Postpartum Fertility Part 1: Options for Birth Control
Over the next few weeks, I will be writing about different aspects of Postpartum Fertility. I will cover options for birth control, natural family planning/fertility awareness, ecological breastfeeding, and sex in your marriage. I will also do a post that compiles all of the resources (books, websites, etc) so you can look further into each of the topics. As always, the wonderful midwives at Breath of Life are more than happy to answer questions you may have.
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I hope you were able to enjoy lots of wonderful sexual intercourse while you were pregnant. Isn’t it fun? I mean, you don’t have to worry about not getting pregnant. You don’t have to worry about trying to get pregnant. Completely stress-free sex! You probably had to invent some new positions. And you never had to deal with having your period. Yes, pregnancy is certainly a wonderful time…for a lot of reasons.
But now your sweet Little One has arrived. Your girly parts are just starting to finally feel like they are attaining normal proportions. And your dear husband has “the look” in his eye. Actually, he’s had that same pained, tortured expression for a few weeks now, but you didn’t really notice because you were propping your eyes open just long enough to latch Little One onto your breast 8 times a night. But now your Beloved can no longer be ignored.
Holey Moley, though, you do NOT want to get pregnant again anytime soon!
Contraception, child spacing, and sex itself can be a major issue for couples with a new baby.
The three main types of artificial birth control are hormonal and nonhormonal. The other option is what can be called a natural (non-artificial method of birth control, and this is natural family planning/fertility awareness. A subheading of NFP is ecological breastfeeding. If you practice ecological breastfeeding (there are 7 tenets, one of which is that you haven’t had your period yet) you have only a 2% chance of becoming pregnant during the first 6 months of your baby’s life. More on that in an upcoming blog post!
Hormonal birth control works by overriding the body’s normal hormone production. Essentially, the estrogen and Progestin released by The Pill, The Patch, hormonal IUDs, vaginal rings (like Nuvaring) and injections (like DepoProvera) fool a woman’s body into thinking that she is pregnant, thus preventing the release of an egg. Because they aren’t always successful in doing that, these hormonal methods of birth control also alter the lining of the uterus so that if an egg is released and fertilized, it cannot implant. This is why some people consider hormonal birth control to be an abortificient–which is why Breath of Life does not prescribe hormonal methods of birth control.
When you use The Pill and the vaginal ring, the “period” that you get is not really your period. It is withdrawal bleeding from the cessation of hormones during that week. Because of the continuous release of hormones in the Patch, hormonal IUDs, and injections, you never have your period or withdrawal bleeding, although you may have spotting and breakthrough bleeding.
Even ignoring all of the physical problems that hormonal birth control can cause you (such as an increased risk of breast cancer, intense moodiness, low libido, and vitamin deficiencies), hormonal birth control can be bad news for your freshly hatched Little One. Because hormonal birth control mimics a pregnancy, it causes your milk supply to decrease, just like a normal pregnancy would. Your body thinks that it needs to prepare for Little One Version 2.0, and that becomes its main priority. Because of this, it is highly recommended that you not use hormonal birth control until you are willing to experience an artificial, premature drop in your milk supply. Research shows that progestin-only hormonal methods, such as the Mini Pill, do not cause this drop in milk supply, but there is copious anecdotal evidence that even without the estrogen, you may produce less breastmilk for your Little One.
Nonhormonal methods of birth control include both barriers and chemicals. Barrier methods do just that: put a physical barrier between the egg and sperm, thus preventing conception. The most common options are condoms, diaphragms, and cervical caps. Although there are no hormones involved, most of these devices require the use of spermicide. Spermicide can also be used on its own but is less effective. Many people are leery of hormonal methods of birth control, especially while they are nursing, and become more interested in other methods.
Barrier methods have no physical side effects, although the spermicide used does irritate some people. Condoms can reduce sensation, especially for the man, and may require a “break in the action.” Diaphragms and cervical caps can be put in hours before sex, and left in for a while afterward. Some people think that this reduces the spontaneity of their sex lives, but I am here to assure you that with sweet Little One earthside, your sex life isn’t going to be all that spontaneous anyway. You do need to be fitted for these, and they do take some practice to put in. Some women aren’t comfortable doing that, or just can’t seem to get the hang of them.
Natural family planning, also called the fertility awareness method, is a highly scientific method that teaches a woman how to observe her signs of fertility so that she and her husband can dialogue together about their desire for children. This is not the old “rhythm” method and your cycles do not have to be remotely “regular” in order to use it. Although it does require learning, the couples who teach NFP are loving, helpful, and use NFP themselves so they are more than able to help newbies learn the method. And trust me, it isn’t too complicated to learn…illiterate women in impoverished areas of Africa use NFP, too! I will devote an entire blog post to NFP, so I won’t get into it too much now, but this is what it basically boils down to:
Throughout the course of her menstrual cycle, a woman produces different types of fluid (mucus) from her cervix. True fact. When you are nearing ovulation, the fluid becomes stretchy, clear, and lubricative–it kind of looks like egg white, actually! Sperm can live in that type of cervical fluid for up to 5 days. The egg itself is only available for fertilization for about 24 hours out of one month. Because of how long sperm can live in fertile cervical fluid, a woman is only truly fertile for about 1 week per month. If you wish to avoid pregnancy, you abstain from sexual intercourse during this time. If you want to get pregnant, make sure you have sex a few time during this fertile phase. Couples choose to use a barrier method when the woman is fertile. Like I said, more to come!
