Is it possible to get pregnant during lactation? How to protect yourself while breastfeeding. Review of effective contraceptive methods for breastfeeding

Medical term“lactation amenorrhea” refers to the natural delay of the menstrual cycle during lactation; this process is popularly called “replacement”.

What is lactational amenorrhea

When a woman breastfeeds, the body intensively produces the hormone prolactin, which interferes with the production of follicle-stimulating hormones. Consequently, the follicles do not mature and ovulation does not occur.

It is important to know! If for some reason the baby is fed exclusively with formula, the first menstruation should come no later than after 8 weeks. A delay longer than three months is a reason to contact an antenatal clinic.

When wondering whether it is possible to get pregnant during lactation, women are often faced with a variety of assumptions from friends and relatives. The period of lactational amenorrhea can vary: from 2 to 14 months.

Changes in the body can be caused by the influence of various factors; following the rules for the effectiveness of lactational amenorrhea will help to avoid a sudden restoration of the menstrual cycle.

Rules of effectiveness for lactational amenorrhea

There are a number of rules for increasing the effectiveness of lactational amenorrhea. A clear understanding of the biological processes in the body will allow a woman to better control them.

Extend replacement during lactation and minimize the chance of getting pregnant possible subject to simple rules, but each mother decides for herself whether to comply with them:

• feeding a newborn baby according to his every requirement, and not according to a standard hourly schedule;
• shorten intervals between feedings to a minimum, the night break should not exceed 5 - 6 hours;
• refuse from introducing any complementary foods into the child’s diet, it is also advisable to abandon pacifiers. They even exclude the baby from drinking.

Is it possible to get pregnant during lactation?

Is it possible to become pregnant unplanned during lactation, or is this exceptional and rare cases, specialists at the antenatal clinic know firsthand. This issue is shrouded in a lot of myths; for a complete understanding it is necessary to turn to scientific and medical data.

Is it possible to get pregnant during lactation? Young mothers are often interested in this question.

During lactational amenorrhea, fertilization of an egg is impossible, so there is a misconception that you cannot get pregnant while breastfeeding a newborn. This fact cannot be denied, but there is still no absolute guarantee.

The essence of the phenomenon is quite simple: when a woman begins to introduce complementary foods or does not follow other rules of effectiveness for lactational amenorrhea, the production of prolactin decreases.

The menstrual cycle begins to recover and ovulation occurs. These changes are almost impossible to feel physically, but the body is already completely ready for the next conception.

As you know, ovulation precedes the first menstruation for a short period of time. It is quite difficult to determine whether replacement has stopped during lactation or not, and it is quite possible to become pregnant during this period.

After this, other processes begin to occur in the body, menstrual cycle is again suspended for the duration of gestation, which is mistakenly perceived as a continuation of lactational amenorrhea.

Is lactation compatible with menstruation?

The arrival of menstruation during lactation is a common and natural phenomenon. As already mentioned, increasing the intervals between feeding the child or introducing complementary foods leads to the production of ovarian hormones, which ends with ovulation and the arrival of the first menstruation.

The restoration of the cycle, as a rule, occurs in the 6th – 7th month of lactation. Usually by this time various dry mixtures are introduced into the baby’s diet. But these are conditional dates; each woman’s process occurs individually, which is largely influenced by the level of effectiveness of lactational amenorrhea.

It is important to know! Contrary to conflicting opinions, the arrival of menstruation does not in any way affect the taste and nutritional properties milk. According to scientists and doctors, menstruation is not a reason to stop breastfeeding.

The first menstruation is often confused with postpartum discharge.. There is nothing wrong with this; the uterus is cleansed and restored within two months after birth. Common occurrence, When bloody issues stop by the 7th week, but resume at the end of the 8th - this is how the uterus completes cleansing.

It is these processes that women often confuse with menstruation, expecting them reappearance a month later. Not understanding the nature of discharge can lead to confusion or fear about your health.

Symptoms of pregnancy during lactation

Taking into account that the first ovulation after childbirth comes almost unnoticed, it is useful to know the first signs of pregnancy during lactation. It happens that many women find out about the child already in the middle of the term, when the baby begins to move.

