BIRTH SPACING AND FAMILY PLANNING

Couples may have their own ideas and plans about the size and timing of their family.

Having another baby might be the last thing on your mind right now. But getting pregnant too soon after giving birth can be risky for both you and your baby. Becoming pregnant again within a year of giving birth increases the chance that your new baby will be born too soon. Babies that are born too soon can have health problems. The World Health Organization (WHO) advises that the best inter pregnancy interval (time from the end of one pregnancy to the beginning of another) is between two and five years. This means that the majority of new moms should be considering a reliable method of contraception early in the postpartum period. There are factors that may change the WHO recommendation

Planning your next pregnancy if you want more children — or preventing a pregnancy if you don’t — is important. Spacing pregnancies at least 12 months apart will give your body time to fully recover. In the meantime, using reliable birth control is the best way to prevent pregnancy until you decide if and when to have another baby.

Women who have just given birth should wait three weeks before using birth control that contains both oestrogen and progestin. This includes the pill, the patch, and vaginal ring. Using these methods in the early weeks after giving birth increases the risk of dangerous blood clots. Wait six weeks to use birth control with both oestrogen and progestin if you delivered by C-section or have other risk factors for blood clots. These risk factors include obesity, history of blood clots, smoking, or preeclampsia.

Women have many good choices for birth control after giving birth. Keep in mind that breastfeeding alone isn’t a fool proof way to prevent pregnancy.

Most women are advised to abstain from intercourse for at least six weeks after delivery. As there are increased risks with using certain birth control methods less than a month after your baby’s birth, it may be best to wait until one month postpartum to start many of the available options, which still gives at least two weeks of use to establish efficacy prior to resuming normal sexual activity.

The fact that many breastfeeding moms may not have regular periods does not mean that breastfeeding alone is a reliable method of birth control. Most doctors advise an additional option.

Dr.Maulik Joshi can offer patients a full suite of family planning and birth control options to fit every woman’s needs. He can help you navigate your options and find the best choice for your lifestyle.No matter your choice, he works with patients on customized family planning solutions, and takes the time to address any personal health risks and answer questions to ease concerns. 

Among the options offered are:

• Oral contraceptives
• Contraceptive patches
• IUD insertion utilizing ultrasound guidance
• IUD insertion assisted by ultrasound guidance increases effectiveness of the device and limits complications.
• Long-term solutions include tubal ligation, which is a permanent birth control procedure that works with a woman’s body to create a natural barrier against pregnancy.

 

There are many factors to think about in choosing birth control after delivery, including

Past experiences with birth control,

Side effects,

Ease of use,

Plans for future pregnancy,

Breastfeeding

Expense.

Ultimately, you may not request any birth control at all. If there is additional information we can give you to help you in making this decision please do not hesitate to ask us.

 

ORAL CONTRACEPTIVE PILLS –

For most women who are accustomed to taking the pill and who have done well on the pill in the past, the simplest, cheapest and most flexible form of birth control after delivery may be resuming the birth control pill. Most pills contain a combination of oestrogen and progesterone. While establishing breastfeeding we try to limit oestrogen use as it may reduce your milk supply. Therefore, if you choose to be on the pill we typically would start you on a progesterone-only pill (sometimes referred to as the “mini-pill”) while you are establishing breastfeeding and then switch you back to a combination pill once breastfeeding is well- established or once you stop nursing. By itself the mini-pill may not provide as reliable birth control as the combination pill; breastfeeding plus the mini-pill is equally effective, but once you stop breastfeeding a combination pill is more reliable. If you choose to be on an oestrogen containing product your health care provider will review in detail the potential side effects and may have you sign a consent form indicating you are aware of those side effects.

Birth control pills

– No invasive procedures to initiate use

– Generally easy to use

– Effectiveness depends on correct use

– Requires daily, weekly or monthly action

— Most likely to result in unintended pregnancy

 

IUDs –

For those women who are looking to minimize hormonal exposure, and who want easy to use and extremely reliable long-term birth control, an IUD can be a great option. This is a small T-shaped device made of plastic and contains progesterone the arm .This is inserted in the uterus in the office in a minor procedure that requires no anaesthesia.

It is

– Highly effective

– Lasts up to five years with no maintenance except monthly string checks

– Quick return to fertility once removed

– Significant decrease in menstrual blood loss (excellent for women with heavy periods)

– Requires small office procedure for placement with some unique risks

– Irregular bleeding in some women

There are various IUDs available –All are extremely reliable protection against pregnancy, as reliable as a permanent tubal ligation, but IUD contraception is entirely reversible. IUDs do not interfere with breastfeeding nor cause any problems for future pregnancies

 

DEPO PROVERA –

This is an injection given every 3 months of a type of progestin that provides highly reliable contraception. The most common side effects include unfavorable changes in bleeding patterns, mood changes and weight gain. It is safe to use while breastfeeding.

Depot Provera: Progestin shot

– Highly effective if used correctly

– Requires action only every three months; therefore, less room for error

– Irregular periods in some women (lighter bleeding may be an advantage)

– Higher dose of hormones may mean more hormonal side effects, such as weight gain

– Longer return to natural fertility

BARRIER METHODS: CONDOMS, DIAPHRAGMS

– Only condoms provide protection from sexually transmitted infections

– No delay in return to fertility

– Require use with each sexual encounter

 

NUVARING –

This is a plastic ring which is inserted in the vagina that releases both estrogen and progesterone that works in a similar fashion to the combination pill, but is simpler to use as it does not require remembering to take a pill every day. Because it contains estrogen we may advise against the use of Nuvaring while breastfeeding.

 

STERILIZATION –

For those who are absolutely certain that they are done having children sterilization may be desired. There are several different forms of sterilization including § male sterilization or vasectomy (your partner would need to discuss this with their family doctor or a urologist), and female sterilization commonly referred to as tubal ligation (having your tubes tied). Laparoscopic tubal ligation may be done as an outpatient surgery o typically 6 weeks or more after delivery. This has a slightly lower failure rate than the postpartum tubal ligation, but does require a general anaesthetic.

 

Postpartum contraception is an important issue to consider toward the end of pregnancy. Discuss the best methods for you with Dr Maulik Joshi.

VAATSALYA CLINIC -the woman and child care clinic conveniently located at at Mahim , offers the most comprehensive and best OBSTETRIC, GYNEC and PEDIATRIC care to women and children in all stages of life. Our Gynecologist DR MAULIK JOSHI and Pediatrician   DR SHAIVALI JOSHI take the time to listen to you, answer your questions and make sure you leave the clinic feeling satisfied,informed and cared for. Our team consists of our Doctors, Nurses and front office staff to give you the best possible medical care.We are dedicated to helping all women and children stay healthy.