6 Myths About Birth Control After Having a Baby

Your doctor can help give you the facts on the right options for you. But know that there can be some misconceptions around birth control after pregnancy.

Here’s the truth behind some common myths about postpartum birth control to help you understand why it can be important.

Myth 1: You Can’t Get Pregnant Right After Childbirth

Fact: It is possible to get pregnant as soon as three weeks after having a baby, before your period resumes—even if you’re breastfeeding.

“The other thing that can be confusing is that you might not be expecting to have your period, which can delay realizing that you’re pregnant again,” says Hoosna Haque, M.D., a board-certified ob-gyn and assistant professor at Columbia University Vagelos College of Physicians and Surgeons, in New York City.

Myth 2: Period Tracking Can Help Prevent an Unplanned Pregnancy

Fact: Fertility awareness methods like period tracking are only around 76% to 88% effective—and they only work if you have a regular cycle.

“In the time immediately after birth, people often have bleeding for up to six weeks, and then it can take a while for your periods to become regular,” says Jonas Swartz, M.D., M.P.H., a board-certified ob-gyn at Duke Health in North Carolina. So, tracking might not allow you to pinpoint exactly when you’re ovulating, which dictates the window of time each month when you can become pregnant.

“I would advise that they not use period tracking as the form of birth control until a person is having regular menses at a predictable interval for the same number of days,” Swartz says.

Myth 3: Breastfeeding Prevents Conception

Fact: Sometimes it can, but not always.

Breastfeeding or chestfeeding can impact fertility, but in order for it to qualify as an effective form of contraception, you must:

• Breastfeed exclusively (no supplementing or pumping)
• Feed your baby at least every four hours (during the day) to six hours (at night)
• Not yet have a return of your period
• Be within the first six months postpartum

This is known as “lactational amenorrhea,” which is thought to be about 98% effective in preventing pregnancy when all these criteria are met.

But even if you do experience this, know that it’s temporary. “Your body will likely release an egg before your first menstrual period returns—in other words, your fertility can return without advance notice,” says Amy E. Paris, M.D., board-certified ob-gyn and director of family planning at Dartmouth Health in New Hampshire. “For this reason, I recommend using caution or another concurrent method.”

Myth 4: You Can’t Take Birth Control If You’re Breastfeeding

Fact: Many birth control options are safe for use while chest/breastfeeding.

In the first six weeks postpartum, many providers recommend nonhormonal or progestin-only options, available in IUD, implant, injectable, and pill forms.

Postpartum birth control without estrogen may be recommended for two reasons: First, you’re at an increased risk of a type of blood clot in your legs known as a deep vein thrombosis, or DVT, in the first few weeks postpartum, and estrogen-containing options could elevate that risk even more. Second, there is some evidence that estrogen-containing contraceptives may decrease milk supply.

Barrier methods can also be useful for preventing pregnancy during this time frame. These include condoms, which can also help prevent the spread of sexually transmitted diseases (STDs).

Diaphragms are another barrier method, but you may want to hold off on using one for now. “Wait until your body has fully healed for the diaphragm to fit properly,” says Haque, noting that it typically takes six to eight weeks for the uterus to shrink back down to its normal size.

After six weeks postpartum, you may be a candidate for both estrogen- and non-estrogen-containing birth control methods if your milk supply is established, Swartz says.

Myth 5: You Have to Wait for Your 6-Week Postpartum Checkup

Fact: You can gain access to birth control at any time postpartum.

You can get contraception before you even head home with your new baby, according to the American College of Obstetricians and Gynecologists (ACOG). That means you can have your doctor place a nonhormonal IUD immediately after delivery, or start on a new form of nonhormonal contraception before you’re discharged.

If you think this might be a good option for you, talk to your doctor. But also remember that it’s recommended to avoid sex for at least the first six weeks postpartum.

Myth 6: Everyone Has Equal Access to Birth Control

Fact: There are a number of factors that can get in the way of one’s access to birth control.

All FDA-approved contraceptives should be covered by health insurance under the Affordable Care Act. Still, people who want birth control may not be getting it.

According to ACOG, up to 40% of birthing parents don’t attend their postpartum visit. That can be for many reasons, whether due to issues with transportation or not getting time off of work, says Swartz. “When people don't come back for that postpartum visit, we don't have the opportunity to get them plugged into contraception.”

That’s why some doctors are prescribing contraceptives right away in the delivery room or operating room after childbirth, Haque says.

Meanwhile, there’s a lot that’s unknown about whether the recent overturning of Roe v. Wade may have an impact on access to birth control in certain states down the line. “Under current laws, there should be no question of the fact that contraception should be available throughout the country,” Swartz says. Nevertheless, things may change as certain states move to pass bills that ban certain forms of birth control, he adds.

Regardless, abortion bans may already unintentionally limit access to contraception for some. “Whenever there are barriers to abortion access, those same barriers create difficulty for people trying to start contraception immediately after their abortion,” Paris says. “They might have had to travel a great distance and pay out of pocket and not be able to afford to also initiate an IUD at the same time, even if they want to.” This has the potential to affect some people who’ve experienced a miscarriage and want contraception as well.

Planning Your Next Pregnancy

ACOG recommends waiting a minimum of six months—and ideally 18 months or more—after having a baby before becoming pregnant again. This can reduce the risk of poor outcomes, such as low birth weight and preterm birth.

If you’re interested in family planning, Haque says that waiting can be good for you, your baby, and a future child, too. “Consider optimum birth planning and spacing out pregnancies for what's healthy for the current baby, and then also for your body to recover, as well as for the new baby,” Haque says.

Talking to your doctor about family planning goals and coming up with a strategy for postpartum birth control even before you bring your new baby home can help you plan for the future.

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