It’s normal to get pregnant during lactation, can you find out about this by certain symptoms, answer medical practice. Experts have identified a number of common symptoms.	The usual pregnancy symptoms that women experience may also be present.
Changes in the consistency and taste of milk if the child begins to refuse feeding for no apparent reason	Nausea or morning vomiting
A decrease in milk production also indicates that the body is conserving its resources due to pregnancy.	Frequent urge to go to the toilet
If uterine contractions become more intense and frequent	Loss of appetite, change in taste needs
Swelling on the chest painful sensations(if there are no injuries).	Lower back pain
—	Delayed menstruation

If a woman decides to have an early pregnancy, breastfeeding the first child should be stopped 1.5 - 2 months before the next birth.

Pregnancy immediately after childbirth - for or against?

Is it possible to get pregnant during lactation, how safe is it for the expectant mother - these are the key questions that a woman should ask after giving birth. If few people thought about this before, now everything has changed, and young parents have begun to take the birth of children more seriously.

Pregnancy after childbirth, or more precisely, after normalization of the menstrual cycle, is a complex issue that requires analysis. On the one side Experts recommend taking a break and allowing the body to fully restore its strength.. In addition, during the first months a newborn baby needs care, attention and timely care.

On the other hand, parents can take such a step quite consciously, due to age or other factors. Nature in this regard also does not set certain restrictions: it is enough to introduce complementary foods to the baby and hormonal background women will begin to change, and the menstrual cycle will begin to recover.

In addition to the colossal load on all body systems, pregnancy after childbirth often becomes a serious stress for the mother - this must be taken into account.

In that complex issue There are more “against” than “for”, but the final word should be with the doctors of the antenatal clinic. If it is still possible to fight and overcome nervous stress, then the disadvantage physical health can lead to adverse consequences.

There is another myth that often scares women: lactation provokes premature birth. This opinion has quite strong confirmation - at this time the body produces the hormone oxytocin, which affects milk production. But according to the data medical practice,Not a single case of miscarriage due to lactation was recorded.

Safe methods of contraception during lactation

If imminent pregnancy is not included in the parents’ plans, you need to turn to approved contraceptives. The lactation period, although safe in this regard, does not provide a complete guarantee; therefore, lactational amenorrhea cannot be used as a reliable method of contraception.

There are many safe contraceptive options available to breastfeeding women:

• lane oral contraceptives , which do not contain the hormone estrogen, for example, Charozetta;
• condoms – the standard and simplest method of preventing unwanted pregnancy;
• intrauterine device;
• various spermicides: creams, suppositories or tablets.

Usually, before starting sexual activity after childbirth, a young mother should visit an antenatal clinic and consult your doctor. He conducts an examination, determines whether the genitals have been restored and will definitely recommend suitable precautions. If a specialist does not give specific advice, you should clarify it on your own initiative, because this point is very serious.

We can summarize briefly: pregnancy during lactation is normal, this has been proven since scientific point vision. A young mother can partially control this process, but she must not lose her vigilance if another child is not included in the plans of the young parents. It is worth noting that early pregnancy after childbirth does not always lead to serious health problems.

Video about the likelihood of pregnancy during lactation

Pregnancy during lactation - features in this video:

To find out whether it is possible to get pregnant during lactation, watch this video:

Is it possible to get pregnant while breastfeeding, see the answer from a professional here:

It’s wonderful and touching to watch children of the same age play, but if the birth of a second one is not included in your immediate plans, special attention should be paid to protection after childbirth.

Why special? Because many traditional methods can no longer be used. For example, classic birth control pills reduce the amount of milk and impair the development of the child. The method of contraception after childbirth must be both effective and safe for both - mother and baby.

When is fertility restored?

In order for conception to occur, it is necessary for the menstrual cycle to be restored, ovulation to occur and menstruation to begin. The time it takes a young mother’s body to do this is very individual and depends on many factors, such as complications of childbirth, breastfeeding, activity hormonal system. According to latest research WHO, for those mothers who do not breastfeed after childbirth, the first ovulation most often occurs between 45 and 94 days. However, there are also shorter exceptions, up to 25 days.

