Family planning after pregnancy

Parenting a child is a blessing, hard work, sometimes stressful, and at many times a joy.

Now that baby is born, you may be thinking about becoming pregnant again.  How many babies you have, and the space between your babies is your decision.

If you are wanting to have another baby soon after the birth of this baby, please take extra care of yourself so that you are ready to cope with a toddler and a newborn. Being sleep-deprived with a newborn baby and a toddler is hard for anybody. Having good hands-on support from a partner and family can make it easier.

If you would like more time between your children,  then there are several ways to plan your family. Contraceptives prevent pregnancy when you use them. When contraceptives are stopped, women can get pregnant again. Women can get pregnant right up until their periods stop at menopause, around 50years of age.

CONCEPTION AND CONTRACEPTION

Pregnancy happens when a man’s sperm meets with a woman’s egg. This is called conception. Men release millions of sperm, and you only need one sperm to meet the egg to get pregnant.

‘Abstinence’ is NO sex at all, and works 100% to prevent pregnancy.

Some men try to squeeze and pull out during sex to stop the sperm meeting the egg. This is called ‘Withdrawal’. Pulling out only prevents pregnancy 70% of the time because men leak hundreds of sperm before millions are released in the fluid. You only need one sperm to get pregnant again.

Some couples try to combine the withdrawal method with knowing the woman’s body calendar but it only works 80-90% of the time. ‘Fertility Awareness’ needs to be taught properly, including how to check a woman’s temperature and cervical mucous EVERY day.

CONDOMS

When condoms are used properly every time a couple have sex, pregnancy is prevented 98% of the time. There are different sizes of condom to fit every size man comfortably. On the back of the condom box are the words ‘nominal width’. A nominal width of 52mm is the closest fit and a nominal width of 60mm is the widest fit. Finding the right fit is a bit like buying a bra: it’s embarrassing and funny trying on different sizes, until you find the size God made you. Finding the right fit is important for enjoyment and for contraception. If a condom bursts, or slips off, an Emergency Contraceptive Pill (ECP) taken within 72hours can prevent pregnancy.

Many couples like condoms because the woman does not have to take any medicines that might affect her health. Condoms are usually sold in boxes of 12 in the supermarket, and other shops for $11-15 without needing to visit a health professional. Some condoms are sold in boxes of 20 for $19, and some in boxes of 30 for $22. Condoms are even cheaper on prescription. You can get up to 144 condoms for $5.
 

EMERGENCY CONTRACEPTIVE PILL (ECP)

The Emergency Contraceptive Pill (ECP) taken up to 72hours after unprotected sex, will prevent pregnancy 98-99% of the time. The ECP is available from your midwife, a doctor, and some nurses. You can get the ECP from your family doctor’s clinic, an after-hours clinic, an FPA clinic, or a Sexual Health Service clinic. Some clinics will give the ECP for free, many will charge $5. The cost of the ECP on prescription from the pharmacy is $5. A pharmacist can also supply the ECP without a prescription at a cost of around $30.

The ECP is great for emergencies. Other contraceptives are also available and whether they will suit you will depend on your health, your lifestyle and your preferences, so you will need to discuss these with your midwife, doctor, or nurse practitioner.
 

LONG-ACTING REVERSIBLE CONTRACEPTION

Contraceptive implant, also known as the rod, prevents pregnancy 99-100% of the time. The implant releases a progestogen hormone slowly for 5years from under the skin. The implant is suitable for most women even with health conditions like diabetes. Once the implant is removed a woman can become pregnant again. The cost of getting the implant inserted is around $75. WINZ can help cover these costs.

Intra Uterine Device (IUD), also known as the loop, prevents pregnancy 99-100% of the time. There are 2 types of IUD, one with progestogen hormone and one without. The IUD is suitable for many women and lasts for 5years. The type used depends on the woman’s health.  Once the IUD is removed a woman can become pregnant again. The cost of the IUD and insertion varies by clinic, and is around $100-300. WINZ can help cover these costs.

Depo Provera, also known as depo and the jab, prevents pregnancy 99-100% of the time. Depo is a progestogen hormone injection that releases slowly for 3months. Depo is suitable for many women who can get to the nurse for the next injection on time. For some women who have used depo for a few years, it takes a few months to get a period after stopping the depo, before they get pregnant again. Many Polynesian women gain weight when they use only depo for contraception. If gaining weight is a problem, then a different contraceptive should be chosen to help you become healthier so you can care for your family, and prepare for the next pregnancy. The cost of depo is around $5-10. WINZ can help cover these costs.
 

OTHER REVERSIBLE CONTRACEPTION

Progestogen-only pill, also known as the mini-pill, prevents pregnancy 99-100% of the time when taken the same time every day. If the mini-pill is forgotten, a woman can get pregnant. The midwife, doctor and nurse practitioner can only prescribe 6months of mini-pill at a time. You will need a repeat prescription for more.

Combined oral contraceptive pill, also known as the Pill, contains oestrogen and progestogen. This is the only contraceptive not recommended during breastfeeding because the oestrogen hormone reduces breastmilk production. The pill prevents pregnancy 99-100% of the time. The pill needs to be taken every day. The time does not matter as much. The pill is suitable for many women. The midwife, doctor and nurse practitioner can only prescribe 6months of the pill at a time. You will need a repeat prescription for more.
 

IS YOUR FAMILY COMPLETE?

If you have enough children, you can use any suitable reversible contraceptive already described until menopause at around 50 years age, or you can use a permanent contraceptive.

A vasectomy is when a man’s sperm carrying tubes get tied so that everything feels and works the same but no sperm are released with the seminal fluid. A tubal ligation is where the woman has her tubes tied but she needs to have a general anaesthetic to have the surgery done by the hospital specialist. A vasectomy is faster to get in the community because he can have the procedure done by a trained GP, and then he has to rest on the couch watching sport on tv for the whole weekend!

WANT TO KNOW MORE?

For further information about contraception options, please ask your midwife, or visit your family doctor’s clinic or the Family Planning website.

A Special Needs Grant to help cover the costs of the contraceptive implant, IUD or injections is available or google ‘WINZ implant’.

Content provided by Dr Fionna Bell

Dr Fionna Bell is a General Practitioner currently working for South Seas, Otara.  Fionna is a mother of twin tween daughters and a son, working in Youth Health and trying to contribute to improvements in young people’s health status, educational achievement and future economic security.