1, you should know before delivery.
Generally speaking, women who have just given birth are not recommended to get pregnant again immediately. The main reason is that the physiological and psychological adjustment of postpartum women is not thorough. As far as doctors are concerned, it is not impossible to get pregnant soon after delivery, but at least half a year apart.
Inadvertently winning the prize within two months after delivery can increase the risk of pregnancy and abortion rate, and cause risks such as premature delivery and fetal malnutrition.
Many pregnant women usually pay attention to the health of pregnant women and their fetuses during prenatal examination. What they want most is how to have a good month after childbirth, and they usually don't care about postpartum contraception.
If the husband and wife have considered this issue in advance, such as ligation, they can think it over in detail before giving birth, and they can do this operation by the way during caesarean section.
However, most couples ignore the possibility of getting pregnant again after giving birth. When the wife accidentally got pregnant, she told the obstetrician and gynecologist that she was worried about what to do next.
Especially for lactating women, the menstrual period usually recovers late, so that they don't realize that they will get pregnant again, and often ignore contraceptive measures. When they are pregnant unexpectedly and don't want to give birth, it will also cause inner struggle.
Therefore, the best way is for both husband and wife to understand the importance of postpartum contraception and take appropriate contraceptive measures.
2. How long does it take to restore sexual life?
Because women who give birth naturally have to wait for the perineum to recover when they are in labor, it is about 4 ~ 6 weeks. It is more appropriate for doctors to check and confirm that the perineum wound has recovered and then go to the same room.
However, there is no perineal wound in caesarean section, and the recovery period of abdominal surface wound is about one week. Generally speaking, it is not so serious when the lochia comes out (usually about 2 ~ 3 weeks) or avoiding pressing the abdomen in the position of sex.
In addition, if lochia suddenly increases during sex, it is recommended to consult a doctor as soon as possible.
3. When do you need to start contraception?
If there is no breast-feeding person after delivery, or if there is a mommy who usually recovers better, ovulation will resume about one month after delivery. Therefore, most couples mistakenly believe that confinement will not "win the prize".
However, studies have shown that women can resume ovulation 25 days after delivery. Therefore, it is suggested that contraceptive measures should be taken actively after sexual life is resumed at least 20 days after delivery (no later than 42 days).
4. Postpartum contraceptive methods
(1) oral contraceptives
The principle of birth control pills is to control estrogen and lutein in women to achieve the effect of inhibiting ovulation. In other words, if there is no ovulation, there will be no pregnancy, or even if there is ovulation, the endometrium will be in a state that is not suitable for implantation.
Contraceptive pills are usually one of the better choices for non-lactating postpartum women; Even the reproductive endocrinology department often uses contraceptives to deal with irregular menstrual cycle, premenstrual discomfort, dysmenorrhea and other problems.
However, the disadvantage of contraceptives is that they may still lead to thrombosis and stroke, and it is best for women to use them 42 days after delivery.
Usually, better contraceptives have lower side effects and can be bought in general pharmacies. However, it is still suggested that if mommy doesn't know how to choose, it is better to consult a gynecologist first and then buy it herself.
Especially for women who have high blood pressure and are used to smoking, it is not recommended to take it because the risk is usually higher after taking it.
Use oral contraceptives during lactation, so will it be safe for your baby to drink milk?
Although the hormones contained in oral contraceptives are trace, there is no study to confirm whether it will affect or change the composition of breast milk, but contraceptives do inhibit lactation hormones and reduce postpartum milk secretion;
Therefore, if the parturient chooses to breastfeed after childbirth, besides using condoms for contraception during the recovery period, it is also possible to consider installing contraceptives and other contraceptive measures during the postpartum visit.
(2) Condoms
Condoms, also known as condoms, condoms. It is a universal, accessible, convenient and safer contraceptive method. It can not only prevent male semen from entering the uterus to get pregnant;
To some extent, it can also be used to prevent sexually transmitted diseases, such as syphilis and AIDS. However, condoms, a contraceptive method, must be worn during the whole process of sexual intercourse in order to play a complete role.
