People joke that having kids is the best form of birth control, but if you don’t want another baby right away, you need a method that really works. Plus, research shows it’s optimal to wait at least 18 months before conceiving again in order to reduce the risk of having a preterm birth or a baby with low birthweight.
That’s why researchers at University of California, San Francisco followed nearly 118,000 postpartum women to identify the most effective form of birth control, and help women attain a healthy interpregnancy interval.
Here’s what they found: Women using long-acting reversible contraception such as the implant and intrauterine devices (IUDs) were four times more likely to meet the 18-month mark, compared to women who only used condoms. And women who used hormonal methods (like the pill, injections, patch, and ring) were twice as likely to meet the mark than condom users. The study was published in the American Journal of Obstetrics and Gynecology.
IU...what? An IUD is a T-shaped device your doctor inserts into your uterus. There are two types: Hormonal IUDs release levonorgestrel, a form of progestin that prevents the lining of the uterus from becoming thick enough for a fertilized egg to implant and grow. And there are copper IUDs, which make the uterus produce a sperm-killing fluid.
“The main difference between IUDs/implants and other methods is adherence,” says Julie Chor, M.D., M.P.H., assistant professor of Obstetrics/Gynecology at the University of Chicago. Once a clinician inserts an IUD, there’s nothing else you need to do. Whereas other methods, like condoms and the pill, require regular responsibilities, from stocking up on condoms to remembering to take a pill every day. “Even the most careful person can have an ‘oops’ moment,” Dr. Chor adds. And as any sleep-deprived parent can attest, forgetting becomes even easier when caring for a newborn.
Related: The New Mom's Survival Guide
But let’s be blunt: An IUD can feel like a pretty off-putting option. (Will I feel it?!) We asked Dr. Chor to address your most pressing questions.
Is it safe?
Absolutely. There’s a very low risk of experiencing a pelvic infection right after insertion, but three weeks afterward your risk of an infection is equal to that of a woman without an IUD.
Does it hurt?
You may experience cramping after insertion, but it usually subsides within 24 hours. If you’ve had a vaginal delivery you’re less likely to experience cramping because your cervix has been open before.
Will it fall out?
Very unlikely—the rate of expulsion is 2 to 3 percent. (Though the risk is higher if placed immediately after delivery, since the cervix is dilated.)
Can my partner feel it during sex?
It’s rare, but if your partner says he feels something, then your provider can trim the strings that come out of the cervix and into the vagina.
Will it interfere with my ability to get pregnant again?
Nope, it’s a completely reversible form of birth control. You return to fertility as soon as it’s removed.
How long do I have to wait after giving birth to get an IUD?
Most doctors wait 6 weeks, since insertion immiediately after labor requires a different technique, but ask your doctor about getting one sooner, which is still a safe option.
Is it hard to remove?
Most removals are very simple and take less than a minute during a minor office procedure.
Is there an alternative?
If you still don't like the idea of having a device in your uterus, talk to your doctor about a progestin-releasing implant instead. (They're inserted into your arm.)