Options for Postpartum Contraception
Options for Postpartum Contraception
| Method | Pregnancy rate in 1 year | Special Considerations |
|---|---|---|
| Sterilization (male & female) | 0.5%, 0.15% | - Permanent |
| Etonogestrel (ENG) Implant | 0.05% | - Must be placed and removed by trained clinician - Clinicians must attend manufacturer training prior to placement |
| IUD: Copper | 0.8% | - Must be placed and removed by trained clinician |
| IUD: Levonorgestrel (LNG) | 0.2% | - Must be placed and removed by trained clinician |
| Injectable (Medroxyprogesterone acetate) | 6% | - Must obtain injection every 3 months |
| Lactational amenorrhea method (LAM) | 2-8% | - May be impractical for many people - Must breastfeed infant frequently & exclusively; be amenorrheic and <6 months postpartum |
| Progestin-only pill (norethindrone) | 9% | - Must take pill at same time every day with 3-hour late window |
| Estrogen/progestin combined pill, patch or ring | 9% | - Must take pill at same time every day, change patch every week, or ring every month - Estrogen-containing methods are contraindicated with some medical conditions and immediately postpartum |
| Barrier Methods | 12-21% | - Must be used with every act of intercourse - Condoms are the only method that prevent STI transmission |
| Withdrawal | 22% | - Continuation rates are low (46% at 1 year) - Requires active participation by a willing partner - Requires user involvement at every act of intercourse |
| Fertility awareness-based methods | 22% | - Continuation rates are low (47% at 1 year) - Requires active participation by a willing partner - Requires daily action(s) - Requires lead time to increase effectiveness |
More Information on Postpartum Contraception
- ACOG FAQ #500: Using Long-Acting Reversible Contraception Right After Childbirth
- ACOG FAQ #194: Postpartum Birth Control
- ACOG FAQ #184: Long-Acting Reversible Contraception: Intrauterine Device and Implant
- ACOG FAQ #052: Postpartum Sterilization
- ACOG FAQ #024: Fertility Awareness-Based Methods of Family Planning
- ACOG FAQ #022: Barrier Methods of Birth Control: Spermicide, Condom, Sponge, Diaphragm, and Cervical Cap
CDC Recommendations on Contraceptive Methods
The Centers for Disease Control and Prevention (CDC) has published guidance regarding who can use various contraceptive methods, and clinical guidance for the initiation and use of specific contraceptive methods. Both the U.S. Medical Eligibility Criteria (MEC) and Selected Practice Recommendations (SPR) address the use of LARC methods immediately postpartum.
The CDC, in collaboration with the Office of Population Affairs at the U.S. Department of Health and Human Services, developed recommendations on how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose not to have children. These recommendations are outlined in Providing Quality Family Planning Services (QFP).
U.S. Medical Eligibility Criteria (MEC), 2016
The 2016 U.S. MEC includes recommendations for using specific contraceptive methods by women and men who have certain characteristics or medical conditions.
U.S. Selected Practice Recommendations (SPR), 2016
The 2016 U.S. SPR addresses a select group of common, yet sometimes controversial or complex, issues regarding initiation and use of specific contraceptive methods.
Providing Quality Family Planning Services (QFP)
The QFP recommends how to provide family planning services so that individuals can achieve their desired number and spacing of children, increase the chances that a baby will be born healthy, and improve their health even if they choose to not have children.