In most cases, women do not become pregnant after the first ovulation, but there are exceptions to this rule. Postpartum measurement basal temperature is ineffective, and therefore you can find out that ovulation has occurred only after the appearance of menstruation. But by that time, fertilization could potentially have occurred. This is where unexpected repeat pregnancies come from after childbirth, even before the start of menstruation.

Breastfeeding delays ovulation and menstruation, thus protecting against pregnancy. However, to use this tool effectively, you must follow several important rules, which we will talk about below.

Bloody discharge after childbirth is normal. But how to distinguish them from menstruation? There is a rule that any discharge before 8 weeks is considered postpartum and does not apply to menstruation. If they appear after this period, most likely we have to talk about menstruation. If the mother does not breastfeed, the cycle may resume before 8 weeks. Your periods may be irregular for some time after giving birth, so if you have any doubts or questions, you should contact your gynecologist.

When to start using contraception after childbirth

WHO experts recommend starting contraception 3 weeks after birth. Of course, such an early pregnancy is unlikely, but minimal risk still there is. Most women who are not breastfeeding experience their first ovulation within 6 weeks of giving birth, and contraception after this period is mandatory.

Does breastfeeding protect against pregnancy?

Breastfeeding can be used as a method of contraception (the so-called “lactation amenorrhea method”), but for its effectiveness several important conditions must be met:

You need to start breastfeeding immediately after birth. If for some reason the young mother was separated from the child in the first days or weeks of his life and could not feed, then contraception additional funds you need to start on a general basis, from three weeks.
Feeding should be completely breastfeeding, without complementary feeding or supplementary feeding. The introduction of formula or puree sharply reduces the effectiveness of breastfeeding as a means of contraception.
Feeding should be frequent, breaks between feedings should not exceed 4 hours, be sure to feed at least once, or preferably twice, at night.
Lack of menstruation. If they start, it means there is ovulation and the possibility of getting pregnant. It is necessary to protect yourself!
Child's age is up to 6 months. The protective effect of GW lasts only until this period. Afterwards, there is a high probability of ovulation, and the contraceptive effect of breastfeeding is sharply reduced.

If at least one of these conditions is violated, the likelihood of pregnancy increases sharply, and you need to use additional methods contraception. If a new mother is not breastfeeding, in most cases she can return to her usual and tried-and-true method, such as combined pills (COCs), but breastfeeding brings its own adjustments to this.

What methods of contraception are suitable for breastfeeding?

Condoms
The most universal method when correct use its efficiency is quite high. It has no effect on mother and child, does not reduce the amount of milk and does not change its composition.
Flaws: subjective decrease in sensitivity, discomfort or allergy to latex.

Candles
Suitable for both occasional and permanent use. Contains a substance (nonoxynol or benzalkonium chloride) that destroys sperm. Active substance is not absorbed into the blood and does not enter breast milk, which means it has no effect on the baby. Suppositories are also effective against some sexually transmitted infections, pathogenic bacteria and viruses, without disturbing the natural microflora.
Flaws:: possible burning sensation, allergies, destroyed by soap.

Intrauterine device
In some cases (discussed in advance with the doctor), it can be installed immediately after birth or caesarean section, but it is best to do this after 6 weeks. It has high contraceptive activity, although pregnancy with the IUD is not excluded. Installed only an experienced doctor gynecologist after examination.
Flaws: can severely irritate the uterus, cause discomfort and prolong bleeding time during menstruation.

Oral contraceptives(pills)
At breastfeeding Only monohormonal progestin preparations (mini-pills) can be used. They contain one hormone - an analogue of progesterone in minimal required dosage, therefore it does not pass into breast milk and does not have harmful action per child. The effectiveness of the mini-pill is lower than that of classic estrogen tablets, so it is better to combine them with barrier methods. You can start taking the mini-pill from the 4th week if you are not breastfeeding, and from the 6th week if you are.
Flaws: do not provide complete protection, must be taken on a schedule, do not miss a dose, may cause nausea and vomiting, and alter the cycle.

Hormonal injections and progestin implants
They are sewn or injected under the skin of the shoulder. Contains one progestin hormone, which can usually be used during feeding. They last for several years and are highly effective.
Flaws: change the cycle, may cause prolonged bleeding, as well as inflammation at the injection site.

