Post natal contraception…realise slightly off topic of menopause but all hormonal!

Just attended another extremely informative BMS conference up in Stirling which you will be pleased to hear was packed with HCPs (health care professional) – predominantly GPs with a sprinkling of specialist nurses, sexual health practitioners and the like there too. I would say if you are a HCP, interested in female health and not yet a member of the BMS you would be wise to join…excellent conferences, the online resources are invaluable plus all the specialists lecturing not only really know their ‘stuff’ but are helpful, approachable and more often than not have a sense of humour…

All the lectures yesterday were very good but there were a couple of lectures which had some nuggets of information in there that I personally found really interesting so thought would pass on…

Post Partum contraception or to you and me…get your contraception sorted out so you don’t get up the duff straight after giving birth! Why is it so important – well apparently there are high rates of unplanned pregnancies within that time…I know, if you were anything like me no way was that ever going to be a possibility following the birth of my three rather gorgeous babies (one is always bias !)…especially after three high forceps…ok too much information! Why is this relevant on a menopause blog…well everything hormonal, plus unwanted pregnancies can then have knock on effects and stresses to deal with later in life when going through the menopause!

Getting back to post natal contraception – I am obviously in the minority and this is a problem which needs to be addressed, one which a Dr Michelle Cooper based in Edinburgh is currently hot on the case of…could have listened to this lady all day, excellent speaker.

Important message to get out there is discuss this before you give birth, and I don’t mean whilst wizzing down the motorway, panting with waters breaking, screaming at your partner never f…..again! Preferably discuss in a calm setting with your GP or obstetrician who will give good measured advice before your brain goes completely to mush post natal! Plus apparently a large proportion of women don’t attend their 6 week post natal appt – bonkers – obviously another potential opportunity to discuss this, but for some it seems too late!

Ok a few points to make…and thank goodness for Dr Cooper and colleagues who are currently in the midst of trials to deliver the best options of contraception for us all (well I’m way past it – a general term)

  • You have about 25 days grace until ovulation potentially kicks in again so 3 -4 weeks, I know how quick is that, so do be careful.
  • 50% of women are sexually active after 6 weeks…
  • A lot of women consider themselves to be covered if they are breast feeding – said to be 98% effective but you have to be full on quality breast feeding, no bottles sneaking in there and you should be amenorrheic – so no bleeding.
  • One of the most effective ways is for an intrauterine device, so a coil, to be inserted immediately post delivery – advantages are numerous – immediate contraception, less uncomfortable compared to leaving it to be inserted later down the line, high continuation rates ( i.e. we are more likely to leave it in there!), low rate of infection and ultimately cost effective for the NHS…win win!
  • If you don’t fancy that …
  • Barrier contraception, so condoms or diaphragms – just be aware diaphragm not advisable to use until 6 weeks after delivery and you should have an appt to check the sizing
  • Fertility awareness method – generally unreliable – should only be considered after you have had 2 or 3 regular cycles and to be quite honest post natal ‘ baby brain’, flip I wouldn’t have trusted my judgement much at that time!
  • Hormones and breastfeeding – all progesterone only contraceptives are safe to use whilst breastfeeding – hurrah!
  • Combined contraception – avoid for 6 weeks, so you need to think of something else in the interim
  • Sterilization – recommended to leave at least 2 weeks between delivery and surgery just to make sure it is the right decision. Give yourself time, have counselling, take advice.

I’ve obviously just skimmed the surface here but would encourage any of you who are currently pregnant to have a plan in place and for any HCP reading this who has an interest in this area I would strongly recommend you get in touch with Dr Cooper currently at the Chalmers unit in Edinburgh – a font of knowledge as this is obviously a fraction of the medical information available.

As always getting back to hormones around the menopause if anyone would like to organise a talk do get in touch :-

info@letstalkmenopause.co.uk / 07709799718