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Fundus
Care
Breast Care & Preventing Infections
Bowel
Habits
Diet/Activity/
Exercise
C-Section
Care
Sex & Birth
Control
Postpartum
Depression
Transition To
Parenthood

SEX
Intercourse should be avoided for at least 6 weeks and until there is no more bleeding. Resuming sexual intercourse after that depends on how you are feeling and if you are ready. If you had an episiotomy or a tear to the perineum area, it may take longer to heal and having intercourse should be postponed until the area is healed. After a vaginal delivery the vagina may be sore and bruised for a couple of days and may feel a little larger than before delivery. The vagina never will be the same size as befpre childbirth, but with perineal tightening or Kegel exercises it can help tighten the vagina and assist with regaining tone. http://www.mayoclinic.com/health/kegel-exercises/WO00119
Breast feeding may cause vaginal dryness, but the use of lubrication prior to sexual intercourse may ease this discomfort.

BIRTH CONTROL
There is a wide variety of birth control options and your choice will depend on what you are comfortable with, what will be best for you and your partner, health/ family history, and the type of feeding method you have chosen for your baby. Birth control comes in many forms including condoms, creams, injections, pills, patches, rings, and intrauterine devices. Prior to discharge after your delivery, your provider will discuss birth control options with you. The decision on the type of method can also be made during a follow up postpartum visit.

Breastfeeding:
If you are breastfeeding, there are some limitations to the types of hormonal contraception you can take, for they may affect milk production and infant growth/ development. For up to six months postpartum if you are breastfeeding exclusively (not skipping feedings, supplementing with bottles, or when your baby begins solids breastfeeding have not decreased breastfeeding by greater that 10%) and you have not had a period, breastfeeding can be used as a method of contraception that is equal to taking the pill. This method is known as the lactational amenorrhea method (LAM). This involves hormones your body is releasing to produce and maintain milk production stopping the hormones that stimulate ovulation to occur. If your period returns or if you decide to supplement with bottle feedings another contraception method should be started to prevent an unwanted pregnancy.

Non Hormonal Choices **Can be used while breastfeeding

  • Vaginal barriers: Diaphragms, caps, sponges, and female condom work by blocking / killing sperm
  • Spermicides: gels, creams, film, and suppositories work can be used with barrier method to increase effectiveness
  • IUD-intrauterine device (copper) provides 10 year coverage
  • Fertility awareness based methods
  • Male condoms

Permanent Methods
Female Sterilization - tubal ligation
Male Sterilization - vasectomy

Hormonal

  • Pills 2 types
    • Progestin only (can be used if breastfeeding, begin at 6 weeks Postpartum)
    • Combined Progestin and Estrogen (may decrease milk supply, can start at 6 months postpartum if adequate milk supply or if you are supplementing)
  • Injections- Depo Provera (can be used if breastfeeding)- 1 injection every 12 weeks
  • The Patch (change weekly)
  • Vaginal Ring (change monthly)
  • Implants (Implanon can be used for 3 years, does not interfere with milk production)
  • Mirena IUD lasts 5 years but can be removed sooner if desired (can be used if breastfeeding)

http://www.mayoclinic.com/health/birth-control/BI999

http://www.acog.org/publications/patient_education/ab020.cfm