Sterilization(tubal ligation)
Suitable only for women who no longer plan to have children. After a difficult birth, you may think that you will never want it again, but after sterilization, after a while you will begin to regret it. That is why it is performed on women only after 35 years of age or if they have at least two children. Sterilization can be combined with a caesarean section, but you should not make a decision about this hastily, and especially under pressure from others.

Which contraceptive methods are not suitable for breastfeeding?

Combined oral contraceptives
These are tablets containing two hormones - one from the estrogen group, the other from progesterone, in large doses. They have a high effect, but during breastfeeding they impair milk production, and, in addition, have a harmful effect on the child, causing mental and mental retardation. physical development. Suitable only if the child is completely on artificial feeding. In this case, they can be used no earlier than 3-4 weeks after birth (since they can cause thrombosis) and must be prescribed by a gynecologist.

Calendar method
Not suitable after childbirth, since at this time there is no clearly established cycle. Ovulation can occur at any time, especially after a break in breastfeeding. Measuring basal temperature at this time does not give anything, because frequent awakenings At night they change it for feeding. As a result, it is impossible to predict “safe days.”

Coitus interruptus
The “method of contraception” is as harmful as it is common. Firstly, it is not at all effective in preventing pregnancy, since the most active sperm can penetrate even before ejaculation. Secondly, the interrupt method has negative impact on the psyche of both – husband and wife, preventing the normal course of sexual intercourse. The result is dissatisfaction, irritability, nervous breakdowns, and all this, coupled with lack of sleep and stress from caring for a small child, contributes to discord in the family.

There is a fairly widespread belief that a woman cannot become pregnant while breastfeeding. In fact, this does not always happen. In this article we will talk about those cases when breastfeeding can really serve as a method contraception.

A little physiology

The postpartum period is one of the important stages in a woman’s life. At this time, all changes caused by pregnancy in the genitals, endocrine, nervous, cardiovascular and other systems are restored in her body. The risk of pregnancy increases by 6 months after birth, regardless of whether a woman is breastfeeding or not. At 7-8 weeks, the restoration of the uterine mucosa ends. Already 6 weeks after birth, 15% of non-breastfeeding and 5% of breastfeeding women experience ovulation - the release of an egg from the ovary. Outside of pregnancy, ovulation occurs in the middle of each menstrual cycle.

An egg that matures in the ovary is released into abdominal cavity, after which it falls into fallopian tube. There she can meet a sperm - in this case, fertilization will occur. That is, ovulation is one of the main points that determines the possibility of conception in a given menstrual cycle.

During pregnancy and several months after childbirth, ovulation does not occur. The most early ovulation registered at 4 weeks postpartum. Thus, by the 3rd month after giving birth, a woman is potentially able to become pregnant. By this time, the production of hormones is restored, ensuring cyclical changes in a woman’s body during the menstrual cycle.

During pregnancy, the production of prolactin increases (it is produced by a gland located in the brain), one of the hormones involved in blocking the maturation of the egg in the ovaries. Prolactin ensures the preparation of the mammary glands for lactation. Towards the end of pregnancy, with the onset of labor, the level of the hormone oxytocin increases. Both of these hormones - prolactin and oxytocin - ensure lactation (from the Latin lacto "I feed with milk") - the formation of milk in the mammary glands and its periodic excretion. The direct mechanism is activated and feedback between the intensity and duration of breastfeeding and the production of prolactin and oxytocin. On the one side, a large number of prolactin ensures the formation of lactation, and on the other hand, maintaining lactation contributes to the preservation high level prolactin. As a result of this, conditions are created for women who breastfeed on demand to suppress ovulation and prolong the period of menstruation restoration. The period of breastfeeding and absence of menstruation is called lactational amenorrhea.

How does MLA “work”?

The lactational amenorrhea method (LAM) is a natural method of preventing pregnancy because... Breastfeeding is used to prevent pregnancy.

Breastfeeding is ensured by lactation reflexes, which are regulated higher departments central nervous system. The nipple-areola complex (nipple circle) is equipped big amount nerve receptors, the sensitivity of which increases as the duration of pregnancy increases and reaches a maximum in the first days after birth. Irritation of these receptors during sucking triggers reflex mechanisms leading to the production of oxytocin and prolactin, hormones that regulate lactation.

