Contraception after birth

Contraception is probably the last thing on your mind with a newborn, but it’s worth thinking about sooner than many people expect — because it’s possible to fall pregnant again quite soon after birth, even before your periods return and even while breastfeeding. A quick plan now saves a surprise later, especially if you’d like a gap between babies.

You can get pregnant before your first period. Ovulation happens before your period returns, so you can conceive without having had a period since the birth. This catches a lot of people out. If you’re not trying for another baby right away, it’s wise to sort contraception before you resume sex, rather than assuming you’re covered.

Breastfeeding is not reliable contraception on its own. Exclusive breastfeeding can reduce fertility (the “lactational amenorrhoea method”), but only under strict conditions — baby under six months, exclusively breastfed including through the night, and no periods yet — and it becomes unreliable as soon as any of those change. Most people want something more dependable alongside it.

Options that suit breastfeeding. Several methods don’t affect milk supply and can often be started early: the progestogen-only pill (“mini pill”), the contraceptive implant, the contraceptive injection, and IUDs (hormonal or copper), which are highly effective and long-lasting. Condoms are an easy, non-hormonal option you can use straight away. Your GP can talk you through timing for each.

Options usually delayed a little. Methods containing oestrogen — like the combined pill — are generally avoided in the early weeks because of a small increased risk of blood clots after birth, and because oestrogen can reduce milk supply. Your GP will advise when (and whether) these are suitable for you, based on how you’re feeding and your health.

Timing and getting it sorted. Contraception commonly comes up at your six-week postnatal check, which is a natural time to discuss it — but you can raise it earlier if you’d like, and you don’t have to wait for that appointment. Longer-acting methods like an implant or IUD can often be arranged around then, and some can even be fitted very soon after birth.

Thinking about spacing pregnancies. Health services generally suggest leaving some time before the next pregnancy to let your body recover, which is another reason to plan. If you do hope to conceive again before long, that’s worth discussing with your GP too — the point is to make it your choice, not a surprise.

It’s your decision. The “best” method is the one that fits your body, your feeding, your health and your life — there’s no single right answer, and you can change methods if one doesn’t suit. Be honest with your GP about what matters to you (convenience, hormones, permanence, cost) so you find a good fit.

Cost and access. In Australia, many contraceptive options are affordable — several pills are subsidised through the PBS, and long-acting methods like implants and IUDs, while involving an upfront appointment and sometimes a fee for insertion, work out very cost-effective over the years they last. Your GP or a family planning clinic can talk you through what’s covered and what to expect to pay, and bulk-billing options exist. Don’t let uncertainty about cost stop you from asking.

If you have unprotected sex and aren’t covered. Emergency contraception (the “morning after” pill) is available from pharmacies without a prescription, and is compatible with breastfeeding — so if a planned method slips, it’s a safe option to ask your pharmacist about promptly. It works best the sooner it’s taken.

Falling pregnant sooner than planned is more common than people think, precisely because it can happen before periods return and breastfeeding isn’t a guarantee. Have a chat with your GP about your options — ideally before you resume sex — and choose what works for you. A little planning now keeps the timing of your family in your hands.