I got my period! Now what to do about birth control????

[ILovePie]

I'm so annoyed - maybe even angry.  I went 18.5 without a period with DS1.  Now I'm nursing BOTH my kiddos and I didn't even go 8 weeks????

So now I'm stuck trying to figure out what we're going to do about birth control.  We were planning to use LAM. 

DH is so adamant that he wants no more kids, and I'm not too far from feeling the same way.  He has said that he'd rather never have sex again than have another baby.  lol

In any case, another pregnancy is not something I want.  I need to move on to making sure I'm around for a long time for the ones I already have - and that means drug therapies that are incompatible with pregnancy (some down the road are incompatible with breastfeeding, but for now I'm good to do that).  If we do somehow decide to grow our family in the (far, far) future, it will be through adoption.

So, all that said...help?

I can't do hormonal birth control, and the study out of University of Chicago linking vasectomy to early onset dementia makes me uncomfortable with that option since DH already has family history of dementia.  And I don't like the idea of a tubal for various reasons.  I've contemplated an IUD, but I had one before (copper) and it made me very sick.  That was before I had had a baby, though - I was told it might be no big deal after having a baby, and I've had two.  But I'm not sure if I want to risk it, since we'd have to pay out of pocket (I think it would be about $300-400, if I recall correctly).

I'm not sure DH is comfortable with NFP while I'm breastfeeding - though if my periods become regular and I start predicting them reliably, maybe he will be.  (And until then...we use condoms, maybe?)

Any suggestions or thoughts?

[rparker]

Well, I'm getting a copper IUD in 2 weeks. I had a Mirena after DD1 was born, but my OBGYN inserted it too early and it fell out. I thought about getting another Mirena, but I didn't really like the side effects of the mini pill (progesterone only) so I'd rather go hormone free. My DH is getting a vasectomy as soon as he stops procrastinating. I'm waffling between a tubal or Essure once I'm not bf-ing around the clock. (I want to be able to take pain meds post tubal guilt free.)

We really, really, really don't want any more babies though. If I was at all open to having more children I'd probably be ok with condoms plus spermicide. I would never rely on NFP unless I was open to having more children. (I was raised Catholic and know way too many families relying on NFP with 4+ children and my limit is 2.) 

If I was in your shoes I'd probably try another copper IUD if you're sure you can't do the Mirena since it's hormonal. (Are you sure that's off the table since it's such a small dose of progesterone?) I'd call up a Planned Parenthood and see if you'd qualify for an IUD on a reduced fee basis if you're paying out of pocket. Other than a surgical option or an IUD, condoms plus spermicide are the most effective non-hormonal method. The Pill works really well and I loved it prior to breastfeeding, but knowing what I know now I plan to avoid it too. 

(I expect to be in the same boat as you sooner rather than later. I went 13 months before my first pp period last time. I'm also tandem nursing, but DD2 goes 4-5 hours without nursing most nights and occasionally she has done 6-8... DD1 is *mostly* totally night weaned. I figure it's only going to be a few months at most before my fertility returns this time.) 

[Magali]

  I really, really do not want to be pregnant again.  I really, really do not want to go thru labor ever again!!!!    I had a molar pg a few years back and I stupidly took depo provera afterwards.  And it was such a horrible few years for me after only one shot of that stuff :(  So even though I know that Depo is an extreme birth control, I just can't bring myself to risk any sort of birth control.  I really don't know what to do. 

[lotusma]

after reading here the connection between dementia and the V, i narrowed down the copper IUD as the least of all the evils. (altho i'm curiuous how it made you sick, ilp) i'm scheduled to have the procedure this tuesday. i'm actually excited. :p

i've already tried the estrogen only pill and it made my hormones so wonky i thought i needed to be committed. :-/

[ILovePie]

Ugh. I was SO sick!  I think I had it in for 2 or 3 months and I spotted the entire time, plus had cramping to the point of nausea (which wasn't even something normal during my periods).  The cramping got better and worse, but it was sort of always there.  At its worst (on my honeymoon, no less!), I threw up on a 500-year-old cedar that was planted to commemorate the wedding of a king...(we honeymooned in Wales).  DH wanted to explore castles and I just wanted to throw up and/or lay down the whole time!