The milk production reflex (prolactin reflex) is associated with the production of the hormone prolactin during breastfeeding, and prolactin, in turn, stimulates milk production in the mammary gland. How longer baby suckles at the breast, the more milk is produced. The production of prolactin has a certain daily rhythm. Its highest level is recorded at night, 2-3 hours after falling asleep, the lowest - from 10 to 14 hours of the day. Therefore, breastfeeding should occur at least every 4 hours during the day and every 6 hours at night. Prolactin suppresses ovarian activity, inhibiting ovulation, so breastfeeding at night and during the day protects against new pregnancy in 98% of cases. Thanks to the prolactin reflex, the mammary gland produces enough milk for successful breastfeeding.

No less necessary for the baby's satisfaction is the oxytocin reflex, or the milk ejection reflex. During the sucking process, in response to irritation of the nipple, the hormone oxytocin is produced in the posterior lobe of the pituitary gland, causing milk to be released. Oxytocin is called the “love hormone”: a mother is happy when milk flows well and her baby is satisfied. Thoughts full of love about the child, the sight of the child strengthen the reflex, and stress, pain, and excitement suppress the oxytocin reflex. Breast milk contains substances (inhibitors) that reduce its production. If breast milk is removed from the mammary glands during sucking or expressing, these substances are also removed, and then the mammary gland produces more milk. Therefore, if the baby temporarily does not breastfeed, milk must be expressed so that its production does not stop. Emptying the mammary gland is the strongest stimulator of its work.

In the early postpartum period, it is the lactation reflexes that ensure the establishment of normal lactation, therefore, for subsequent successful breastfeeding, it is advisable to carry out the first latch in the first hour after birth, when the baby’s reflexes and the sensitivity of the nipple-areola complex are the highest.

Only complete exclusive breastfeeding reduces the likelihood of pregnancy in the first 6 months after birth.

The more intense the breastfeeding (frequent, at the request of the child, latching to the breast up to 10 times, feeding both during the day and at night with night breaks of no more than 6 hours, feeding from both mammary glands), the longer the period of inability to fertilize and the less often pregnancy occurs before the onset of menstruation.

When does MLA stop working?

Although with a high frequency of exclusive breastfeeding, the ability to fertilize after menstrual bleeding is still significantly suppressed, the appearance of menstruation remains the most reliable sign restoration of the ability to fertilize.

As the number of months passes after childbirth increases, the risk of ovulation before menstruation returns gradually increases. After six months, using only the lactational amenorrhea method as contraception is unacceptable. The six-month mark was also chosen because by this time mothers are recommended to feed their baby. They begin to wean him off the breast, which leads to an increase in the intervals between feedings, which means an increase in the risk of a new pregnancy.

MLA as a method of contraception is distinguished by the fact that its reliability can only be said if a number of conditions are met: absence of menstruation, exclusive breastfeeding, and the child is less than 6 months old. Pearl index (number of unplanned pregnancies occurring in 100 women using this method during the year) in this case is equal to 2. For comparison: when using condoms it is equal to 14. Even when using a hormonal drug, a purely progestin “mini-pill” recommended in the postpartum period, the Pearl index is equal to 5. If after using MLA for 6 months after childbirth, the woman remains amenorrheic and continues to breastfeed before each complementary feeding, then it becomes possible to extend the MLA to 9-12 months. The Pearl index in these cases is 3-6.

Disadvantages of the method

1. In the event that any of the three necessary conditions the use of MLA is not carried out (menstruation resumes, breastfeeding is irregular or the child is older than 6 months), it is necessary to promptly switch to other methods of contraception that do not affect lactation and the development of the child.
2. The duration of protection is limited to 6 months.
3. There is no protection against sexually transmitted infections.
4. The reliability of the method depends on compliance with the rules of breastfeeding. Today, the socio-biological status of a woman has changed, her role in society, politics, and business has increased. The principles of exclusive breastfeeding are not always suitable if the mother is working or studying.

When can I resume sex life?

