Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Postpartum staining and contraceptive options

21 July, 2015

Question:

Hi! Thank you for your wonderful site and for this opportunity to ask you a question.

B''h I am blessed with 5 children. My oldest is 7 years old and my baby is almost 5 months. After every birth I bleed for at least 6 months and then it gets less and less, usually stabilizing to normal periods by a year after the birth. I don't have to explain to you how hard it is to be a nidda for so many months. Even if I am successful at going to the mikvah, it usually only lasts a few days. It's not just staining, it's like I get a second period every month. I went to the mikvah once last month and it lasted less than a week.

The problem is that I need to use a good form of birth control. I have tried all the pills and I get so nauseous from them that it's not worth it. Last pregnancy happened while using spermicide, so that's not an option now. The diaphragm is OK but there is still a 16% chance of pregnancy. My doctors and rabbi think I should get an IUD. After reading all the side effects online, I got nervous and cancelled my Mirena appointment. Now a different doctor says I should get the copper IUD. I am still nervous about the side effects (I am very sensitive and I get reactions from things that no one else seems to be affected by) and I am also nervous about bleeding forever on the copper IUD.

What should I do? I am really afraid of the IUD and what it will do to me. I really want to be a good wife. But we are not ready for another baby now. You might tell me to get the IUD, it's not so bad, other people have no problems with it. Then I should only do 2 bedikas and go to the mikvah even if I'm staining. So maybe that's my only option…. But if I am staining, but the last bedika is still OK, and I go to the mikvah, are relations allowed that night? Do we have to wait till staining stops? It's hard to know what's staining and what's a real flow.

Thanks for listening and I appreciate your advice!


Answer:

Mazal tov on the birth of your baby!

Given your staining history, we suggest that you reconsider using the diaphragm.  Used properly in conjunction with spermicide, it has a failure rate of much less than 16%.  (Success is usually given as 95-98%.)  For added contraceptive efficacy, you may wish to combine diaphragm use with the fertility awareness method (FAM).  Both the diaphragm and FAM are discussed on our site under "Family Planning".

If you have not already, we also suggest that you discuss your prolonged staning with your physician.  Once its cause is well understood, you may find that the staining is treatable.

When a woman has staining that does not make her niddah, relations are permitted.  We usually advise against them as a precaution against a flow developing during relations.  But in cases such as yours, where staining is prolonged, we would not recommend abstaining.

Please write back with any follow up questions.


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