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After-Baby Birth Control

Believe it or not, you will want to have sex again, and even if you're breastfeeding (which provides most, but not all, women with about three months of protection), you'll need to think about birth control. Bottle-feeding moms can start ovulating a few weeks after delivery, says Phillip Stubblefield, M.D., a professor of ob-gyn at the Boston University School of Medicine. In other words, plan ahead.

• Hormonal methods, such as birth-control pills, the patch, or the ring, contain estrogen and synthetic progesterone (progestin) to suppress ovulation. They're 97-percent effective*, can be started six weeks postpartum, and are a good choice for bottle-feeding moms. Since estrogen can reduce milk supply, a better bet for nursing moms is a progestin-only "mini-pill" (94- to 97-percent effective) or shot (99-percent effective).

• Barrier methods include the diaphragm, an 80-percent effective rubber dome that covers the cervix, and the smaller cervical cap, which fits directly on the cervix, but is only 60-percent effective in women who've given birth. (Both need to be refitted after pregnancy.) Male and female condoms (86- and 79-percent effective) are easy over-the-counter choices.

• The IUD Now that you've given birth, you can try the highly effective (99 percent) intrauterine device (IUD). (The uterus of a mom is more receptive to an IUD.) They work by thickening the cervical mucus that blocks the sperm from fertilizing the egg.

*Note: All effectiveness rates are for "typical" use; "perfect" use can be significantly higher.

Hormonal methods, such as birth-control pills, the patch, or the ring, contain estrogen and synthetic progesterone (progestin) to suppress ovulation. They're 97-percent effective*, can be started six weeks postpartum, and are a good choice for bottle-feeding moms. Since estrogen can reduce milk supply, a better bet for nursing moms is a progestin-only "mini-pill" (94- to 97-percent effective) or shot (99-percent effective). ï

Barrier methods include the diaphragm, an 80-percent effective rubber dome that covers the cervix, and the smaller cervical cap, which fits directly on the cervix, but is only 60-percent effective in women who've given birth. (Both need to be refitted after pregnancy.) Male and female condoms (86- and 79-percent effective) are easy over-the-counter choices. ï The IUD Now that you've given birth, you can try the highly effective (99 percent) intrauterine device (IUD). (The uterus of a mom is more receptive to an IUD.) They work by thickening the cervical mucus that blocks the sperm from fertilizing the egg.

*Note: All effectiveness rates are for "typical" use; "perfect" use can be significantly higher.

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