Contraception: What are your options?

I have a three year old and I am eight months pregnant. After this birth, we are not interested in having any more babies. What contraceptive options, including surgery, are available?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

If you breastfeed exclusively, lactation amenorrhea (no period due to lactation) provides some protection. Condoms, a diaphragm or a cervical cap are effective, but again, not 100 percent and they require interruptions before intercourse.

The most effective non-surgical options are oral contraceptives -- progestin-only pills while breastfeeding, an IUD, Norplant (an implant good for several years) or Depo Provera (a shot every three months).

But if you're absolutely positive you don't want any more pregnancies, tubal ligation and vasectomy are good choices. Your mate could undergo a vasectomy before the birth to ensure his ejaculate is sperm-free when you resume intercourse.

Tubal ligation is a relatively simple procedure, which can be done the day after your delivery; however, it usually is performed with the patient under general anesthesia. If you delay, you must wait at least six weeks and, of course, endure another stay in the hospital or day-surgery clinic.

Some physicians like to know of planned tubals one to two months ahead of time, so discuss your desires with your provider at your next visit.

For in-depth information on contraceptive options, talk to your health care provider.

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