Pregnant women have an increased risk of developing blood clots because of hormonal changes. This is commonly referred to as a hypercoagulable state. Birth control pills that contain both estrogen and progestin (aka combination pills) are not recommended for the first 42 days after the delivery because they increase the risk of blood clots in the legs (Deep Venous Thrombosis, aka DVT) and also decrease breast milk production. The vaginal ring and patch are also not recommended. However, birth control pills that only contain progestin are safe to take immediately after delivery because they don’t increase the risk of developing blood clots nor do they reduce the amount of breast milk production. The Depo- Provera injection may also be given as well because it is a progestin-only product. What women are at increased risk for developing a DVT? Women who are
- Over 35
- Had previous DVTs
- Had a history of postpartum hemorrhage
According to the Center for Disease Control (CDC), a woman may use combination birth control pills 21 days after having a baby if she is not breastfeeding.
Can a woman have an intrauterine device (aka IUD) inserted after she delivers a baby? Only if it can be inserted during the first 10 minutes after the placenta has been delivered. According to a recent article in OBGManagement, the FDA has approved immediate placement of the copper IUD (aka Paragard) after a delivery. Why can’t the IUD be placed after the first 10 minutes? Because the chances that it will be expelled or fall out of the cervix are increased by at least 12 to 24 percent if it is inserted between 10 and 48 hours after delivery.
So, is it safe to use a birth control method immediately after having a baby? Yes, provided those methods are
- Progestin-only products which include pills, the Depo-Provera shot and progestin implants
- Tubal ligation which is a permanent method of sterilization
- The IUD if it is inserted within the first 10 minutes after the placenta is delivered
There are approximately 4 million babies born each year in the U.S. According to CDC, half of them are unintended. A pregnancy that occurs less than six months from the last increases the risk of complications to the mother. Therefore, choose wisely and choose safely. A discussion with your healthcare provider before your baby is born is probably not a bad idea.
*This blog post was originally published at Dr. Linda Burke-Galloway*