During the first 6-8 weeks after childbirth, sexual activity should be limited, as during this time the woman’s body is recovering after childbirth. In the uterus - in the area of ​​​​the site to which the placenta was attached, there is an extensive wound surface; the so-called ones stand out from the genital tract. The cervix and the body of the uterus contract gradually and do not immediately acquire prenatal sizes. Immediately after birth, the cervix remains quite short, the cervical canal leading into the uterine cavity is open. All these conditions are a predisposing factor for infection of the uterus in the postpartum period. Therefore, after they stop postpartum discharge(this happens just after 6-8 weeks), you need to consult a doctor. Only after an examination can you obtain permission to resume sexual activity.

Advantages of the method

1. The use of MLA is controlled by a woman; this method cannot be considered typical medical procedure, it does not require medical supervision.
2. MLA is an effective method of contraception used after childbirth, which not only improves breastfeeding, but also ensures a timely transition to the use of other contraceptives during lactation.
3. The method has a beneficial effect on the health of mother and child. Children who receive exclusive breast milk are less likely to get sick in childhood and are less susceptible to illness as adults. chronic diseases, cancer, blood diseases.
4. The mother has a reduced risk of postpartum inflammatory diseases uterus, lactation is a means of preventing breast cancer.

So, as we see, the lactational amenorrhea method can be used as a means of contraception only from the 1st to the 6th month postpartum period, with careful adherence to the rules of breastfeeding “on demand”. In other cases, it is necessary to use other methods of contraception.

Lyudmila Petrova
Obstetrician-gynecologist of the highest category,
Head of the maternity department of maternity hospital No. 16,
Saint Petersburg
Article from the magazine "9 months" No. 7 2006

Many nursing mothers think that during breastfeeding the likelihood of getting pregnant is reduced to zero. This , Maybe, it will be so, but only if certain rules are strictly observed. Below we will talk about them, as well as about other methods of contraception during breastfeeding.

Do I need to use protection during breastfeeding?

It is important to think about your health and not plan for the birth of your next child too early. It is not always possible to rely solely on the production of hormones during breastfeeding.

To lactational amenoria method worked, you need to follow four rules:

1. Breastfeed only. Feeding should be done with breast milk, from the breast, and not from a bottle.
2. Feed every 4 hours.
3. The child is already 1.5 months old, menstruation has not yet arrived, but the child is not yet 6 months old. At this time, lactation hormones are highest.
4. Complementary foods have just begun to be introduced; there is no additional formula feeding.

Those. if the baby sleeps at night, or the mother leaves for a long time (expressing milk into a bottle), then the lactational amenoria method will not work and you need to look for other methods of contraception during breastfeeding.

Contraceptives during breastfeeding

Unfortunately, not all contraceptives are acceptable during breastfeeding.

COCs (combined oral contraceptives) containing both estrogens and progesterone are contraindicated for nursing mothers. They affect the quantity of milk, its quality, and the hormonal state of the child.

However oral hormonal contraception (mini-drink) in the form of pure progesterone, it is completely safe during breastfeeding. When choosing this method, the main thing is to strictly observe the intake time. Omission may result in the protection being unreliable.

Hormonal injections progesterone tests are done every three months.

Hormonal implants(also with progesterone) are injected under the skin for a period of three or five years.

From natural methods protection The best way is to track the onset of ovulation using a mini microscope. It helps track whether ovulation has occurred by monitoring how saliva solidifies. In the morning (before eating, drinking water and before brushing your teeth), a small amount of saliva is placed on a glass slide. Based on how the saliva dries, we can conclude whether the day is dangerous (when conception is possible) or not. This method is much more effective than the same method, which simply does not work after childbirth.

Barrier methods of contraception:(male, ), vaginal diaphragm, caps.

Intrauterine devices (IUD)

Chemical spermicides. When using them, you need to take into account that after the birth of a child, it does not recover immediately, so spermicidal tablets are not suitable. But candles, gels, sprays can be used.

Emergency contraception- this is not a method of protection, but last resort really Emergency. EC, almost on a par with abortion, harms a woman’s health and reduces the chances of another pregnancy.

Consequences of pregnancy during breastfeeding

Why is it so important to take a break between carrying a child?

