Kind of OT - Birthcontrol after babies

[Maxixe]

I have had two kids and don't plan to have any others but I don't want
to have my tubes tied. I can't get a lot of information from my ob/gyn
about birthcontrols. She recommended IUD but I researched that and
chose to wait until I find out more about my options because I am not
sure if I will like the IUD and I have to pay for it myself (insurance
will not cover any of it - not even checkups). The two kinds I
researched: Hormonal and copper would range in cost from $600 - $800
including the device and the doctor's fees. It seems the most
convenient but I am afraid if I hate it and want it removed because of
side effects I will have wasted my money. Right now I just told them
to give me an oral contraceptive that doesn't interfere with
breastfeeding but I don't even know for sure if there is such a thing!
What do the rest of you do about this dilemma?

[Naomi Pardue]

> I can't get a lot of information from my ob/gyn
>about birthcontrols. She recommended IUD

>Right now I just told them
>to give me an oral contraceptive that doesn't interfere with
>breastfeeding but I don't even know for sure if there is such a thing!

Well, first of all, I agree with the other poster (didn't note the name) that
if your gyn won't actually sit down with you and discuss your many options for
contraception, you really need a new GYN! She really shouldn't just be telling
you what SHE thinks you need to be using (in this case, an IUD), but explaining
the pros and cons of all the methods, and letting you make your own decision.)

If you want to use OCs, the best method for breastfeeding is progesterone only
pills, commonly called the mini-pill. (Most common brand name is micronor).
These work differently from the more common combined pills, and have to be
taken at the same time every day [much less margin for error], but won't affect
your milk supply.

If your baby is less that 6 months old and you haven't started your periods
again, and baby is still nursing often, you might also consider LAM
(Lactational Amenorrhea Method), which simply means that, as long as baby is
nursing on demand and you haven't yet had a period, you are extemely unlikely
to begin ovulating yet, and so extremely unlikely to become pregnant. In the
first 6 months post partum, this method is about 98% effective. (Comparabl e to
the IUD or the pill.)


If this won't work for you, or you aren't comfortable with it, you could also
rely on barrier methods (condoms, a diaphragm, foam, some combination thereof),
for the short or long term, at least while you weigh your options. Or
DH/partner could get a vasectomy.
There is also Depo-provera, (the shot you get every 3 months); it has the same
basic hormones as the mini-pill, so won't affect your milk supply but, if you
have problems with side effects, it can take a while for them to wear offf.

(FWIW, we've been using condoms for several years, and have no problem with
them.)


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)

[Nina]

"Naomi Pardue" > wrote in message
...
> > I can't get a lot of information from my ob/gyn
> >about birthcontrols. She recommended IUD
>
> >Right now I just told them
> >to give me an oral contraceptive that doesn't interfere with
> >breastfeeding but I don't even know for sure if there is such a thing!
>
> Well, first of all, I agree with the other poster (didn't note the name)
that
> if your gyn won't actually sit down with you and discuss your many options
for
> contraception, you really need a new GYN! She really shouldn't just be
telling
> you what SHE thinks you need to be using (in this case, an IUD), but
explaining
> the pros and cons of all the methods, and letting you make your own
decision.)

I had a problem when I lived in NYC. THe military had us going to a Catholic
hospital,so they wouldnt do the contraceptives there. We'd make an
appointment, discuss the options and THEN have to make another appointment
w/the Dr at their private practice.
Anyway, I was 23 and wanted a diaphragm,. This *#&#! doctor did NOT want to
give me one. She kept on and on about how I was too young and how I may
forget to take it out, or use it etc. That young people had sex
spontanously. I didnt want to quite nursing, my son was maybe 6 months. SHe
said "well, he's 6 months old, wean him, he's just playing with it. THen
come back and I will give you a prescription for the pill" I did not want
hormonal contraceptives because of the history of breast cancer, heart
disease and fibroids in my family.
Let me just say, I was in a STATE by the time I left there and ended up
filing a complaint. I was so furious. For one, how dare she tell me what I
was able to handle,as if I were too stupid to remember to take a diaphragm
out. Secondly, if i returned after weaning, she wouldnt have given me the
pills then, I would have had to make a 3rd apt w/her so she would be getting
paid 3 times for what should have been handled in one visit. 3rd, I was
paying her and I said I wanted a diaphragm, bottom line she should have made
it happen

I totally made sure I NEVER saw her again!
>.
>
> If your baby is less that 6 months old and you haven't started your
periods
> again, and baby is still nursing often, you might also consider LAM
> (Lactational Amenorrhea Method), which simply means that, as long as baby
is
> nursing on demand and you haven't yet had a period, you are extemely
unlikely
> to begin ovulating yet, and so extremely unlikely to become pregnant. In
the
> first 6 months post partum, this method is about 98% effective. (Comparabl
e to
> the IUD or the pill.)
>
It worked 18 months for me w/each child. I believe it is the nighttime
nursing that helps go the extra time. (and not because the baby is in the
way, either,lol) But I wasnt hell bent on not having another child, so I
didnt care how effective it was.

