New recommendation on birth control after delivery

It’s best for a woman’s health to wait 18 months before getting pregnant again. It gives your body time to heal, rebuild its energy stores, and it lets you get used to being a mom. And short birth intervals can have negative outcomes for both mom and baby. Since ovulation can take place as soon as 25 days after delivery, it’s important to establish a contraceptive plan to ensure you’ve got the time you need.

If you plan to go back on the pill, when should you start taking it again? New recommendations from the CDC say it’s very important to wait at least three weeks after giving birth before starting estrogen-progestin combined oral contraceptives. Why? Studies have shown that there is a significant increase in the risk of serious, potentially fatal blood clots, called venous thromboembolism or VTE, in women who use the combined contraceptive during the first 21 days postpartum.

The recommendations go on to say that 21-42 days postpartum, women without risk factors for VTE generally can begin combined hormonal contraceptives, but women with risk factors for VTE (e.g., previous VTE or recent cesarean delivery) generally should not use these methods. After 42 days postpartum, no restrictions apply to the use of combined hormonal contraceptives based on postpartum status.  Any other medical conditions, however, need to be taken into account.  Women who are breastfeeding also should steer clear of the combined pill because of the side effect it has of reducing milk production.

What about the other forms of contraception?  It’s still safe to immediately start using other birth control methods like progestin-only contraceptives (pills, injections, and implants), intrauterine devices (IUDs), and contraceptive methods other than combined hormonal contraceptives. It’s a good idea to plan ahead with your health care provider before you deliver so that you can start your preferred method of contraception at the best time for you once you deliver.

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