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Home › Articles › Issues for Mom › Breastfeeding and Birth Control

Breastfeeding and Birth Control

Family Planning for
the Nursing Mother

By Michele St. Martin

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Barrier Methods
Most women are at least somewhat familiar with the better-known barrier methods: condoms, diaphragms and the cervical cap. "With perfect use and combined with spermicide, the pregnancy rate varies from 3 percent to 30 percent. However, with typical use, the pregnancy rates are much higher, ranging from 1 to 40 percent," Dr. Barrere says, adding that cervical caps "by far" have the most failures.

Denise Thomas and her husband use condoms in combination with FAM/NFP to increase both methods' effectiveness. "The diaphragm or gel-based spermicides are not an option, as I suffer from bladder infections when I use them," she says.

One reason for the high failure rate of barrier methods is that their inconvenience and messiness may mean that they are not always used. "Of course [the diaphragm] interferes with spontaneity and is messy and a little uncomfortable," Dr. Pearman says. "Also, you must be religious about using it if it's to work – I was."

Hormonal Methods
Hormonal methods are among the most effective contraceptive choices for a woman – and the most controversial for a nursing mother.

There's not much difference of opinion about a lactating woman using the standard combination estrogen-progestin birth control pill. "It has been well documented that taking contraceptives containing estrogen markedly reduces the quality and quantity of breast milk," says Dr. Barrere, summing up the prevailing opinion.

It's the mini-pill and other methods such as Depo-Provera injections and Norplant implant, that is subject to differing opinions. Michelle Bailey is currently using the mini-pill. "This particular brand does not reduce my milk supply," she says. "Once I'm not breastfeeding, I'll go back to a regular birth control pill because it is more effective."


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