptive suppresses ovulation, increases the viscosity of cervical mucus, reduces the level of estradiol in the blood serum to the values ​​noted in the early follicular phase. Tablets do not affect carbohydrate, lipid metabolism.

When they are taken, nausea, bad mood, headaches, swelling of the mammary glands, and acne may occur. The drug is prescribed with caution for persistent hypertension, prolonged immobilization, liver cancer, chloasma. Contraindications are:

• pregnancy;
• hypersensitivity to the components of the composition;
• venous thromboembolism;
• severe liver disease, its insufficiency;
• malignant neoplasms;
• vaginal bleeding of unknown etiology.

Exluton

With lactation, you can use Exluton tablets (28 pieces cost 2050 rubles) based on the hormone linestrenol. They normalize and control the menstrual cycle, are taken 1 pc. per day. Tablets do not imply interruptions in use. Irregular intake or skipping a dose threatens the development of an unwanted pregnancy. The decrease in the effectiveness of Exluton is affected by the occurrence of vomiting or diarrhea.

Side effects are nausea, swelling of the mammary glands, headache, swelling of the extremities. Among the contraindications are:

• pregnancy;
• diseases of the liver, gallbladder;
• cancer of the genital organs, mammary glands;
• vaginal bleeding of unknown origin;
• tubal (ectopic) pregnancy in history or the risk of its occurrence.

Microlute

Contraceptive dragee Microlute (cost of 28 pieces - 300 rubles) contains the hormone levonorgestrel. Due to it, the activity of luteinizing and follicle-stimulating hormones decreases, the release of the egg is inhibited, it becomes impossible to attach the embryo due to the growth of the endometrium, thickening of the cervical mucus and difficulty in getting sperm to the egg. The drug is taken 1 tablet per day.

Its side effects are: urticaria, rash, itching, flatulence, vomiting, thrush, acne, decreased libido, chloasma. The drug is taken with caution in kidney pathologies, epilepsy, tuberculosis, migraine. Contraindications include:

• hepatic neoplasms, breast cancer;
• uterine or vaginal bleeding of unknown origin;
• thromboembolism;
• sickle cell anemia;
• diabetes mellitus with complications;
• herpes;
• a history of stroke;
• hemolytic anemia;
• pregnancy;
• hypersensitivity to constituents.

Rules for taking birth control pills while breastfeeding

Contraception during breastfeeding should be carried out taking into account the rules. These include the following recommendations:

1. Mini-pills begin to drink 21-28 days after childbirth in the dosage and frequency of administration according to the instructions and prescription of the doctor.
2. You can't skip pills. If there is a gap, you should read the instructions and take additional contraceptive measures.
3. It is forbidden to change the dosage or change the drug yourself. This threatens the development of severe side effects or the abolition of the contraceptive effect of the drug.
4. Tablets are drunk at the same time of day.
5. When lactating in the first two weeks of using contraceptives, it is better to use additional methods of protection against unwanted pregnancy.
6. Doctors advise taking pills before bed to minimize possible side effects such as dizziness, nausea, malaise and weakness.
7. If adverse reactions are strong, develop frequently, then it is better to contact a gynecologist for examination and a possible change in therapy.
8. If pregnancy occurs, birth control pills are canceled. Otherwise, it threatens hormonal disruptions and risks for the development of the fetus.

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The first time after childbirth, a woman does not have a menstrual cycle. In this regard, many young mothers are sure that they will not be able to become pregnant again during this period, and lose sight of the need for contraception. Indeed, breastfeeding is a good contraceptive, but it is effective for a short time and only under certain conditions.

In no more than six months, each woman will have to use additional means - barrier methods, spirals or tablets. The first two methods during lactation are used as usual, but not all birth control pills are allowed during breastfeeding, some of them can suppress milk production.

About lactational amenorrhea

Amenorrhea is the absence of cyclic hormonal changes in an adult woman. At the same time, menstruation stops, as the work of the ovaries stops. If this condition lasts more than three cycles at the usual time, the woman needs treatment. But during GV, amenorrhea is the norm. This is a completely physiological phenomenon, designed to protect the mother's body from excessive stress.

During lactation, the amount of prolactin increases significantly, which affects milk production. Prolactin suppresses the production of luteinizing and follicle-stimulating hormones in the pituitary gland, which are necessary for the maturation of follicles in the ovaries and ovulation. Thus, during breastfeeding, the ovaries rest and no new pregnancy.

