Postpartum Birth Control Options (Without Artificial Hormones or IUDs)

Many women, who love the idea of fertility awareness, think they can’t use a Fertility Awareness Based Method (FABM) while they are postpartum and waiting on their return of fertility, because they are not experiencing a regular cycle. Actually, there are ways to effectively fertility chart during postpartum amenorrhea, however it is true that many women find the postpartum time to be confusing and frustrating. Here are some birth control options for that unique season in your fertility that will help you continue to avoid artificial hormones and IUDs:

• Lactational Amenorrhea Method (LAM)
  This is an option for breastfeeding women who have not yet had their first menses, and can be used up to 6 months postpartum. In order to practice this method, it is important that a woman is breastfeeding her baby on demand, both day and night and not feeding other foods or liquids regularly. LAM is 98% effective when correctly followed. You can find more information about this method here.
• Ecological Breastfeeding
  This is a set of guidelines regarding breastfeeding behavior that help to cultivate suppressed fertility. There’s nothing strange or terribly unique about the guidelines, the guidelines could also just as well be called “natural mothering practices,” but they are specifically studied in the context of suppressing fertility. It is highly recommended if you are practicing LAM to also follow the Ecological Breastfeeding guidelines as an additional precaution. If you are looking to child space instead of prevent pregnancy indefinitely, then Ecological Breastfeeding is an effective way to space births usually 18-30 months apart. You can find more information about this method here and by reading the book “The Seven Standards of Ecological Breastfeeding: The Frequency Factor” by Sheila Kippley.
• Cervical Fluid Methods
  There are a number of methods which teach cervical fluid (CF) observations. The most well known CF methods are: FEMM, Justisse, Billings, and Creighton. In these methods women chart their period and observations about their CF. Cervical fluid methods can be used postpartum while you are waiting on your return of fertility, because CF gives a biomarker indication of when you are becoming fertile. It also can be used to indicate the end of the fertile window, however during postpartum amenorrhea especially, there is a chance that CF could falsely indicate the end of the fertile window. So, even if it looks like your CF pattern is indicating ovulation has passed, you still need to treat all observations of CF as potentially fertile unless working with an instructor to establish a Basic Infertile Pattern (BIP). CF charting can be cross checked with a CB Monitor protocol and/or a BBT protocol. It is highly recommended to work with an instructor to learn and practice a CF-only charting protocol, especially postpartum. You can find more information about these methods on my Super Long List of Fertility Awareness Based Methods (FABMs).
• Hormone Monitor Methods
  (Clearblue Fertility Monitor protocol)
  Currently, only two methods have a protocol for using the Clearblue Fertility Monitor (CB Monitor). Those are the Marquette Method and the Boston Cross Check (BCC) method (more formally known as the Archdiocese of Boston Cross Check Method). CB Monitor charting can be used postpartum while you are waiting on your return of fertility, because it gives a biomarker indication of when you are becoming fertile. It also can be used to indicate the end of the fertile window, however during postpartum amenorrhea especially, there is a chance that the CB Monitor results could falsely indicate the end of the fertile window. So, even if it looks like your CB Monitor pattern is indicating ovulation has passed, especially during postpartum amenorrhea, you still need to follow the CB Monitor protocol from your method instructor. CB Monitor charting can be cross checked with a CF protocol and/or a BBT protocol. It is highly recommended to work with an instructor to learn and practice a CB Monitor method protocol, especially postpartum. You can find more information about these methods on my Super Long List of Fertility Awareness Based Methods (FABMs).
• Intercourse Dependent Birth Control
  (no charting to find safe/infertile days)
  Intercourse Dependent Birth Control (IDBC) or Non-hormonal/Non-IUD Birth Control is absolutely a part of a couple’s sex life if they choose to have protected sex when they are fertile. However, there is also the option to choose to not fertility chart in order to try to find “safe days” in your postpartum fertility season, and instead just use protection every time until your regular cycle resumes. These options include things like condoms, cervical barriers, withdrawal, and spermicide. It is important to realize that using any IDBC method when fertile is less effective than following a FABM and abstaining when fertile. It’s also important to consider the studied efficacy of the IDBC method you would like to use in relation to how seriously you wish to avoid pregnancy (your intention level) and make sure those two thing are in agreement. However, for many women the slightly lowered efficacy is an acceptable trade off. It’s a completely valid option, especially if fertility charting is new to you and you’re just feeling overwhelmed. There’s a lot of new life changes postpartum and some women are just not interested in adding learning a new fertility charting method to the long list of new things they’re already learning. That’s completely ok. Please contact me if you want to learn more about your IDBC options.

What about
Basal Body Temperature?

You absolutely can chart basal body temperature (BBT) while you are waiting on your return of fertility. In fact, an option that many women like to use for postpartum BBT charting is the wearable thermometer Tempdrop ($10 off coupon here). However, BBT should only be charted as a cross check fertility sign and not used as the sole indicator of fertility status during postpartum amenorrhea. This is because there is no inherent information in basal body temperature to let a woman know she is becoming fertile. There is biomarker information from basal body temperature to let a woman know when ovulation has passed. So, BBT is an excellent cross check for women waiting on their return of fertility to let them know that ovulation has occurred, they are now in their first postpartum infertile luteal phase, and to expect their first postpartum period soon.

My best advice for navigating the postpartum season is to work with an instructor, instead of feeling like you’re having to wing it on your own. If you want help sorting through your options for postpartum birth control, please contact me. We can work together to develop a plan that is best for you and your family.