What are my options for long-term contraception whilst breastfeeding?

Congratulations for your new-born baby! Although you had just delivered, a nagging worry begins. What are your options to space your next baby?

Breastfeeding is a natural contraception Breastfeeding prevents pregnancy by suppressing your hormones and menses. However, the effectiveness is short-lived for only 6 months in exclusive breastfeeding. Your cycles may resume after 6 months and other contraception method should be considered.

Permanent contraception method You can opt for female sterilisation (where the fallopian tubes are ligated) or male sterilisation (AKA vasectomy). However, it’s best not to make this decision hastily, as many couples do regret. Failure rate is also higher if performed immediately post-natal.

Long-acting Mirena intra-uterine device When you are breastfeeding, oral contraception pill is not a good option as it affects milk flow.

You can consider long-acting progesterone (Mirena) intra-uterine device if you want to space your next child for 3-5 years. This is safe for breastfeeding. The best time to insert is 3-6 months after a delivery, even after C-section. Effectiveness is about 99%.

Hormonal methods

You can also consider 3-monthly hormone injection or progesterone implant which lasts 3 years. Some women dislike the side-effects like weight gain or spotting.

Emergency Contraception This involves taking a contraceptive pill, ideally within 48 to 72 hours after sex. Emergency pill is a less preferred choice as it may cause irregular cycles and efficacy is lower (75%). Do speak with your doctor to recommend the best contraception option for you.

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