Quote:

Originally Posted by lotusma 

after reading here the connection between dementia and the V, i narrowed down the copper IUD as the least of all the evils. (altho i'm curiuous how it made you sick, ilp) i'm scheduled to have the procedure this tuesday. i'm actually excited. :p

i've already tried the estrogen only pill and it made my hormones so wonky i thought i needed to be committed. :-/

[corban's mum]

i asked my family doctor if using LAM was ok as i really dont want to go on hormonal contraceptives + i had an ectopic pg/lost my right tube so i dont want an iud as i heard it increases the incidence of ectopics?  anyhoo my doctor said, and i quote "LAM is ok if you're in africa, but it doesn't work for western women" ummmm wowzah i didn't realise african mamas have different biological make-up to me... lmao

still, im totally stuck, we dtd for the first time last night and it was ok- using condoms, but im 100% sure that at some point we'll **forget** to use them IYKWIM so im trying to think of another method?

[CherryBomb]

Originally Posted by corban's mum 

i asked my family doctor if using LAM was ok as i really dont want to go on hormonal contraceptives + i had an ectopic pg/lost my right tube so i dont want an iud as i heard it increases the incidence of ectopics?  anyhoo my doctor said, and i quote "LAM is ok if you're in africa, but it doesn't work for western women" ummmm wowzah i didn't realise african mamas have different biological make-up to me... lmao

still, im totally stuck, we dtd for the first time last night and it was ok- using condoms, but im 100% sure that at some point we'll **forget** to use them IYKWIM so im trying to think of another method?

WHAT?!  What a bizarre thing to say!! 

LAM isn't effective for me, never has been no matter how perfectly I follow it.  My fertility returns by 12 weeks every time.  I had some stretchy mucus today, I'm only 7 weeks pp.  Blah.  Guess we'll see if I start bleeding in twoish weeks!

We still haven't DTD but we use NFP only, I've been charting for a couple of weeks.

[corban's mum]

im clueless about NFP though i can ALWAYS  feel ovulation, can tell which side i O from, but obviously thats not good enough as im not regular so im pretty sure id fall pg within three months if i relied on that lol  no idea about charting etc?

i wish i just had on off switch for my fertility...

[CalmCenter]

I got my flow back at 3 months, even though I was breastfeeding around the clock! I got a copper IUD. It has worked great and was painless to go in. I guess after birth it is much less painful and problematic. My periods are a little heavier, 5 days instead of 3, and a bit more cramping... but pretty minimal. I am really happy with it. In Europe it is way more normal, I hear, and it is only the USA that makes it seem so dangerous or untrustworthy. Also planned parenthood paid for it, as we are a low income family. It has been the first reliable birth control I have used that didn't make me go crazy (like all hormone types.)

[MaybeJ]

That was a strange thing to say, cobran's mom!

I don't trust LAM (for me) and won't go back to FAM for a long, long while.  We still haven't DTD yet (sigh) but we're planning on using condoms...

I've been getting the stretchy CM and a bit pimply so I think my period will be coming back soon...

After the next babe is born, I'm thinking of getting an IUD of some sort.  We're planning on stopping at two children, but don't want to do anything permanent for a little while.

[waitingmama]

Well, you don't want to assume that 4+ kids is due to a lack of NFP effectiveness-- many people just want a larger family, especially Catholics :) NFP gets a bad rap because many people do not use it properly but it is quite effective (and I personally think easy) when done properly. I have been a Billings Ovulation woman for five years and have two kids spaced just the way I wanted them to be spaced. I prefer Billings, much easier than sympto-thermal methods of NFP, which I tried for a while. My favorite book is "Honoring Our Cycles" by Katie Singer.

Corban's Mum: what a heinous thing for your dr to say! And I've heard the same thing about IUDs and ectopic pregnancy. Any research on it? I have a couple of friends who have had a few miscarriages after a year of IUD use, and they are wondering if there is any link between the two. I don't know much about it.

