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What New & Hopeful Moms Need to Know About Birth Control

If you are thinking about stopping birth control to get pregnant, the most important thing to remember is to prepare your body for pregnancy before you stop, which means take your prenatal vitamins for 6 months to a year before you try to get pregnant. Although some OB/GYN’s recommend stopping birth control a month before you try to conceive, it is not necessary.  The main reason for waiting a month or two after stopping oral contraceptives is to establish a regular cycle.

How Do Birth Control Pills Work?

The pill works in various ways to prevent pregnancy.  The most common mechanism involves stopping the release of an egg from the ovaries.  Birth control pills thin the lining of the uterus and thickens the mucus in the cervix making it difficult for a fertilized egg to stick to the uterine wall and sperm to reach the egg, respectively.

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Birth control pills consist of hormones, which remain in the body for a very short period.  In most cases, most birth control pill hormones leave the body in one to two days. This explains why women usually start bleeding within a couple of days of taking the sugar pills of a pack of birth control.  Progestin only pills (POPs) or “mini pills” leave the body within 24 hours. This is why women taking POPs need to take their pills at the same time daily. If you are just 3 hrs late on the POPs, you need to abstain from sex or use a backup for 48 hrs and you might need EC if you had sex within 48 hrs.

How does the Birth Control Ring work?

Birth control rings work the same way as birth control pills and can be removed after three weeks and left out for 1 week, so you can have a withdrawal bleed. However, this week off is optional. There is actually 35 days worth of medicine in the ring. So you could just change it every month and aim for no bleeds.

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How do Birth Control Shots and Implants Work?

The implant and shot (depo-provera, depot medroxyprogesterone) work similarly, except the effect of the implant lasts much longer.  Depo-provera shots last approximately 12 weeks. Implants are good for 3 years.

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How does the Birth Control Patch Work?

The birth control patch works the same way as birth control pills – by blocking the egg from being released, thinning the lining of the uterus, and thickening the cervical mucus.

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How do I Stop Taking Birth Control if I Want to get pregnant?

It is important to keep in mind that whatever your previous menstrual pattern was, it will return quickly once the pill/patch/ring is no longer in your system.  If you had irregular cycles before you started on birth control, then you are likely to have irregular cycles again once you stop.

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To stop the pill, patch, ring. Just stop taking the pill, take off the patch, or take out the ring.

To stop the implant or an Intra Uterine Device (IUD, copper or hormonal), ask your provider to remove it. Hormones from implants leave the body very quickly as well. It is possible to become pregnant right away once the implant and IUD are removed, and there are virtually no risks to mother or baby.  

The Depo-Provera (aka birth control shot) may take  3 to 18 months to leave your system.

After stopping birth control, keep track of your menstrual cycles to help you predict ovulation a.k.a. figuring out the best times to try to conceive.  Longer or irregular cycles may indicate less frequent/irregular ovulation. If after 1 year, you have been unsuccessful, you should talk to your provider about fertility testing for both you and your partner. The birth control shot may affect your fertility for several months, so it is important to note this method to your provider to address concerns.

If I Get Pregnant While I am on The Pill, will it Harm my Baby?

The hormones in birth control pills prevent ovulation and create a difficult environment for fertilization, but they are not strong enough to stop a pregnancy that has already occurred.  The pill also causes changes in the linings of the fallopian tubes and uterus, meaning that if an egg becomes fertilized, there is less chance that the egg will implant outside the uterus.  Evidence suggests that estrogen based birth control lowers the chance of ectopic pregnancies (pregnancies outside the uterus and that cannot survive).  

There have been women who have given birth and were on the birth control pill during the entire pregnancy and there were no effects on the baby. The hormones in the birth control pill mimic pregnancy. So that may be why they don’t “hurt” the pregnancy.

Will Emergency Contraceptives or the “Morning-After Pill” Harm my Baby?

According to the Office of Population Research at Princeton University, a study performed on 332 women giving birth after using emergency contraceptives revealed no increased risk of birth defects.  Hormones present in emergency contraception are designed to immediately keep you from ovulating once taken.  These pills are taken so early on in the process and leave the body so quickly that the risks of birth defects are virtually non-existent.  In fact, the FDA removed warnings about birth defects from packaging several years ago. If you become pregnant after emergency contraception, notify your healthcare provider as soon as possible to establish proper prenatal care and monitoring.

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How Soon After I Have my Baby Should I Start Taking Birth Control Again?

Women who plan on taking the pill after giving birth should speak with their medical provider at their first postpartum checkup or even before giving birth.  Recommendations from the CDC and the World Health Organization state that women should wait a minimum of three weeks after childbirth before beginning oral contraceptives.  The primary risks for beginning too early include an increased risk of blood clots in new mothers. Clinical studies reveal that risks for blood clots are greater in women after giving birth, and it takes approximately 42 days (6 wks) for the risks to return to normal.

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The CDC and WHO recommend a waiting period of 4 weeks for the progesterone only pill and six months for combination pills due to their effects on lactation.  Women who plan on breastfeeding should speak with their pediatrician and OB/GYN or other health provider concerning the effects of hormonal contraceptives on breast milk.  Some birth control pills reduce the amount of breast milk that is produced and supplementing breast milk with formula may be necessary.

If you are not breastfeeding and you have no other risks for blood clots, you can start regular birth control pills at 3 wks after giving birth.

What is the Best Birth Control pill after Pregnancy?

Before you deliver, you should plan for birth control after pregnancy. That way your medical provider can assist you in making the right decision.  

You can start: any progesterone only or non hormonal method specifically: the IUD with or without hormone, the implant, the birth control shot, or progestin only pills immediately after giving birth. 

If you want a pill:

If you plan on breastfeeding, the progestin only pill contains only progestin, which is unlikely to affect milk production.  It’s important to remember, you can get pregnant if you are 3 hrs late taking the medication. Having some Emergency Contraception around in case, would be a good idea.

What New & Hopeful Moms Need to Know About Birth Control

Progestin based pills affect women differently.  Some women report higher occurrence of side effects, like headaches, and mood swings with this type of contraception compared to “regular” combination hormone birth control pills.

If you are not breastfeeding, consider the combination pill.

Many physicians will advise women to wait 1 month before beginning combination pills if you are breastfeeding.  The hormones may affect milk production and proper breastfeeding patterns need to be established before starting them. There is little if any risk to the baby.

Does Birth Control Affect Breast Milk production?

Progestin-only pills, IUDs,  and implants have little to no effect on milk supply; however, every woman is different, and some have reported a decrease in supply with the POPs.  Many doctors recommend beginning with progestin only pills after pregnancy for nursing mothers before other forms of hormone-based birth control methods.  

Combination (estrogen and progesterone) aka “regular birth control” pills are linked with decreased milk supply. Most pediatricians and OB/GYN’s advise nursing mothers to wait at least six to eight weeks before beginning any hormone based birth control and choose lower dose options.

Taking Care of Yourself Prior to Pregnancy

Your health provider is your best resource in planning your pregnancy.  The benefits of discussing your future pregnancy with your provider ensures the best possible care for you and your new baby before, during, and after your pregnancy.  Many doctors recommend 400mcg of folic acid each day or prenatal vitamins (which have that in them) a month or two before stopping birth control to provide a head start for changing needs in both mother and baby.  Maintaining positive and open communication with your health provider will give you peace of mind as you plan for your new arrival.