Postpartum Contraception: 7 Safe Options

After giving birth, your fertility may return sooner than you expect — even if you’re breastfeeding. On this page, you’ll learn when you might be fertile again, which methods are safe (including during breastfeeding), when to start them, and how we organize this in our The Hague region.

Would you like personal advice or to arrange something immediately? Feel free to contact us. In our Margriet’s Library, you’ll also find useful information.

When are You Fertile Again?

The first ovulation can occur before your first menstruation. With no breastfeeding, this can happen as early as 3–4 weeks; with breastfeeding, it’s generally later, but unpredictable. Therefore, assume that you may need contraception again from 3 weeks postpartum if you don’t want to become pregnant (again) yet.

LAM Method (Lactational Amenorrhea Method)

This contraceptive method is only reliable (about 98%) when all three conditions apply:

you are exclusively breastfeeding (day and night, no long breaks),
you have not had a menstrual period
your baby is < 6 months old.

As soon as one of these three changes, you need additional contraception. We generally do not recommend this method or only in combination with another form of contraception.

Quick Decision Guide

Condoms – can be used immediately; no effect on milk production.
Copper IUD (Cu-IUD) – can be inserted immediately after delivery or from 4–6 weeks; hormone-free.
Hormonal IUD (LNG-IUD) – from 4–6 weeks; safe during breastfeeding; often reduces menstrual bleeding.
Hormonal implant – can be inserted immediately postpartum or later; safe during breastfeeding; effective for 3 years.
Progestogen-only pill (mini-pill) – can be started immediately; take daily at the same time.
Contraceptive injection (DMPA) – usually from 6 weeks if breastfeeding; effective for 12 weeks per injection.
Combined hormonal contraceptives (pill/patch/ring) – not before 6 weeks postpartum due to thrombosis risk and possible decrease in milk production; often only after 6 weeks (or later) and only if suitable for your situation.
Natural methods / ovulation apps – unreliable in the first months due to unpredictable cycles.
Emergency contraception – see below; can also be used while breastfeeding.

Contraception Methods

1. Condoms

Hormone-free, can be used immediately, also as a temporary solution until your definitive choice. Good protection against STIs. Disadvantage: risk of user errors.

2. IUDs

Copper IUD (Cu-IUD) is hormone-free and effective for 5–10 years (depending on type). Menstrual flow may be slightly heavier/more cramping than you were used to.
Hormonal IUD (LNG-IUD) releases progestogen locally; effective for 3–8 years (type-dependent) and often reduces menstrual bleeding.
Timing: insertion immediately post-partum (within 48h) or after 4–6 weeks. With immediate placement, the risk of expulsion is slightly higher; we advise on this personally.

3. Hormonal implant (etonogestrel implant)

A small rod inserted under the skin of the upper arm. Effective for 3 years, quickly reversible, safe during breastfeeding, and can be inserted immediately postpartum. May cause spotting in the first few months. Also known by the brand name ‘Implanon’.

4. Progestogen-only pill (mini-pill)

Contains no estrogen and is suitable during breastfeeding; can be started immediately after delivery. Take at the same time every day for good reliability.

5. Contraceptive injection (DMPA)

Injection every 12 weeks. Often leads to little or no menstruation over time. Usually started from 6 weeks postpartum if breastfeeding. Be aware that fertility may return slowly after stopping (sometimes taking months).

6. Combined hormonal contraceptives (pill/patch/ring)

Effective and well-known, but there’s a temporarily increased risk of thrombosis postpartum.
• Non-breastfeeding: generally after 3–6 weeks, depending on risk factors.
• Breastfeeding: postpone until ≥6 weeks (sometimes longer) due to milk production and VTE risk.
We assess this individually.

7. Diaphragm/cervical cap & natural methods

Only after recovery and with careful sizing; less reliable in the first months due to changed anatomy and unpredictable ovulations.

Emergency Contraception (if Something Went Wrong)

Copper IUD: most effective; can be inserted up to 5 days after unprotected sex and then becomes your regular contraception.
Levonorgestrel pill (morning-after): take as soon as possible (up to 72 hours); breastfeeding can continue.
Ulipristal pill: effective up to 120 hours; temporarily interrupt breastfeeding according to the package insert.

Call us for advice; we’ll ensure you quickly get the best option.

Contraception and Breastfeeding

Progestogen methods (IUD, implant, mini-pill) are perfectly compatible with breastfeeding. Estrogen can reduce milk production in the early postpartum period; therefore, we usually postpone combined methods. Are you concerned about your milk production? Let us know — we’ll monitor and coordinate with a lactation consultant/hospital if necessary.

We usually discuss your preferences during check-ups or at the postpartum check. Many options can be arranged in primary care (prescription or insertion), sometimes in collaboration with the hospital (e.g., immediate IUD insertion on the maternity ward or for specific medical indications). In the The Hague VSV chain (HMC/Haga and others), we adhere to national guidelines and maintain consistent agreements on breastfeeding, start times, and risks. We clearly record your choice and plan in your file, so everyone knows what has been agreed upon.

Ready to choose or want to compare options? Send us a message via contact — we’ll schedule it for you right away.

Frequently Asked Questions

When is the Best Time to Start Contraception?

It depends on the method. Condoms/mini-pill/implant can be used immediately; IUD usually 4–6 weeks; combined methods often ≥6 weeks (longer if breastfeeding/risks). We’ll coordinate this together.

Is Contraception Necessary if I'm Exclusively Breastfeeding?

As long as you meet the LAM conditions, the chance of pregnancy is low. But once your baby is ≥6 months old, your menstruation returns, or you supplement/have longer breaks, you need additional contraception.

Can I get an IUD after a Cesarean Section?

Yes. We usually plan insertion after 6 weeks (or immediately during/after the cesarean section in the hospital if that has been agreed upon).

Does Contraception Affect My Mood or Libido?

It varies per person. If you notice any issues, let us know — sometimes a different method might be more suitable.

When Can I Have Sex Again after Giving Birth?

As soon as you feel ready and your body has recovered. For most people, this means: waiting until the bleeding (lochia) has significantly decreased and any wounds have healed (episiotomy/tear or cesarean section). This often occurs around 4–6 weeks and coincides with the postpartum check-up. If you had a more severe tear (grade 3–4) or a cesarean section, expect to need some extra time and wait for your healthcare provider’s advice.

If it remains painful, you have a fever, an unpleasant odor, or heavy bleeding: contact us.

Back to Library

Blog

MIDWIFERY PRACTICE MARGRIET

On this Page