Postpartum family planning.. prevention of unplanned pregnancies, avoiding a new pregnancy very quickly after childbirth

Postpartum family planning:

Postpartum family planning focuses on the prevention of unplanned pregnancies, avoiding a new pregnancy very quickly after childbirth.

This is important because this ensures proper breastfeeding and care for the newborn for at least the first two years of life.

For this reason, it is recommended to obtain counseling for contraception after childbirth and the breastfeeding period.

Risks of pregnancy at close periods:

Pregnancies separated by short intervals of time are those that present the greatest risk for the mother and the newborn.

Very close pregnancies can bring problems such as: premature births, low birth weight and small babies for gestational age.

In fact, the highest risk of infant mortality occurs when a woman becomes pregnant again within 12 months of her first pregnancy.

If parents wait 24 months to conceive again, the mortality of children under 5 years of age decreases by 13%. If the period between pregnancies is extended to 36 months, the decrease will be 25%.

Benefits of proper postpartum planning:

Proper postpartum planning can prevent more than 30% of maternal mortality and 10% of infant mortality as long as couples manage to space two years between each child.

Adequate postpartum contraception has allowed many couples to achieve the desired family composition, thereby reducing the appearance of dangerous scenarios for both the mother and the baby.

Having information and advice of this type is important to make conscious and healthy decisions for the future.

Planning needs:

The goal of postpartum family planning is to help women decide which contraceptive method they want to use, when to start it, and how to continue using it for two years or more, based on the reproductive decisions you make with your partner.

After childbirth, mothers remain without menstruation for variable periods of time according to their breastfeeding practices.

Women who do not practice exclusive breastfeeding (breast milk + formula milk) can become pregnant before the return of menstruation and pregnancy can occur within 45 days after delivery.

It is important to consider sociocultural expectations and norms about resuming sexual activity after childbirth.

Sexual activity in the first weeks after birth:

It is recommended to postpone sexual activity in the first six weeks, known as diet; this favors the reduction of physiological inflammation, the healing of tissues in the case of vaginal tears or surgical wounds, and the regeneration of the abdominal wall in the case of caesarean section.

It should be noted that after childbirth there is a vaginal secretion that corresponds to the expulsion of residual tissues, occurring in a variable way in the six weeks following it.

At the same time, the uterus returns to its normal size with painful spasms and a progressive closure of the cervix.

The affectation of this process through early relationships favors the appearance of infections, painful intercourse (dyspareunia) associated with a lack of vaginal lubrication and a natural decrease in sexual desire, this change in libido being a natural prevention mechanism to promote recovery mother, breastfeeding and baby care.

Transient methods:

Women who breastfeed or breastfeed their babies can start using all progesterone-only birth control methods (shots, implants, and pills) as early as 6 weeks after delivery.

In contrast, pills that combine it with estrogen (oral contraceptives for routine use) cannot be started until six months after delivery.

Breastfeeding women can use the amenorrhea method (lack of menstruation after childbirth), always accompanied in a complementary way with the use of a condom, diaphragm or cervical cap. As for emergency contraceptive methods, these can be used only if warranted.

Likewise, the IUD, an intrauterine contraceptive device (with copper or with progestin) can be inserted after six weeks postpartum, when the uterus and cervix have already returned to their normal state.

definitive methods:

These must be taken into account when you no longer want to have more children, either by your own decision, or by medical indication in the presence of diseases that endanger the life of the mother in future pregnancies.

Female sterilization (Pomeroy or cutting and ligation of the fallopian tubes) can be performed immediately after delivery if it was vaginal, or intrapartum if it was cesarean section; In addition, it can be done at any time after six weeks after delivery.

Male sterilization (vasectomy), on the other hand, can be performed on the spouse at any time before or after childbirth.

It should be noted that its effectiveness is confirmed when the subsequent spermogram shows a sperm count equal to zero; otherwise a complementary method such as a condom should be used.

Thus, the mother does not require the implementation of other postpartum planning methods.