Originally Posted by rparker 

...I would never rely on NFP unless I was open to having more children. (I was raised Catholic and know way too many families relying on NFP with 4+ children and my limit is 2.) ...

[KistheMum]

One word.  Vasectomy.  :)

[blessed.mommy]

LAM worked well for us w/ our 2 lil ones.

I don't want to use BC of any kind (that's not natural) so I can understand where you're coming from. I am thinking of using FAM, charting and using a fertility monitor as well. 

[nadoja]

Odds are that you had the side effects of the Copper IUD, because it was placed before you had any full term pregnancies. I had one placed in November, after I had my daughter in August. The spotting in between periods is normal, and should subside. So far, so good for me with the IUD. I have not got my period yet, but I did not want to chance getting pregnant too soon. Talk to your practitioner and even get a second opinion from a trusted practitioner that a friend sees.

[KimPM]

Originally Posted by corban's mum 

i asked my family doctor if using LAM was ok as i really dont want to go on hormonal contraceptives + i had an ectopic pg/lost my right tube so i dont want an iud as i heard it increases the incidence of ectopics?  anyhoo my doctor said, and i quote "LAM is ok if you're in africa, but it doesn't work for western women" ummmm wowzah i didn't realise african mamas have different biological make-up to me... lmao

The doctor probably was trying to indicate the difference between ecological breastfeeding (practiced by many african women, as well as those western women who understand the difference) and cultural breastfeeding (mostly the kind of breastfeeding practiced in the west).  But I'm guessing that the doctor didn't truly understand the difference, perhaps only noting that african women tend to have much longer LAM than your typical breastfeeding western mother - because of the ecological breastfeeding, not because of any physical african-western differences.  Perhaps the doctor should understand the facts better before making such offhand comments that are not technically correct - and are downright confusing.

[juniper_mama]

Read the book Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health by Toni Weschler.  Seriously, the most important and empowering book I've ever read.  I used the the Fertitility Awareness Method (FAM) for birth control for over a year before I used the method to conceive.  It will teach you how to use basal body temperature, cervical fluid consistency and other signals to determine your fertility throughout your cycle.  I cannot say enough good things about this book or this method.  You will be amazed at what you learn about your monthly cycle and will wonder why every woman has not been taught these things. 

[corban's mum]

? what is the difference? lol im probably being really silly asking.....

i BF round the clock, express in between (storing feeds in freezer for xmas day so i can have some wine haha)

Originally Posted by KimPM 

Originally Posted by corban's mum 

i asked my family doctor if using LAM was ok as i really dont want to go on hormonal contraceptives + i had an ectopic pg/lost my right tube so i dont want an iud as i heard it increases the incidence of ectopics?  anyhoo my doctor said, and i quote "LAM is ok if you're in africa, but it doesn't work for western women" ummmm wowzah i didn't realise african mamas have different biological make-up to me... lmao

The doctor probably was trying to indicate the difference between ecological breastfeeding (practiced by many african women, as well as those western women who understand the difference) and cultural breastfeeding (mostly the kind of breastfeeding practiced in the west).  But I'm guessing that the doctor didn't truly understand the difference, perhaps only noting that african women tend to have much longer LAM than your typical breastfeeding western mother - because of the ecological breastfeeding, not because of any physical african-western differences.  Perhaps the doctor should understand the facts better before making such offhand comments that are not technically correct - and are downright confusing.

[CherryBomb]

Yes, this :)  We're NFP using Catholics with 4 kids, because we want 4 kids.  And actually, we were not Catholic when our first 2 were conceived, and I was on birth control!  (condoms and pills with #1, condoms and nuvaring with #2!)  Most of the time when I talk to someone who says NFP failed for them, it's because they were "taking a chance" and using fertile days.  There's no taking chances with NFP, either you're trying to get pregnant or your not!  The rest of the time it's due to not using properly.  My ectopic pregnancy was unexpected, but I hadn't been observing my fertile signs at night when I used the bathroom, so I can't blame it on the method!

corban's mum, here's a link on ecological breastfeeding.  Here's some on LAM.  LAM doesn't work for me, I'm one of the 2% who will get a return to fertility before 6 months.  I did all of the ecological breastfeeding steps except for the one nap with baby during the day (not possible with other kids!) with dd3 and my fertility still returned at the same time.
 