1. During menstruation, a layer inside the uterus peels off in a woman's body. But first it must grow. During pregnancy, the uterus rests from the growth of the endometrial layer. Therefore, after the birth of a child, it does not recover immediately. And if he has not yet recovered by the time of the onset next pregnancy, then the egg, once in the uterine cavity, can slide lower and grow (implant) too close to the exit of the uterus (complete placenta adherence). And then the placenta, when formed, will simply block the part that will allow the child to come out during the next birth. And then the birth of a child will be possible only through a caesarean section. Not to mention, complications are possible during a pregnancy with a fully adherent placenta.
2. It is very important to breastfeed your baby for at least a year in order to develop his health. It is unlikely that the body will have enough strength for both breastfeeding and pregnancy. In this regard, it turns out that when breastfeeding and pregnancy occur at the same time, the hormones produced by the placenta conflict with lactation hormones. This leads either to a decrease in milk supply or to the threat of miscarriage. That’s why it’s so important for a woman to recover herself. And it is also important that the child receives a sufficient amount breast milk.
3. The first child must be ready for the arrival of a second baby in the family. The most difficult time to perceive such news is 3 years, 7 and 11 years. At these ages, the child experiences peculiar crises of growing up; he can distance himself from his parents. Therefore, it is so important to devote more of your time to him, helping him cope with his problems.

When a woman becomes a mother, she does not cease to be a wife. And for some time after giving birth, she begins to be interested in issues related to contraception. Is it possible to take birth control pills during breastfeeding? What drugs are there? Or is it better to use barrier methods when feeding? Or maybe there is no need to use protection at all during lactation? In this article we will try to answer all these questions and even look at the situation a little more broadly.

Why is a second pregnancy in a row undesirable?

Some mothers who gave birth to their first child and did not encounter serious difficulties during pregnancy and childbirth do not pay special attention protection. Pregnancy will come - good. I still want another child. Otherwise, I’ll shoot early and be free.

This approach is, of course, possible, but a woman must understand that too short a break between births can have a bad effect on both the mother herself and both children: the older and the younger. What problems may arise (of course, everything is individual, and such problems may not arise, but every woman needs to know about this)?

1. A woman fully recovers after pregnancy, childbirth and breastfeeding only after 2.5-3 years. Exhaustion of the body can lead to miscarriage or premature birth.

1. Having experienced serious stress during pregnancy and lactation, a woman is psychologically unprepared for its repetition.

1. If new pregnancy occurs earlier than 2 years after the previous birth, then the woman’s body often does not have time to restore iron reserves, especially if the child has been on breastfeeding for a long time. And during the second pregnancy it occurs Iron-deficiency anemia. This condition often leads to late toxicosis and premature birth. The baby may develop poorly in utero and be born with insufficient body weight. Serious problems can be expected even if not too heavy bleeding in childbirth.

1. Caring for two very young children is very difficult, especially if there is no one to help the mother.

1. The older child loses his mother's attention too early. Often you have to stop breastfeeding ahead of time. Severe stress for the baby there may be a situation when the mother goes to the maternity hospital. If the mother has to remain in confinement for a long time, the child may receive psychological trauma that will affect him throughout his life.

1. Coming too early is especially dangerous. repeat pregnancy after caesarean section. A seam that has not yet had time to fully form may simply come apart.

Some people believe that abortion is an option as a last resort. Let's omit the moral and psychological aspects this step. Let's talk only about health. To restore the uterus even after natural birth, passed without any problems, it takes time. Any intervention at this point is fraught with serious complications, which may subsequently lead to the inability to have children. After a caesarean section, abortion is prohibited due to a fresh suture on the uterus.

Easier to carry medical abortion. But, firstly, it needs to be done on time, and the woman caring for the baby rarely listens to her own condition and may well miss early signs pregnancy. Secondly, mothers who have recently given birth to a baby find it psychologically very difficult to tolerate even a medical abortion during pregnancy. early stages. In addition, medical abortion usually means refusing breastfeeding.

So let’s take it as an axiom that a breastfeeding woman needs to take protection.

When is it time to start protecting yourself?

In the first weeks after childbirth, gynecologists usually do not recommend that women have sex, even if there were no cuts or tears during childbirth, and no stitches were applied. The reason for this is that during childbirth, almost everyone develops microcracks, which can easily become infected, which can lead to serious inflammation. Inner surface The uterus is a continuous wound, which can also easily become infected.