The effectiveness of this natural method is quite high - pregnancy occurs in only 2% of women. In terms of efficacy, lactational amenorrhea is comparable to the use of condoms and significantly superior to vaginal spermicides. It was this method that was the main one of our great-grandmothers - married women of childbearing age in the villages were either pregnant or lactating.

Observations in modern life do not confirm historical facts, many women, in the absence of contraception, become pregnant in the first year. The weather is not uncommon in our lives, and not always a quick re-pregnancy was desired. The fact is that the method of lactational amenorrhea is highly effective only if a whole list of conditions is met.

Why should you take precautions while lactating?

Breastfeeding protects against pregnancy if the following conditions are met:

1. Feedings should be frequent, during the day and at night, with intervals between them no more than 3 hours.
2. You need to apply the baby at each of his requirements, do not limit the sucking time.
3. The baby should not consume anything other than breast milk - water, formula, complementary foods. The use of a pacifier is also not allowed.
4. Menstruation in a nursing mother should be absent.

A high contraceptive effect is achieved only if the entire list of conditions is met. When the baby begins to sleep more at night, or he has to give dill water for tummy pain, the effectiveness of this method drops sharply. The most effective lactation method of contraception is for mothers of restless, actively sucking babies. And even in this case, you will have to think about additional contraceptives when the child is 6 months old and the introduction of complementary foods should normally begin.

The disadvantages of the method are:

• the need to control the frequency of breastfeeding, sometimes the child will have to be woken up to give him a breast;
• a strong decrease in the contraceptive effect in case of a child’s illness, when you have to give him the medicine in a diluted form or additionally supplement it with saline solutions;
• lack of protection against the penetration of infection into the female genital tract, so it should be used only with full confidence in the partner.

With a decrease in the contraceptive effect, pregnancy can occur during the first ovulation, the appearance of menstruation for conception is not required. Gynecologists do not consider breastfeeding a sufficiently reliable method of protection and insist on the use of other methods, especially in cases where repeated pregnancy is contraindicated in the near future.

Ways to protect yourself while breastfeeding

Resume sexual intercourse after childbirth in most cases resolved after 2 months, with a mandatory preliminary examination by a gynecologist. From now on, it is worth thinking about contraceptives.

There are quite a few options for contraception for a nursing mother, adjusted for the preservation of lactation, all the main methods are allowed:

1. Interrupted intercourse in combination with the calendar method is the most risky contraceptive method. In 73% of cases, pregnancy occurs already in the first year of its use, and in case of insufficient self-control of a man, even earlier. In addition, it negatively affects the sexual function of both the woman and her partner.
2. Spermicides in the form of vaginal tablets, gels, creams and suppositories are not much more effective, with them the probability of pregnancy is 71%. Also, these drugs can cause allergic reactions.
3. Condoms as a contraceptive method are especially recommended when changing sexual partners. In addition to sexually transmitted diseases, they will protect against the introduction of new microflora, which can disrupt the balanced system of bacteria in the woman's vagina. When using high-quality products in accordance with the instructions, pregnancy will not occur in 98% of cases. With errors in application, the contraceptive effect is reduced to 85%.
4. Other barrier methods - uterine caps, condoms for women - are often used in Western countries, but are not widely used in Russia. These are quite effective ways that allow a woman to control the possibility of conception herself, without relying on a man.
5. The intrauterine device is the best contraceptive for women who do not plan to become pregnant in the next 5 years. Copper coils provide 99.2% protection. The Mirena system, which contains the hormone levonorgestrel, which is allowed for HB, is considered the most effective contraceptive and provides 99.9% protection from pregnancy. Mandatory conditions for their use are the installation only by a gynecologist and the absence of inflammatory diseases in the pelvic organs.
6. Oral contraceptives have a contraceptive effect in 99.7% of cases. For nursing mothers, not all pills are allowed, but only mini-drank. They contain only the hormone desogestrel, which is safe for breastfeeding. Despite this, they are no less effective than full-fledged birth control pills.

If emergency contraception is needed after intercourse, nursing mothers can use drugs based on levonorgestrel - Postinor and Escapel. The sooner they are taken after unprotected sex, the better the protection will be. Breastfeeding after their use will have to be interrupted for a day. Levonogestrel inhibits fertilization, but is safe for pregnancy that has already begun, it is not an abortifacient.

Contraceptives for breastfeeding mothers (names)

Contraceptive pills for nursing mothers are allowed to be used 2 months after the birth of a child, that is, they can be protected immediately after the onset of sexual relations. Ordinary tablets are combined, that is, they contain progestogen and estrogen. It is impossible to use them in the first six months of the child, since estrogen suppresses lactation. For nursing mothers, tablets containing only progestogen are suitable.

