Contraception in Specialized Conditions

Postpartum Contraception

Postpartum contraception includes breastfeeding, fertility awareness, and barrier methods. Breastfeeding women have a longer period of postpartum infertility than women who do not breastfeed. Women who solely breastfeed and experience amenorrhea are 98% protected from pregnancy for six months following the delivery.

Fertility awareness is another method used to support postpartum contraception, but it may be difficult to practice until regular cycles are reestablished. Barrier methods such as the diaphragm and cervical cap are good contraception methods for lactating women but should be refit at six weeks postpartum. An IUD can be placed immediately postpartum but is normally placed 6-8 weeks postpartum or sterilization.

Combined birth control pills are not good options for lactating women as estrogen decreases milk supply but can be taken after three months. Women who are not breastfeeding should wait to start taking combination birth control pills until 2-3 weeks postpartum due to the risk of thromboembolism.

Emergency Contraception

Emergency contraception methods are used after intercourse to prevent pregnancy. For emergency contraception to be effective, it has to be used within 72 hours of unprotected intercourse taking place, but effectiveness is greater the sooner the contraceptive method is used. It may decrease the chance of pregnancy by 75%. Emergency contraception can be used for up to 5 days after intercourse with some efficacy but not as effective as taking it within the first 72 hours.

Morning after pill

The morning-after pill is intended for use following unprotected intercourse during the ovulation period. It contains a substantial dosage of steroids, which serves to disrupt the endometrial lining after ovulation has taken place, preventing the implantation of a fertilized egg.

Plan B

Plan B is an emergency contraception available “behind the counter,” without a prescription, for those 18 years of age or older. If you are under 18 years old, you require a prescription to take Plan B. Levonorgestrel are two 0.75 mg pills that can be taken together or taken 12 hours apart for five days.


Preven is a product with ethinyl estradiol and levonorgestrel, approved for emergency contraception. The side effects of emergency contraceptives include nausea, abdominal pain, fatigue, headache, bleeding irregularities, breast tenderness, diarrhea, and vomiting.

This method of contraception is not as effective as other methods of contraception. A pregnancy test should be used if there is any delay in the menstruation cycle. If pregnancy occurs, therapeutic abortion is recommended as it has a teratogenic effect.

Paragard IUD

Paraguard is another form of emergency contraception that can be inserted within five days of unprotected intercourse.

Contraception Summary

Numerous contraception options are available to accommodate various preferences and requirements. When contemplating family planning, it is crucial to assess both the potential side effects of each method and the level of protection sought. Engaging in discussions with medical professionals can assist in determining the most suitable contraception method for individual circumstances.


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Human Reproduction: A Clinical Approach Copyright © 2023 by Dr. Hala Bastawros, M.D is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.