Originally Posted by waitingmama 

Well, you don't want to assume that 4+ kids is due to a lack of NFP effectiveness-- many people just want a larger family, especially Catholics :) NFP gets a bad rap because many people do not use it properly but it is quite effective (and I personally think easy) when done properly.

[KimPM]

Originally Posted by corban's mum 

? what is the difference? lol im probably being really silly asking.....

i BF round the clock, express in between (storing feeds in freezer for xmas day so i can have some wine haha)

 

I was only addressing the doctor's strange comment, not specifically your particular situation. 

Good question...not silly at all asking...Cherry Bomb posted a good link (above) for ecological BF-ing.  Cultural BF-ing is anything that is NOT ecological BF-ing.  Cultural BF-ing includes things like scheduled feedings, supplementing with formula, using pacifiers, and more.  Pumping, though necessary in many cases, may also interfere, as it changes the timing and style of "nursing" (your body can tell the difference).  You may be doing everything right for ecological BF-ing...(check the link to be sure)...but still you may be in the minority of women who are doing everything right and still get a return of menses and/or fertility.  Apparently those two are not necessarily one in the same, and you wouldn't know unless you are charting temperature and mucus.
 

Edited by KimPM - 12/1/10 at 10:08am

[rparker]

Sorry! I wasn't trying to diss Catholics or NFP. It does seem though like one of the biggest determiners for whether or not NFP is a good fit for a woman is how she feels about the possibility of another pregnancy (i.e. if she is dead set against it or if she could accept it as being God's will) and whether she sees methods of artificial birth control as abortificants or otherwise immoral. Most Catholics are in a better headspace to accept a failure of NFP (even if the odds are tiny) because sex for procreation fits into their personal faith. A vasectomy still seems the best way to avoid "accidents" but it goes against some major religions. (e.g. My parents chose that route after my sister was born even though my mom--who is Catholic--knew that she was going directly against her church's teachings.) No method of birth control is 100% though... my friend's 4 year old survived the "morning after pill." 

Originally Posted by waitingmama 

Well, you don't want to assume that 4+ kids is due to a lack of NFP effectiveness-- many people just want a larger family, especially Catholics :) NFP gets a bad rap because many people do not use it properly but it is quite effective (and I personally think easy) when done properly. I have been a Billings Ovulation woman for five years and have two kids spaced just the way I wanted them to be spaced. I prefer Billings, much easier than sympto-thermal methods of NFP, which I tried for a while. My favorite book is "Honoring Our Cycles" by Katie Singer.

Corban's Mum: what a heinous thing for your dr to say! And I've heard the same thing about IUDs and ectopic pregnancy. Any research on it? I have a couple of friends who have had a few miscarriages after a year of IUD use, and they are wondering if there is any link between the two. I don't know much about it.

Originally Posted by rparker 

...I would never rely on NFP unless I was open to having more children. (I was raised Catholic and know way too many families relying on NFP with 4+ children and my limit is 2.) ...

Corban's mum: I agree with pps that your doctor was very clumsily trying to distinguish between ecological and cultural breastfeeding. I came very close to ecological breastfeeding with DD1 and got my first period at 13 months postpartum, so not too bad. (Here's another link on it that my friend sent me recently.) Most western women--even AP practicing ones--don't come very close to ecological bf-ing... I don't think any of my friends IRL have. Pacifier use is one factor that rules out LAM. I personally expect my period back a lot sooner because Livia has been a) STTN and b) I've been leaving her for 2-2.5 hours with my husband (no bottles yet) while I do other things because she's happy having her feedings that spaced out... Alice would never have tolerated that. Regardless of whether you're practicing ecological or cultural bf-ing, I'm pretty sure LAM is considered unreliable after 6 months pp.