The characteristics of the most common oral contraceptives allowed during breastfeeding are shown in the table:

The effect of birth control pills

Contraceptive pills, which contain only the gestagen in the smallest amount that provides contraception, are called minimal pills, or mini-pills. They were created for use in cases where estrogen is contraindicated - for women who smoke, with diseases of the cardiovascular system, for mothers who are breastfeeding.

When using these contraceptives there is no risk for the child on breastfeeding. To receive a dose of progestogen, which is contained in just one tablet, an infant must be fed breast milk for 3 years. Mini-pills also do not have a negative effect on the amount of milk and feeding time. Moreover, some studies have noted an increase in lactation with their use.

The action of birth control pills with progestogen is based on a change in the density of the mucus that is on the cervix. It becomes more viscous and the sperm cannot reach the egg. Also, drugs containing desogestrel suppress ovulation, in 99% of the release of the egg does not occur. For linestrenol-based mini-pills, this figure is less (about 50%), which explains their lower contraceptive effect.

With the advent of the baby into the world, the mother has a lot of trouble that can disrupt the emotional state. Keep handy, a list of sedatives while breastfeeding.

How to take birth control while breastfeeding

Contraceptives are started no earlier than 3 weeks after the birth of the baby. The best time to take the first pill is 6 weeks after giving birth, before resuming sexual activity. In this case, additional protection is not needed. If the reception is started later, it is necessary to make sure that there is no pregnancy and use other contraceptives in the first week.

You need to drink birth control pills during lactation 1 piece per day at the same time. At different times of admission, the contraceptive effect decreases, especially with Exluton. If you miss a dose, you need to use other methods of protection for 7 days and continue to drink mini-pill. A pass is considered to be a break of more than 36 hours (27 for Exluton).

With diarrhea and vomiting due to indigestion, the absorption of the contraceptive may not be complete. In this case, additional protection is needed, as when skipping a pill.

Some antiepileptic, sedative, antifungal agents, some antibiotics, St. John's wort, activated charcoal reduce the effectiveness of the mini-pill. When prescribing these drugs, you should check with your doctor about the possibility of taking them together.

Side effects with HB

The main side effect when taking progestogen-based tablets is a change in the nature of menstrual flow. The endometrium in 40% of women passes into an inactive phase, its thickness decreases. In this regard, the allocation becomes scarce, irregular, may disappear completely, especially after six months of admission. These phenomena are considered the norm and disappear in the first cycle after the abolition of contraceptives.

When taking pills, the follicles in the egg continue to mature, they may be larger than usual in size, in the future they resolve on their own. When conducting an ultrasound, it is necessary to warn the specialist about taking contraceptives in order to exclude incorrect diagnosis.

In the first months of taking mini-pills, they can cause headaches, mood changes, and nausea. With further use of drugs, they disappear or significantly decrease.

Today, family planning is one of the priority areas in gynecological practice, especially if there is a baby in the family. Not all families are morally and financially ready for the birth of the weather, and abortion for a woman who has recently given birth to a child and is breastfeeding is also a negative impact on health. Therefore, contraception after childbirth against the background of breastfeeding, after the start of intimate relationships between spouses, becomes one of the most important tasks.

Contraception after childbirth

Today, there are many methods of preventing unwanted pregnancy, but their effectiveness varies, there are both relatively reliable and unreliable methods. Against the background of lactation after childbirth, a relatively long period of amenorrhea persists, the absence of menstruation due to blocking the work of the ovaries for the maturation of the egg against the background of lactation. This phenomenon is used by many married couples, practicing the method of LAM prevention (method of lactational amenorrhea). In addition, there is a marital calendar, this is the calculation of safe days, as well as interrupted sexual intercourse, in which sperm does not enter the woman's vagina. There are also barrier means of protection - condoms and vaginal caps and membranes, preparations for oral hormonal contraception and intrauterine devices. The most radical method of protection is the method of cutting or tying the fallopian tubes in a woman or the vas deferens in a man.

When to Consider Contraception

Actually, with the onset of intimacy, the question of contraception should already arise, since even with intensive breastfeeding, LLA may not work, since its effectiveness reaches 95-96%, that is, purely theoretically 4-5% of women may well become pregnant. So, starting from 8-10 weeks after birth, when the discharge has ended, or with the onset of regular menstruation, pregnancy is quite likely, and it is necessary to decide how to protect yourself. Each of the methods has its indisputable advantages and disadvantages, the most reliable and indisputable method is only abstinence.