But within about four weeks everything heals, and after a month and a half or two, gynecologists allow you to have sexual intercourse. From this moment you need to start protecting yourself.

Before this, it is advisable to see a doctor to make sure that recovery after childbirth went well. At the same time, you can discuss with your doctor what contraception for nursing is.

Lactational amenorrhea

It is believed that pregnancy is impossible while breastfeeding. Is it so? Yes, but not so. Indeed, the phenomenon of lactational amenorrhea exists. But, firstly, not for everyone. And secondly, it is necessary that the mother feeds the child on demand, including at night, and does not supplement or supplement with anything. And even in this case, there is no point in hoping that she will not ovulate even after 6 months after giving birth.

The fact is that ovulation occurs before menstruation, therefore, even while breastfeeding, a woman can become pregnant, even if she has never had menstruation after giving birth. So it’s better not to rely on the lactational amenorrhea method, but to use other methods during breastfeeding.

Hormonal contraception

One of the most reliable methods of contraception, the effectiveness of which is 98-99% depending on the drug, is hormonal. Previously, it was believed that oral contraceptives were not suitable for breastfeeding women. But science has long moved forward, and doctors may well recommend birth control pills for nursing mothers.

But you cannot prescribe these medications yourself when feeding your baby, since not all of them are compatible with breastfeeding.

It is unacceptable to take pills containing both estrogen and progesterone.

Such drugs pass into milk. And the child has absolutely no use for them.

Besides, similar drugs reduce the secretion of breast milk. And this is another reason why combined oc should not be taken while breastfeeding.

The recently popular vaginal ring NuvaRing also contains estrogen, so NuvaRing cannot be used during lactation.

When breastfeeding you can drink the following OK:

• tablets containing only progesterone;
• mini-pills, progestogen-based pills.

These drugs do not affect the baby and do not reduce milk supply. But both tablets and mini-pills must be taken at exactly the same time every day. A missed pill in the hassle can cause your baby to have a brother or sister.

What hormonal drugs can be an alternative to oral contraceptives:

• contraceptive injections;
• capsules injected under the skin.

Both injections and capsules contain the hormone progestogen. Their efficiency is close to 99%. You don't need to take them every day like you do pills every day. After all, injections are made once every 8-12 weeks, and the capsule lasts for as long as 5 years.

Disadvantages of all hormonal contraceptives:

• possibility of intermenstrual bleeding;
• too much heavy discharge during menstruation;
• do not protect against sexually transmitted infections;
• After discontinuation of the drug, conception may not be possible immediately.

Hormonal also includes emergency contraception. Drugs such as Postinora and Expapela contain levonorgestrel, which is compatible with breastfeeding. But we must understand that emergency contraception should not be used constantly.

Intrauterine device

This good method for nursing mothers. It has high efficiency. An intrauterine device is installed for several years, does not affect the baby in any way, and does not affect lactation. But it does not protect against infections and may lead to painful menstruation. Not used after caesarean section.

Enter intrauterine device possible as early as 6 weeks after birth. Until this time, there is usually no need for contraception. But if a woman begins intimate relationships earlier, then she should use barrier methods just in case.

Barrier methods of contraception

Barrier methods of protection include the use of:

• condoms;
• caps and diaphragms;
• spermicides.

All these methods are easy to use and can be used during lactation. But they are less effective compared to hormonal agents. But condoms protect against various infections, which is very important after childbirth.

To increase effectiveness, you need to use high-quality condoms. Choose a new size of caps and diaphragms due to changes in the size of the cervix and vagina.

Spermicides: suppositories, creams, gels are best used in conjunction with other methods, since these products are not very effective. The names of some drugs: “Pharmatex”, “Zhinofilm”, “Sterimine”.

Calendar method

Suitable only for women with regular cycle. But since after childbirth it takes time to recover, calendar method It is not recommended to use during this period.

During breastfeeding, almost all means of protection are acceptable for use. And birth control pills for nursing mothers are easy to find. Only combinations are prohibited hormonal drugs. But it is still advisable that a woman select a contraceptive method together with her gynecologist, since their experience makes it possible to determine best contraceptives for nursing mothers.