--- title: "Contraception after a birth" description: "When fertility can come back, contraception options while breastfeeding, and the rules for using breastfeeding as contraception." url: "https://myruva.co/learn/contraception-after-birth" language: "en-GB" topic: "After a birth" published: "2026-10-18" updated: "2026-10-19" author: "Ruva team" reading_minutes: 4 --- # Contraception after a birth When fertility can come back, contraception options while breastfeeding, and the rules for using breastfeeding as contraception. *Written and reviewed by the Ruva team · Updated 2026-10-19 · After a birth* ## Key points - You can get pregnant 3 weeks after giving birth, even before your period comes back. - Several methods can be used straight after birth, including while breastfeeding. - Breastfeeding only works as contraception under certain conditions. Expressing milk may make it less reliable. - When you can start combined hormonal contraception depends on breastfeeding, your risk of clots and local guidance. You can get pregnant 3 weeks after a birth, even if you’re breastfeeding and haven’t had a period. If you want to avoid pregnancy, make a contraception plan before you start having sex that could lead to pregnancy again. ## When you can start each method Your midwife can talk to you about contraception after the birth, and you can ask a GP or sexual health clinic at any time. Tell the clinician whether you’re breastfeeding and what you want from a method. Ask when you can start it, whether you need extra contraception at first, and who to contact with questions. The table below shows NHS guidance. Your clinician can help you use it to choose a method that suits you. Advice differs between countries, especially for combined hormonal methods while breastfeeding. | Method | NHS timing after birth | | --- | --- | | Progestogen-only pill, implant or injection | Can be started straight after birth, including while breastfeeding. | | External or internal condoms | Can be used straight after birth. | | Copper IUD or hormonal IUS | Can be fitted within 48 hours. Otherwise, you usually wait until 4 weeks. | | Combined pill, patch or vaginal ring | From 3 weeks if not breastfeeding and a clinician confirms no clot risk factors. Usually at least 6 weeks if breastfeeding. | | Diaphragm or cap | Usually around 6 weeks. Have the fit checked again. | ## Your options while breastfeeding You have several options while breastfeeding, including progestogen-only methods and coils. The US CDC also allows an implant to be fitted in the weeks after birth, including while breastfeeding, once a clinician checks it suits you. Ask how your feeding plans affect the method you’re thinking about. Combined pills, patches and vaginal rings contain oestrogen and a progestogen. A clinician needs to check when you can start them. The NHS usually advises waiting at least 6 weeks while breastfeeding. CDC uses more detailed groups. Combined methods are ruled out before 21 days and usually avoided from 21 to <30 days. They may be considered at 30–42 days for breastfeeding patients with no other risk factors for clots. Ask your clinician to explain the local guidance and check whether a combined method suits you. If you’ve already been prescribed a method, talk to the prescriber about any worries before changing it. ## Using breastfeeding as contraception The lactational amenorrhoea method (LAM) uses breastfeeding to delay ovulation (the release of an egg). It only works as contraception under certain conditions. The NHS says you must breastfeed at least every 4 hours in the day and every 6 hours at night. LAM only applies in the first 6 months after birth. It stops being suitable if your periods come back or you give your baby formula or solid food. Expressing breast milk may make it less effective, though there’s little research on this. US CDC criteria are: no periods, fully or nearly fully breastfeeding, and less than 6 months since the birth. The gaps between feeds must be no more than 4 hours in the day or 6 hours at night. The wording about feeding differs from NHS guidance. So ask a trained clinician to explain the method used where you get care. Plan another method if feeds become less frequent, night feeds stop, you start formula or your period comes back. The NHS counts even light spotting as a reason to start another method. When feeding changes, ask for advice rather than assuming the old plan still works. ## Fertility awareness and app estimates Ruva’s estimates are not contraception. NHS advice says fertility awareness methods need to be taught by a trained professional. It doesn’t officially recommend fertility-tracking apps or devices. LAM doesn’t protect against sexually transmitted infections either. Condoms lower the risk of passing on infections. ## Getting advice after unprotected sex If you’ve had sex without effective contraception and want to avoid pregnancy, get help today. In the UK, contact a sexual health clinic, GP or pharmacist. In the US and elsewhere, contact your doctor or local contraception service. Emergency contraception works best when taken soon. Tell them when you gave birth, when you had sex, whether you’re breastfeeding and what contraception you’ve used. Then they can advise what you need and what suits you. For a planned method, book a contraception appointment with your GP, midwife or sexual health clinic in the UK, or your doctor or midwife elsewhere. Take your questions about feeding, start dates and any medicines you take. ## When to get help - **Same day:** Contact a sexual health clinic, GP or pharmacist today (UK), or your doctor or a local contraception service (US and elsewhere), if you’ve had sex without effective contraception and want advice about emergency contraception. Tell them when you gave birth and whether you’re breastfeeding. - **Book an appointment:** Book a contraception appointment with your GP, midwife or sexual health clinic (UK), or your doctor or midwife (US and elsewhere), to talk about a method and when you can start it. ## Where you live Services and advice differ between countries. - **UK:** If you’re breastfeeding, NHS advice usually means waiting until at least 6 weeks after birth for combined pills, patches and rings. Coils can be fitted within 48 hours, or usually from 4 weeks if you miss that window. - **US:** CDC allows some breastfeeding patients with no other risk factors for clots to use combined methods at 30–42 days after birth. A clinician checks whether this suits you. - **Elsewhere:** Elsewhere, ask your local contraception service which methods and timings apply while breastfeeding. Don’t assume UK or US start dates apply everywhere. ## Sources 1. [Sex and contraception after birth](https://www.nhs.uk/baby/support-and-services/sex-and-contraception-after-birth/), NHS 2. [Natural family planning](https://www.nhs.uk/contraception/methods-of-contraception/natural-family-planning/), NHS 3. [Combined Hormonal Contraceptives](https://www.cdc.gov/contraception/hcp/usspr/combined-hormonal-contraceptives.html), CDC 4. [Emergency contraception](https://www.nhs.uk/contraception/emergency-contraception/), NHS 5. [Implants](https://www.cdc.gov/contraception/hcp/usspr/implants.html), CDC 6. [Appendix G: Lactational Amenorrhea Method](https://www.cdc.gov/contraception/hcp/usmec/lactational-amenorrhea-method.html), CDC --- This guide is general information to help you keep and use your own records. It isn’t medical advice. If you’re worried about a symptom, or something changes suddenly, talk to a doctor, nurse or pharmacist.