[Naomi Pardue]

>> If your baby is less that 6 months old and you haven't started your
>periods
>> again, and baby is still nursing often, you might also consider LAM
>> (Lactational Amenorrhea Method),

>It worked 18 months for me w/each child. I believe it is the nighttime
>nursing that helps go the extra time. (and not because the baby is in the

Well, the actual definition of LAM is that you have to be less that 6 months
post partum. (LAM is an actual method of birth control, not just the general
idea that you sometimes don't ovulate/get pregnant while nursing.) While many
women DO remain annovulatory for longer than that, and night feedings DO
increase the likelihood of remaining annovulatory longer, the statistical
likelihood of pregnancy (and especially of pregnancy BEFORE the first menstrual
period) goes up quite sharply after around 6 months, hence the cut-off date.)


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)

[Nina]

"Naomi Pardue" > wrote in message
...
> >> If your baby is less that 6 months old and you haven't started your
> >periods
> >> again, and baby is still nursing often, you might also consider LAM
> >> (Lactational Amenorrhea Method),
>
> >It worked 18 months for me w/each child. I believe it is the nighttime
> >nursing that helps go the extra time. (and not because the baby is in the
>
> Well, the actual definition of LAM is that you have to be less that 6
months
> post partum. (LAM is an actual method of birth control, not just the
general
> idea that you sometimes don't ovulate/get pregnant while nursing.) While
many
> women DO remain annovulatory for longer than that, and night feedings DO
> increase the likelihood of remaining annovulatory longer, the statistical
> likelihood of pregnancy (and especially of pregnancy BEFORE the first
menstrual
> period) goes up quite sharply after around 6 months, hence the cut-off
date.)
>

I hear you. Let me clarify- "breastfeeding" for a while worked for me. Why,
in other places adn times, has nursing been able to keep pregnancies space
further apart than 6 months? From everything I have seen/read, in
traditional societies, 2 years or so is the average. Why doesnt it work
here?

[Maxixe]

Thanks MKP posters for sharing information and experiences.
Considering the costs, I am going to try the micronor. At least part
of it is covered by insurance and I won't have to eat $600-$800
choosing either of the IUDs if I have side effects or want to try
something else. So far of course no period, I didn't have a period
after the first baby until about 18 months too, but I am told that you
can *still* get pregnant and I am not planning to have more children.
Of course if it happened...well, we'd make room, but there you have
it!

[Daye]

On Sat, 02 Aug 2003 23:28:57 GMT, "Nina" >
wrote:

>Let me just say, I was in a STATE by the time I left there and ended up
>filing a complaint. I was so furious.

Go for you! I would have too.

--
Daye
Momma to Jayan
EDD 11 Jan 2004

[Ericka Kammerer]

Nina wrote:


> I hear you. Let me clarify- "breastfeeding" for a while worked for me. Why,
> in other places adn times, has nursing been able to keep pregnancies space
> further apart than 6 months? From everything I have seen/read, in
> traditional societies, 2 years or so is the average. Why doesnt it work
> here?


It works here the same as it does there. The
question is just what you mean by "work". Sure,
statistically speaking, long term breastfeeding will increase
spacing between children dramatically in the absence of any
other birth control in a population. However, a number of
*individuals* will get pregnant much sooner. It's a question
of how certain you want to be that you won't get pregnant.
If you want to get the 98-99 percent effectiveness, then
you have to follow the rules of LAM because anything less
increases the odds that you'll get pregnant. You might
well not get pregnant relying on breastfeeding even after
breaking the rules of LAM, but it's not as reliable. If
you're willing to take the increased risk of pregnancy,
that may be fine for you.

Best wishes,
Ericka

[Naomi Pardue]

>From everything I have seen/read, in
>traditional societies, 2 years or so is the average. Why doesnt it work
>here?
>

In addition to Ericka's usual excellent response, consider the following:
pregnancy lasts 9 months ...
Seriously -- several studies I've seen have found that the average return of
menses in women who are exclusively bfing is about 9 months. So.. if we assume
that a menses return at around 9-12 months... and it takes, on average, 3-6
months to conceive from the time fertility returns, the new baby would arrive
around 18-24 months after the previous baby. Don't forget too, that in many
societies where breastfeeding is the sole form of contraception, women tend to
be poorly nourished, which would tend to reduce their overall fertility, and
probably increase the legnth of amenorrhea. (Our bodies tend to know better
than to get pregnant if there isn't enough food available to support another
child.)

(Also, in some societies, the couples abstain from sex while the mother is
nursing, which certainly adds to the contracpetive effects....)

But the main thing is that it is, indeed, just an AVERAGE. Some women conceive
sooner, some later.


Naomi
CAPPA Certified Lactation Educator

(either remove spamblock or change address to to e-mail
reply.)