I spent several years as a public health nurse working with pregnant women and new families. I talked about birth control on a daily basis. I carried aroud what I fondly referred to as my "birth control action pack" to demonstrate all kinds of birth control methods. All of the information below is well researched and combines my nursing and lactation consultant expereince. With birth control there are a few main things to remember:
1. If you don't like it and won't use it, it won't work.
2. Every method of birth control can fail.
3. Every method of birth control has a horror story inevitably about a cousin's friend... "My cousin gained 70 pounds on depo" "My friend had a baby with an IUD in its head" etc etc
"Getting your tubes tied" permanent BC done under anesthesia where the fallopian tubes are generally cut and then sealed off. No organs are removed so you will continue to have periods and hormonal changes. The egg and the sperm simply can't meet. Safe with breastfeeding. A more involved operation than a male sterilization. Should not be considered reversible.
"Vasectomy" the vas deferens is cut and ligated so that semen does not contain sperm. A man will still be able to ejaculate and have an erection. Generally done with a local anesthetic (they numb the area like at the dentist) in a physician's office. Very safe and highly effective. Requires a semen analysis after 20 ejaculations/12 weeks to confirm there are no sperm. Safe with breastfeeding.
Note: Vasectomies can be reversed although its effective only about half of the time and rarely covered by insurance.
Birth Control Pills
Combined oral contraceptives have both estrogen and progesterone. If taken daily as prescribed they are very effective. Side effects include nausea, breast tenderness, mood changes etc generally side effects lessen over the first few months. The World Health Orgnaization (WHO) recommends delaying combined oral contraceptive use in breastfeeding mothers until 6 months postpartum
Progestin only oral contraceptives (the minipill) have less hormones and generally less side effects than the combo pills. they are not quite as effective as the regular pill. However they need to be taken daily at the same time (with a 3 hour timeframe) to be efective. Safe in breastfeeding mothers after 6 weeks postpartum.
Depot is a shot given every 12-13 weeks. Because it takes "user error" out of the picture it is over 99.7% effective. Many women have irregular bleeding the first 6 months on depot and then cease having periods. Can delay the return of fertility for up to 18 months after stopping use. Safe for breastfeeding at 6 weeks postpartum.
Other hormonal BC
The patch and nuvaring are alternate ways to take combined estrogen and progesterone contraceptives. Some women who forget a pill everyday like only having to thing about birth control once a week or month. They are as effective as BCP with similar side effects. WHO Considers them safe in breastfeeding moms after 6 months postpartum.
IUDs are long-term reversible birth control. They are plastic T shaped devices inserted into your uterous by your doctor. there is a sting attatched that hangs into the top of your vagina so the device can be removed. Women at risk for STDs should not get an IUD as it increases the risk of pelvic inflammatory disease. Some women with fibroids or different uterine shaping may not be able to use the IUD
The copper IUD (paraguard) can stay in place for 10-12 years, but can be removed at any time without a delay in fertility. Side effects include heavier bleeding and cramping with periods. It can be inserted immediately after delivery or after 6 weeks postpartum. Safe in breastfeedng moms.
The levonrgestrel IUD (mirena) contains hormones and can stay in place for up to 5 years. Most women have lighter periods and less cramping and some women stop having periods with Mirena. There is still a question as when Mirena is safe for breastfeeding mothers....most women who have it inserted after 6 weeks postpartum do not have problems although some sources recommend waiting until 6 months.
Exclusive Breastfeeding/Lactational Amenorhea
Breastfeeding delays the return of ovulation and can be considered a form of birth control if all of the following 3 conditions are met:
1. A woman is less than 6 months postpartum
2. A woman has not resumed periods (is amenorrheic)
3. the baby does all of its suckling at the breast (no pacifiers, no bottles...)
Other Birth control
Of course there are barrier methods like condoms, diaphragms and sponges all safe with breastfeeding and there are fertility awareness methods too....just thought I'd give the basics on the ones there seem to be more questions about...