In memory of Chaya Mirel bat R’ Avraham

In memory of Chaya Mirel bat R' Avraham

Contraception while breastfeeding
05/02/2025

Question

Hi, I am supposed to be going to the mikva soon after the birth of my baby, now 7 weeks old. This is my first time exclusively nursing, in the past I have bottle fed.
I'm unsure about contraception. Many years ago I used (combined) pills which threw me into depression. It took a few years of treatment to get out of it and I am no longer on medication for it. I have since used only the nuvaring and thankfully this hasn't had the same depressive effects for me. However, I'm hesitant to try any other birth control other than what I know I'm ok with.
Nuvaring is not recommended for breastfeeding though as it reduces supply. I have worked really hard to be able to breastfeed this time and don't really want to risk it. I did not use the minipill previously so I'm aware the effects may be different than the combined pill, though i much prefer NOT to have to take a daily pill that is so super time sensitive.
I have the after birth doctor checkup coming up soon and not sure who to ask about other options. I don't really ask my friends who are breastfeeding what contraceptives they use and how that works out for them. The doctor is male and not Jewish, he will prescribe whatever I request but won't really be able to give advice on how each method works with breastfeeding, mikva etc. I have googled extensively but would just like to ask advice from someone who gets it and understands... A rav has recommended a cervical cap which I am nervous is difficult to use. Additionally, the checkup is in a few more weeks.
Should I delay mikva until only after this is sorted? Or is it better to go earlier but still wait until then before having intimacy?

Answer

Mazal tov on the birth of your baby!
Given your understandable reluctance to use a new progesterone contraceptive or to use a combined hormonal contraceptive at this stage of breastfeeding, the two main options to consider are the copper IUD and the diaphragm with spermicide. (To the best of our knowledge, the cervical cap is considered less effective in women who have given birth.) Please see our site's discussion of the IUD and diaphragm, and please get back to us with any follow up questions.
When nursing is more established, you could look into getting back on the Nuvaring, perhaps working with a lactation consultant to help ensure that you sustain milk supply.
Mikveh immersion postpartum, prior to having medical approval to resume sexual intimacy, can be very worthwhile in removing other constraints on a couple's conduct while in niddah. Sometimes, in consultation with their physician, a couple who have not yet worked out a long-term contraceptive plan find spermicide to be a sufficient contraceptive shortly postpartum. See further discussion of mikveh, resuming intimacy, and contraception postpartum on our site, here.
Please don't hesitate to follow up with us.

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