Usually, if mothers have oral contraceptives and install them, they may also wear an extra layer of condoms during sexual intercourse (the disadvantage is that a few people will feel bad). Condom is indeed one of the options that can effectively achieve safe sex.
(3) spermicide
At present, spermicide is rarely used in China. Because of the high contraceptive failure rate of spermicide (about 20%), it can only reduce the number of sperm swimming into the uterus, but can not really achieve the effect of complete contraception, so doctors usually do not praise this contraceptive method.
Because spermicide is a kind of gel emulsion, it seems convenient and quick to apply it to women's private parts to block sperm passage, but unless it is in the early lactation period (lactation period within 20 days after delivery), ovulation may not occur.
In order to slightly block the number of sperm swimming in, compared with other effective methods, this contraceptive method is generally not recommended. Especially when the female perineal wound is not completely healed, it may also bring slight irritation to the wound.
(4) Copper ion contraceptive device
Contraceptive devices containing copper ions are generally installed in the uterine cavity of women, which have "long-lasting" and "reversible" contraceptive effects. As far as the validity period is concerned, the above-mentioned contraceptives are short-lived, and women must take them every day (a box is usually about one month). It is relatively expensive and troublesome to take them on time every day.
But the so-called "reversibility" means that women can still get pregnant without destroying their fertility after use. For example, two years after installing the IUD, when a couple has a birth plan for their next child, they only need to go to the hospital to take out the installed IUD, so that they can restore the original fertility of women and get pregnant again without any influence.
However, copper ion contraceptive devices also have some disadvantages. Because the IUD is placed in the uterine cavity to prevent embryo implantation, it may cause a slight inflammatory reaction in the endometrium, thus causing dysmenorrhea or menorrhagia.
Secondly, it is not recommended that women who often have pelvic inflammatory disease use this kind of IUD. Because there may be a risk of bacteria increasing or hiding in the uterus.
As for the best time for installation, it is suggested that you can arrange it by the way during the follow-up visit 4 ~ 6 weeks after delivery. Except in areas where foreign medical resources are less common, women will install them immediately after delivery when the rate of follow-up visits by women is not high.
However, the postpartum uterus is still large and cannot be retracted into the pelvic cavity. Therefore, there is still the risk that 12% contraceptives will be squeezed out of the uterus during uterine involution and contraction.
(5) lutein contraceptive device
The use of lutein IUD is the same as that of IUD containing copper ions. The only difference lies in the principle of contraception. Lutein contraceptives do not stimulate the endometrium in a mild inflammatory state like contraceptives containing copper ions.
Instead, lutein is used to make the endometrium thinner, so that fertilized eggs are not easy to implant and achieve the effect of contraception. Therefore, the disadvantages of copper ion IUD become the advantages of lutein IUD, which provides the best contraceptive countermeasures for women with different uterine conditions.
For example, women with excessive menstrual blood are very suitable for using lutein IUD. Even if they are not used for contraception, they can improve the efficacy and function of women with menorrhagia or treat menstrual pain.
However, the price of lutein contraceptives is about four times that of copper-containing contraceptives, which is about NT$ 8,000 to NT$ 9,000. It is suitable for patients with pelvic inflammatory disease, adenomyosis and hysteromyoma.
In particular, it can effectively improve the most headache problems such as menorrhagia and excessive endometrial thickening in patients with adenomyosis. Because the release of lutein is very low, it has no side effects on lactating women.
Similarly, after installing contraceptives, women should go back to the obstetrics and gynecology department regularly for another check-up every year.
(6) Safety period
Safe period, that is, avoiding sexual intercourse within 2-3 days from the ovulation day when the basal body temperature suddenly rises, can provide regular menstruation for women to avoid ovulation, or make countermeasures for contraception or pregnancy.
But for postpartum women, the first menstrual recovery is late, and it is necessary to gradually establish a regular ovulation cycle. Therefore, it is still difficult to ensure effective contraception through safe period or basal body temperature measurement.
However, the use of basic temperature measurement can still help women know whether they have the possibility of ovulation, as another reference value for contraceptive measures.
