BOOK YOUR CLASS

A Guide to Contraception

A Guide to Contraception After Birth

After your baby is born, your fertility returns before your periods do. That means you can become pregnant before your first period back, sometimes within weeks. If you don’t want another pregnancy straight away, contraception is essential.

This page sets out the main options, when to start each, and which are compatible with breastfeeding. The right choice is the one that fits your body, your life, and your plans.

When to start contraception

For most women, contraception is recommended from 3 weeks postnatally, though some methods can be started straight after birth. Speak to your GP, family planning service, or at your 6-week postnatal check.

Important to know:

  • The first ovulation can happen before your first postnatal period. Don’t wait for a period to start contraception.
  • If you are fully breastfeeding (exclusively breastfeeding day and night, baby under 6 months, and no periods returned), the “Lactational Amenorrhoea Method” (LAM) is up to 98% effective, but only if all three conditions are met. As soon as one changes (you stop breastfeeding at night, start solids, or your periods return), you need another method.
  • The contraception that worked for you before pregnancy is not always the right choice now, particularly if breastfeeding.

Contraception options at a glance

Progesterone-only pill ("mini pill")

How it works: A daily pill containing only progesterone. Thickens cervical mucus, thins the lining of the womb.
What to know:

Safe in breastfeeding.
Can start from 3 weeks after birth.
Must be taken at the same time every day (within a 3 to 12 hour window depending on type).
91% effective with typical use.

Combined hormonal contraception (combined pill, patch, ring)

How it works: Contains both oestrogen and progesterone. Suppresses ovulation.

What to know:

  • Not recommended in the first 6 weeks postnatally, and generally not recommended while fully breastfeeding (oestrogen can reduce milk supply).
  • Suitable after 6 weeks if not breastfeeding, with no other risk factors.
  • 91% effective with typical use, 99% with perfect use.

Intrauterine device (copper coil or hormonal coil / IUS)

How it works: A small T-shaped device placed in the womb. The copper coil prevents fertilisation; the hormonal coil thickens cervical mucus and thins the lining.

What to know:

  • Safe in breastfeeding.
  • Can be fitted at 4 weeks postnatally (sometimes within 48 hours of birth in some hospitals).
  • 99% effective.
  • Lasts 5 to 10 years depending on type.

Contraceptive implant

How it works: A small flexible rod placed under the skin of the upper arm. Releases progesterone.

What to know:

  • Safe in breastfeeding.
  • Can be inserted at 3 weeks postnatally, or earlier.
  • Over 99% effective.
  • Lasts 3 years.

Contraceptive injection

How it works: A progesterone injection every 12 to 13 weeks.

What to know:

  • Safe in breastfeeding.
  • Can be started from 6 weeks postnatally.
  • Over 99% effective with on-time injections.
  • Return to fertility can take several months after stopping.

Barrier methods (condoms, diaphragm)

How it works: Physically prevent sperm reaching an egg.

What to know:

  • Safe in breastfeeding.
  • Available immediately.
  • 82 to 87% effective with typical use.
  • Diaphragm may need to be re-sized after birth.

Breastfeeding and contraception, the key points

  • The progesterone-only methods (mini pill, implant, coil, injection) are all safe in breastfeeding and do not affect milk supply for most women.
  • Combined hormonal methods are generally avoided while fully breastfeeding, as oestrogen can reduce milk supply.
  • Barrier methods (condoms, diaphragm) are safe and effective when used correctly.
  • The Lactational Amenorrhoea Method (LAM) is up to 98% effective, but only when all three of the following are true:
    1. Your baby is under 6 months old.
    2. You are exclusively breastfeeding day and night, with no formula or solids.
    3. Your periods have not returned.

As soon as any one of those changes, your protection drops, and you need another method in place.

Where to get contraception

  • Your GP. The first place to start. Most GPs offer the full range of methods or refer you on for coils and implants.
  • Family planning clinics. Often more specialised; some offer faster access for coils and implants.
  • Your maternity team. Some methods (e.g. immediate postpartum coil) are offered by the hospital before discharge. Ask if interested.
  • HSE. From 2022, contraception has been free for women in certain age groups in Ireland. Check current eligibility at hse.ie/freecontraception.