Discuss contraception with your doctor at the six-week check-up after the birth and remember that you can become pregnant even if you are breast feeding. If you have been using the diaphragm it will have to be refitted. You will also need a new intrauterine device. Although there is only a slim chance of pregnancy occurring it is wise to use a contraceptive like the condom or sheath before you decide on the method you will use regularly after your six-week qheck-up. If you are not breast feeding you can choose any method of contraception. While you are breast feeding it will be necessary to avoid the Pill in certain forms.

The Pill. The combined oestrogen and progesterone contraceptive pill is effective and convenient, but must not be taken if you are breast feeding as it can’ decrease your milk supply.

The mini-pill’ does not contain oestrogen and has a low progesterone content. The failure rate is slightly higher than that of the combined pill and there may be slight breakthrough bleeding because of the low hormone content. The mini-pill should not affect lactation but if your milk supply is not ample it is wiser to use some other form of contraception. Depo-Provera is a contraceptive injection given every three or six months. It has a low failure rate and works well in women who have medical conditions such as diabetes, tuberculosis, high blood pressure and heart problems. There may be menstrual irregularities such as spotting or absence of periods, as well as drying of the normal vaginal secretions. The contraceptive injection can be used while breast feeding and may even increase lactation. All women on the Pill should have their blood pressure checked at least once a year.

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