In addition, don't think that contraception is neglected because you don't ovulate because your first menstruation hasn't come yet! Although there are ovulation and menstruation, some postpartum women don't ovulate for the first time.
Sometimes ovulation may still exist a few days after menstruation. Mommy should not ignore contraceptive measures to avoid winning the prize unexpectedly.
Therefore, whether it is postpartum or not, whether it is breastfeeding or not, mommy should be regarded as still likely to experience ovulation. Only by taking contraceptive protection measures as much as possible can we be absolutely assured.
(7) Interrupting contraception during sexual intercourse
The unwritten contraceptive method with the highest contraceptive failure rate is the so-called interruption of sexual intercourse or interruption of sexual intercourse. It is common that many young boys or girls lack common sense, or often admit that they didn't ejaculate because they tasted the forbidden fruit.
Or just hang around in women's private parts without breaking the hymen, thinking that there is no fact of sharing a bed, but in fact, a little semen is discharged from women's private parts or swims into the uterus, which still makes women pregnant, so this contraceptive method is the most inappropriate.
Usually within 24 hours after ovulation, it is called the best pregnancy. If no sperm meets the egg within 24 hours, the egg will naturally shrink. However, the high temperature period after ovulation is about 3 days, so there is still the possibility of pregnancy during sexual intercourse.
In contrast, the sperm quality can be up to 48 hours, but the survival time can be up to 3 days. In other words, if there are no contraceptive measures during sexual intercourse, sperm still have the opportunity to wander in women's private parts or uterus, so women still have the opportunity to get pregnant!
(8) Ligation (sterilization)
Strictly speaking, sterilization is irreversible. Therefore, Dr. He Xinyi pointed out that this contraceptive method must be carefully considered by family members.
Because, once both men and women are ligated, they can no longer have children. Therefore, unlike some people's misunderstanding, it is completely incorrect to think that ligation can be reattached in two years.
Secondly, if you go back on your word after ligation, the success rate of fallopian tube (or vas deferens) recanalization is very low, and the probability of forced pregnancy leading to ectopic pregnancy is also very high.
Therefore, usually only one child has been born, and most doctors will ask mommy to think clearly before deciding whether it is really necessary to have such an operation, or ask mommy to consider using other methods of contraception first.
The so-called ligation method is to tie up the fallopian tube (or vas deferens) and disconnect it directly through surgery; You don't just ligate the fallopian tubes (or vas deferens).
In addition, many people think that ligation will affect mood, obesity, menstrual disorders, sexual dysfunction and so on. But in fact, neither men nor women will.
Because the operation only moves to the fallopian tube (or vas deferens) and not to the ovary (or contraceptive), the hormonal function of the ovary is still the same, and ovulation can still be carried out as usual.
There will also be menstruation, but the discharged eggs will not encounter sperm in the fallopian tube, and the discharged eggs will naturally be absorbed by the human body in the abdominal cavity.
5. Contraceptive skills after abortion
One: placing an intrauterine device
IUD can be placed immediately after induced abortion, but it needs to be confirmed that there is no residue and infection. Putting intrauterine devices after induced abortion has certain experience and technical requirements for doctors. If the patient is likely to be infected, the placement of IUD should be postponed until 3 months after induced abortion. After placing intrauterine device, it may have a certain impact on patients' lives. Do not engage in heavy physical labor within 1 week after placing, and avoid sexual life within 2 weeks. Within 3 months after placement, you should pay attention to whether the IUD falls off when going to the toilet or taking a bath, and the patient should go to the hospital for regular follow-up examination.
Two: long-acting contraceptive needle
After induced abortion, you can choose a long-acting contraceptive needle for contraception. At present, there are many kinds of long-acting contraceptive needles used clinically in China, but if this contraceptive method is adopted, women need to go to the hospital for injections regularly (depending on drugs, 1-3 months), which may bring inconvenience to women's lives and may also produce some side effects, such as menstrual changes.
3. Preparation for subcutaneous embedding
Before placing subcutaneous implants for contraception, women should consult a doctor, because menstrual changes may occur after placement, such as dripping bleeding, and the cost of this operation is high.