Imagine turning up to your six-week postnatal check, only to discover you’re pregnant again. While uncommon, it can and does happen. Here’s what you need to know about postnatal contraception.

Women who have just had a baby may fall pregnant again sooner than they expect. The technical term “rapid repeat pregnancy” refers to the fact that an unexpectedly early pregnancy can impact significantly on both the mother and the baby. It is therefore important for women, from teens to those in their 40s, to be informed about postnatal contraceptive options.

Women who are not breastfeeding may ovulate as early as 28 days after delivery. They can therefore become pregnant again as early as 21 days after childbirth because sperm, at least the very determined ones, can survive for up to seven days in the female genital tract. The female egg is not so long-lived and only survives for about 24 hours after its release from the ovary.

For some women who have recently given birth, sex may be low on the priority list but for women who have resumed sexual activity, waiting to discuss contraception at the postnatal six-week check may be too late!

Options if you’re breastfeeding

Breastfeeding can protect against pregnancy but it is not 100 per cent effective. Breastfeeding delays the return of the first ovulation and the onset of periods due to the effect of the “breastfeeding” hormone called prolactin. In breastfeeding women, the average time from delivery to the first ovulation is 33.6 weeks but it can vary from 14 to 51 weeks.

For breastfeeding to protect against another pregnancy it must be less than 6 months since the delivery, the woman must not have had a period yet and the baby must be “fully breastfed”. This means no supplementary foods and intervals between feeds of no longer than about four hours during the day and six hours at night. Just to add to the challenge, we know that many women release their first egg before their first period so they may be unaware their fertility has returned.

Luckily Australian women, unlike many women around the world, have additional contraceptive options compatible with breastfeeding. These options have no negative effect on breastmilk or infant growth and development:

– Barrier methods such as condoms or a diaphragm. If breastfeeding’s impact on hormone levels leads to vaginal dryness, use water-based lubricants to make intercourse more comfortable.

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