MLA while breastfeeding

LAM is a method of lactational amenorrhea practiced by many breastfeeding women. Subject to all the rules of this method, its efficiency reaches 96%, in connection with which it is convenient for many couples in the first time after childbirth.

The undoubted advantage is its naturalness, ease of use and free. A significant disadvantage is the degree of reliability, which significantly depends on the strict observance of the conditions for compliance with all the rules in breastfeeding.

A similar method can be practiced if breastfeeding does not allow pacifiers, supplementary feeding and drinking water, application strictly on demand, including at night, the child sucks actively and the mother does not have menstruation.

It is usually practiced before children when it already loses its effectiveness and degree of protection. Against the background of active and full breastfeeding without interruptions, there are usually no periods, ovulation is suppressed due to the active release of lactation hormones and conception does not occur. Usually this method is practiced by those couples who do not worry about the possible hit in 4-5% of those who can become pregnant.

Calendar method for HB

One method of natural contraception is to keep a marital calendar (often along with measurements of basal body temperature). The effectiveness of the method for HB is low, since conception can often occur before the first menstruation, and with this method they are guided by the timing of menstruation.

note

Due to hormonal changes, the days of ovulation can shift, respectively, as well as “stray” and safe days.

Against the background of breastfeeding, it can only be used in the second year of feeding, when menstruation is already established, its terms are stable, and hormonal effects on reproductive functions are not so great. Efficiency ranges from 40 to 65%, depending on whether the cycle is regular or not.

The advantages of this method:

• Free
• Natural

Cons of this method:

Coitus interruptus with GV

Many couples practice PAP (pullout) as a method of preventing unwanted pregnancies. Its essence lies in the fact that a man before the onset of ejaculation during intimacy removes the penis from the woman's vagina, respectively, the sperm does not enter the vagina.

It is difficult to call this method reliable due to the fact that some of the active spermatozoa are contained in the secrets released before ejaculation, and sometimes a man in a fit of passion simply does not have time to "come out", which causes misfires.

The advantages of this method:

• Free
• Natural

Cons of this method:

Barrier methods of contraception for HB

Barrier contraception includes condoms that are put on a man's penis during intimate contact or caps (membranes) that are placed or put on a woman's vagina. Due to these products, sperm and, accordingly, male germ cells cannot enter the cervix and fallopian tubes, where conception occurs. Caps and membranes have not received much distribution in HB, as well as in other intimate contacts due to the difficulty with their use and low reliability. Therefore, we will discuss condoms as one of the most popular methods.

A condom is put on the penis in an erect state just before intimacy, and due to it, the sperm simply physically cannot get into the woman's hearth paths, remaining inside the condom. The effectiveness of this method reaches 95-98% with proper selection and use.

Advantages of the method:

• Simple, does not require special skills
• Reliable when properly sized
• Protects against STIs

Cons of the method:

• The condom may fall off, tear, or not fit
• May be allergenic (grease, latex)
• Every intimate encounter requires a new condom, which is financially sensitive (quality products are expensive).

Ligation (cutting) of pipes during HB

Refers to radical methods of contraception, in which, due to artificially created obstacles, conception in the fallopian tubes is impossible. It is used only for those women who have reached the age of 35, have 2 or more children, or for medical reasons, pregnancy is dangerous for a woman. Efficiency reaches 99-100%.

Advantages of the method:

• Free
• Effective

Cons of the method:

• Does not protect against STDs
• Requires an operation if the dressing was not done in childbirth with.

Ligation (transection) of the vas deferens

It is similar to this method in women, but is performed in men. It is indicated when a man reaches 35 years of age and older and has 2 or more children. The method can be both reversible and radical. When ligating the cords or placing a special cork, fertility can be restored, when transected - only after the operation, and not always successfully.

Advantages of the method:

• Free
• Effective

Cons of the method:

• Radical, further conception is possible only after surgical intervention
• Does not protect against STDs.

Contraceptive pills for nursing mothers

When breastfeeding, only pure gestagenic contraceptives (mini-pills) are acceptable for use, since combined ones (COCs) lead to a violation of milk production, and also affect the child.

Taking a mini-pill gives, when used correctly, an efficiency of up to 98%, but requires pedantry in observing the timing of taking the pills.

Advantages of the method:

• Effective
• Does not affect the quality of milk
• It is applied from early terms after childbirth, it is possible from 8-12 weeks after birth