Postpartum contraception

In the postnatal period contraception needs to be considered if a woman is sexually active. Some women may be sexually active in the first six weeks postpartum.¹ Contraception options can be discussed antenatally as well as in the immediate postnatal period. NICE guidance advocates discussing contraception with mothers in the first week following delivery.² Discussing contraceptive options antenatally when the women has time to consider the options might be more effective than postnatally when the day-to-day care of a newborn is her top priority.

All contraceptive advice should be tailored to the individual by taking a thorough medical history and assessing any plans for future children. The UK Medical Eligibility Criteria for Contraceptive Use (UKMEC) can be consulted. Having a further pregnancy within six months of giving birth is associated with an increased risk of adverse perinatal outcomes.¹ Maternal health is also adversely affected. The risk of sexually transmitted infections and the need to use barrier contraception such as condoms might also usefully be discussed in some situations.