A method of birth control that seems defy the three major categories is the copper IUD. The copper IUD is different from the hormonal IUD in that, obviously, it does not release artificial hormones into the body. It can last for up to 10 years in the body, and has fewer side effects than the hormonal IUDs. Because it is nonhormonal, a woman still has her normal menstrual cycles–meaning that she is still ovulating. Thus, the copper IUD does not affect milk production in women who are breastfeeding. Yay for Little One getting lots of wonderful milk!
Interestingly, your body treats copper like a poison. The copper IUD, then, causes such irritation in the woman’s uterus that it becomes inflamed to the point that sperm essentially is halted on its path to the egg. If the sperm does make it through the irritated uterus and fertilizes an egg, the inflammation in the uterus prevents implantation. This is why some people consider the copper IUD to also be an abortificient. Both the hormonal and nonhormonal IUDs carry an increased risk of a woman developing pelvic inflammatory disease (PID), ectopic pregnancy if fertilization does occur, and uterine perforation.
Sources:
http://www.kellymom.com/health/meds/birthcontrol.html
http://naturalfamilyplanningandmore.org/
http://ccli.org/breastfeeding/
http://ccli.org/nfp/
http://onemoresoul.com/category/contraception/risks-consequences
http://www.paragard.com/what-is-paragard/Default.aspx
http://onemoresoul.com/contraception/risks-consequences/what-a-woman-should-know-about-birth-control.html
http://tcoyf.com/
http://www.womentowomen.com/sexualityandfertility/birthcontrolmethods.aspx
Husband…mortgage partner?
I once attended a talk in which the presenter had us think of all the reasons we had married our spouse. So we listed things like sense of humor, good looks, same hobbies, shared religion, in love, etc. The presenter concurred that these were all wonderful reasons to get married. She then said that when couples come into her office seeking marriage counseling, and she asks they why they are still married, the most common reason they give is “well, we own the house together.”
The point is that you didn’t marry your spouse so that you could someday have a mortgage together. You married your spouse because you wanted to have a life together. Sometimes, we need to remember why we got married in the first place, and rework our lives so that it again becomes the reason we are still married.
The first year after a baby is born is really tough on marriages. Sure, it is wonderful to see this little being that your Love has created. It is endearing to watch your husband cuddle your baby close and coo back to her. It may fill a husband with awe to watch his wife breastfeed their son. But as amazing and incredible and GOOD as it may be to bring a new life into your lives, it is still tough.
My husband and I felt that we would be fine having a baby; that it wouldn’t upset our lives too much because we had a very kid-friendly life before we had kids. We weren’t into partying, or drinking, or expensive vacations or lavish meals out or going to professional sports games. We liked being at home, watching movies, going camping a few weekends a month, and visiting our families. So while we might have had a smaller adjustment than a couple whose social life is built around clubbing, it felt like a major adjustment for us.
While we still have gone out to eat once a week, we have to select the restaurant based on how ok they are with Rachel tossing food on the ground. And just recently we decided to forgo going out, and will start ordering dinner in once a week. I am so exhausted that I can only make it through about half a movie before I fall asleep, and we really enjoy watching movies together. Sex is no longer something we can spontaneously do when the mood strikes us. First off, it has taken a year for my “mood” to return, and now we have to plan our intimate time around Rachel’s sleep schedule. No more sleep Saturday mornings together in bed…we trade off who sleeps in on the weekend and who gets up to be with Rachel.
But regardless of what you enjoy doing with your spouse and how that will change once babies arrive, the real struggle is that priorities change. While I firmly believe that marriage needs to come first, since you will be married long after the kids are out of the house for good, the fact is that to have a joyful family, the needs of the baby do come first during that first year. And that can be a really hard adjustment for a husband and wife who are used to putting themselves and each other first.
I have had to learn to give up sleep so that I can be with my husband. When I nurse Rachel to sleep at night, there is nothing more that my body longs for than to crawl into bed along with her. But there is someone else who needs me now. So I go join Steve for an hour or so before we both go to bed–and wow, is it nice to not worry about a little one need a diaper change or spilling the flour all over the floor! I do treasure these times “alone” with my husband, even if they do mean that I get a bit less sleep. It is worth it. Likewise, my husband has had to learn patience, since we have been interrupted during our intimate times by screaming baby in the other room more times than I can count!
So as hard as it is, and as tired as you are, remember the reasons you got married to your spouse. Remember why you chose each other. And find ways to live that out, despite the needs of your family and your household. God wants more for your marriage than a mere mortgage!















