Mamas on Bedrest: It’s Time to Consider Your Birth Control Options

July 20th, 2011

I had a tubal ligation at the same time I delivered my son. I had a c-section and my OB and I both decided to get it done while she was there. Worked for me.

As I have openly said, my reproductive history was fraught with complications and I am forever thankful that I have the two beautiful children that I have. And when it became evident that my son (my second child and 4th pregnancy) was a healthy boy, I didn’t want to tempt fate. I had a girl and now would have a boy. At 40 and with my history, I was done. Nip/Tuck away!!

Mamas on Bedrest, although you may be on bed rest now, it’s time to consider your birth control options and to choose a birth control method.

The Centers for Disease Control and Prevention, in conjunction with the World Health Organization, have updated their recommendations for post partum contraception.

“The revised guidelines affirm the importance of starting contraception during the postpartum period to prevent unintended pregnancy and short birth intervals, which are associated with adverse health outcomes for the mother as well as for the infant. These include greater risks for low birth weight and preterm birth”.

The World Health Organization and CDC both emphasize the importance of women NOT using combination hormonal contraception for the first 21-42 days post partum due to the increased risk of blood clots forming and migrating to the heart, lungs and brain. (VTE).

“Compared with control participants, women in the first 42 days of the postpartum period have a 22-fold to 84-fold increased risk for VTE.”

The CDC and WHO recommend that women who choose to use hormonal contraception use progestin only injections, implants, mini pills or IUD’s.  All can be started immediately post partum and all are safe for use with breastfeeding. (Combination hormonal contraception can hinder successful breastfeeding.)

Condoms can be safely used at any time, but use of the diaphragm and cervical cap should be delayed until 6 weeks postpartum.  And of course, for women who have all they children they desire, they can consider permanent sterilization. 

It my seem strange to even ponder contraception while working so hard to grow this baby. But in the interest of your own health and the health of subsequent children, adequate time should be allowed for you to recover so that (if you choose) you can enter your next pregnancy healthy, strong and doing all that you can to avoid another high risk pregnancy and potentially, bed rest.  

Sources:

MMWR Morbidity and Mortality Weekly Report. 2011;60:878-883.
The World Health Organization – Position Statement on Post Partum Contraception and Combined Hormonal Contraception in the Early Post Partum. (PDF)

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