Dr. Amy Demarchi discusses the convenience, longevity, and effectiveness of various contraception options for established families
Most of us went to our first OB/GYN appointment as teens looking for help with our heavy periods, cramping, acne, or contraception. We were handed pills and have been taking them until it was time to have children. But women’s needs can change after having kids – and it may be time to explore some new options. There are many types of birth control available to help meet your needs once your family is fully established. I’ll discuss the range of options from temporary to more permanent solutions, and your provider can help you find one that works best for your family.
Reversible contraception
If you aren’t sure if you want more children, you might want to consider reversible birth control options. There are many more options than you might have been given at early visits to the gynecologist. Beyond condoms and pills, there are also contraceptive patches, vaginal rings, injections, implants, and intrauterine devices (IUDs).
The patch and the vaginal ring are, like the pill, combined hormonal methods of birth control. These methods combine estrogen and progestin to prevent ovulation. They help to regulate your period, make it lighter, and reduce cramping. If you like the idea of not having to take a pill every day, the patch only requires switching once a week, and the ring is inserted for 21 days at a time.
Birth control injections protect against pregnancy for 13 weeks, so you’ll only need to get an injection 4 times a year. Injections are given by an OB/GYN or other health care provider. It does take a little time to become pregnant after stopping injections, though. On average, it takes 10 months.
Implants and IUDs are long-acting, reversible contraception, sometimes referred to as “set it and forget it” methods. They last for several years, and you don’t have to remember to use them or worry about using them incorrectly. But when you are ready to stop using them, they can be removed at any time.
Some of these options may help with menstrual cycles more than others. If you have certain medical problems such as migraines with aura or high blood pressure, or if you are a smoker, you may need to exclude certain forms of contraception. Your provider can help you find an option that meets your needs.
Permanent contraception
If you (and your partner, if appropriate) are certain you do not want to have children in the future, you may also consider permanent forms of contraception, also known as sterilization. These forms of contraception are designed to be irreversible. They are safe and nearly 100% effective in preventing pregnancy.
Bilateral Salpingectomy
Bilateral salpingectomy is a surgical procedure to remove both fallopian tubes, which are the pair of ducts connecting your ovaries to your uterus. It is effective as a permanent form of birth control immediately after the procedure. Bilateral salpingectomy can be done immediately after delivery (at some hospitals) or at 6 weeks postpartum.
You’ll need to talk to your doctor in the weeks leading up to your due date if you’d like to have a bilateral salpingectomy immediately after your baby is delivered.
If you wait to have your salpingectomy until 6 weeks postpartum, you will undergo outpatient laparoscopic surgery and receive general anesthesia.
Bilateral salpingectomy is also a preventative measure for ovarian cancer, significantly reducing the risk. (A high percentage of ovarian cancers are believed to originate in the fallopian tubes.)
What is the difference between a salpingectomy and a tubal ligation?
A tubal ligation, commonly referred to as tubal sterilization or “getting your tubes tied,” is any procedure that interrupts the function of the fallopian tube to prevent sperm from reaching an egg, including a bilateral salpingectomy. Tubal ligation is a permanent form of birth control.
The term “getting your tubes tied” is misleading, as tubes are not actually tied during a tubal ligation procedure. Tubal ligation involves either cutting the fallopian tubes, removing the fallopian tubes (bilateral salpingectomy), blocking the tubes with clips or bands, or destroying or sealing the tubes with heat or chemicals.
A salpingectomy is now recommended over other forms of tubal ligation because it significantly reduces the risk of ovarian cancer.
Vasectomy
Of course, don’t forget your partner can get involved too. Vasectomy is a safe, outpatient procedure with minimal risks and recovery. This option is an equally effective permanent option for contraception once your family is complete.
Which options are most effective?
With regard to efficacy, the contraceptive implant is most effective at 99.95%, followed by the IUD at 99.8%, vasectomy at 99.8% and tubal sterilization at 99.5%.
If you are unsure regarding permanent sterilization, an IUD or implant is a wonderful option that can also help with heavy bleeding, cramping or pain symptoms all the way to menopause around age 50.
It’s a personal decision, but we’re here to help.
Ultimately, choosing your birth control options after having children is a very personal decision. There are many variables to consider, but we’re happy to help you find the right solution for you and your family.
To make an appointment with an OB/GYN provider at one of our Richmond, VA, locations, call VPFW at 804-897-2100 or message us to schedule online.
Sources:
https://www.acog.org/womens-health/faqs/long-acting-reversible-contraception-iud-and-implant
https://www.acog.org/womens-health/faqs/combined-hormonal-birth-control-pill-patch-ring
https://www.acog.org/womens-health/faqs/progestin-only-hormonal-birth-control-pill-and-injection
https://www.acog.org/womens-health/faqs/sterilization-for-women-and-men
