Contraception After Baby

Rethink your contraception after giving birth


Planning on using the same birth control as before you conceived? That may not be a smart move. According to the U.S. Centers for Disease Control and Prevention (CDC), there are potential safety issues with certain types of hormonal contraceptives—especially in the first few weeks after having a baby.

"One of the main concerns in the immediate postpartum period is that women are at higher risk for something called venous thromboembolism, or a blood clot," says Naomi K. Tepper, M.D., M.P.H., a medical officer in the division of reproductive health at the CDC. "If these women use birth control that contains estrogen—which also raises the risk of blood clots—they're at even higher risk."


In guidellines released in 2011, the CDC advises that all women avoid estrogen forms of birth control for the first 21 days after having a baby, when the risk for a blood clot is the highest. These include combined birth control pills (those that contain estrogen and progestin), the patch and the vaginal ring. Women who have risk factors for developing blood clots—a history of preeclampsia, a blood-clotting disorder or a Cesarean delivery; or being a smoker, obese or age 35 and older, to name a few—are at even higher risk and are advised not to use estrogen birth control for the first six weeks. If you are nursing, avoid estrogen birth control for the first month because it might affect your milk supply.


Contraceptives that contain only progestin are safe for all women, even those who are breastfeeding in the immediate postpartum period—and indefinitely, says Tepper, who helped draft the guidelines. These include progestin-only birth control pills; Depo-Provera (injections given every 12 weeks); Implanon (a small rod inserted under the skin of the arm that lasts for three years but can be removed at any time); and Mirena (a hormonal IUD that is effective for five years but also can be removed at any time). In addition, the copper IUD, which does not contain any hormones, is safe and lasts for 10 years.

Whatever type of contraceptive you're considering, discuss it with your doctor or midwife, preferably while you're still pregnant—and be sure to mention any potential risk factors you may have. —Carole Anderson Lucia