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The Best Birth Control After the Baby

Sterilization

Tubal Ligation

Couples who have completed their families may opt for one partner to be sterilized. Tubal ligation is the most popular method of birth control in the country, and the most common method of sterilization for women.

Pluses: Women can have the surgery -- to cut and tie the fallopian tubes -- performed immediately following a C-section or vaginal birth, or they can have it done laparascopically once the uterus has returned to its normal size (two to three months later), says Charles Debrovner, M.D., associate clinical professor of obstetrics and gynecology at New York University. The surgery usually won't require a longer stay, and will not interfere with your ability to care for your new baby. Some women prefer to wait several months after delivery before deciding on sterilization. "One reason is that they want to be absolutely sure their baby is healthy before they end their fertility," says Dr. Debrovner.

Effectiveness: 99.5%

What You Should Know: Tubal ligation -- whether done right after birth or several months later -- may interrupt breastfeeding, especially if performed under general anesthesia. Nursing mothers can minimize the problem by making sure the surgery is done with a local or regional anesthetic, and that they won't be away from the baby for more than a few hours.

Vasectomy

Pluses: The procedure, which involves cutting the tubes that carry sperm from the testes, is easier, cheaper, and safer than female sterilization. It's done in a urologist's office, takes about 20 minutes, and requires only a local anesthetic.

Effectiveness: 99.85 %

What You Should Know: Other forms of contraception should be used following the surgery; since sperm remain in the tubes, it takes about 15 to 20 ejaculations and a mandatory semen analysis before a man is considered sterile. Although rare and usually not serious, there may be some bleeding and an infection following the procedure.

Whatever method you decide on, a careful choice is worth the effort. As difficult as it might be to think of anything else but your newborn, it pays off in family-health dividends for all new parents to practice safe and effective after-baby birth control.

*Effectiveness rates reflect a typical user and account for people who don't use the method correctly as well as for product or procedure failure.

Beth Weinhouse is the coauthor of Outrageous Practices: How Gender Bias Threatens Women's Health.

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