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Hands full? The argument for IUDs post pregnancy

Hands full? The argument for IUDs post pregnancy

I’ve never used an intrauterine device (IUD). I know it’s an effective birth control option that is only supposed to be momentarily uncomfortable, but I’ve always been slightly terrified about the placement process. But my IUD-devoted friends swear by them, including some who are new moms. I wondered: does having a baby change the relationship between the uterus and the IUD? As it turns out, yes — and it might even make your experience easier.

“If someone had an especially small uterus before (pregnancy), and it may have been too small for the use of the IUD, that might change after delivery,” says Dr. Anna Reinert, an OBGYN at Dignity Health in Phoenix. The cervix is also a little bit more open postpartum, which can make placing the IUD easier, she says.

While you should wait six weeks after delivery to have sex, when you do start back, doctors recommend using some type of birth control. That also goes for people who are exclusively breastfeeding. You might not have a period while you produce milk because the hormone prolactin suppresses ovulation, but you shouldn’t rely on breastfeeding for birth control. Dr. Reinert explained that how long someone experiences lactational amenorrhea is unpredictable. Because of this, there is a two-week fertility window where you could get pregnant before you’ve had your first period.

If you’re interested in a post-pregnancy birth control that you don’t have to remember to take on the daily — and will be effective for for three to six years — here are some things to know about using an IUD.

How soon can you get an IUD?
The doctor can insert the IUD at your six-week postpartum checkup. But if you don’t want to wait that long, you can actually get it placed about ten minutes after your vaginal or cesarean delivery, says Dr. Reinert. This is recommended if you might have trouble making your follow-up appointment or if you think you’ll be one of the 40-57 percent of females who have unprotected sex before their postpartum evaluation and don’t want to risk an unplanned pregnancy.

Signs something is wrong
There is a higher chance that the IUD will come out if placed immediately after giving birth. While rare, breastfeeding might increase the risk of uterine perforation with an IUD. Some spotting and cramping is normal after the procedure, but talk to your doctor if you experience pain or abnormal bleeding that gets worse and lasts for more than a few days after your IUD placement. A pelvic ultrasound can show if it’s sitting in the right place, says Dr. Reinert.

Why an IUD might be a good choice
When you get an IUD placed, there’s nothing else you usually need to do to prevent pregnancy. And because there is no pill to take or patch to remember, Dr. Reinert often recommends using an IUD postpartum (or another long-acting reversible contraception like an implant) because it’s one less thing for a new parent to think about.

“That ease of use makes them a good option, especially when someone has a new baby and their day and night become blurred, which makes it hard to be on top of something you’re supposed to do at the same time every day,” says Dr. Reinert.