As a new mom, you have a lot on your plate — you’re learning to care for a brand new little human, after all. The last thing you probably want to think about is birth control.
Luckily, there’s one birth control option that towers above the rest when it comes to convenience: the intrauterine device, or IUD. If you hate the idea of having to remember to take a pill every day (one more thing to put on your to-do list? no thanks!), read on to see if the IUD could be right for you, particularly if you're planning to breastfeed.
What is an IUD?
An IUD is a small, T-shaped device that your practitioner inserts into your uterus to prevent pregnancy.
It’s known as a form of long-acting reversible contraception (LARC), meaning that once it’s inserted, your work is done. (The implant is another example of a LARC). But it’s also easily removed if and when you decide you want to get pregnant again, and it doesn’t affect your fertility at all.
How does an IUD work?
IUDs come in two categories: hormonal and non-hormonal. Hormonal IUDs work by releasing small amounts of progestin directly into the uterus, which changes both your cervical mucus and your uterine lining, making it harder for sperm to reach an egg and fertilize it.
The only non-hormonal IUD is the Paragard. It’s made of copper, which triggers a reaction that acts as a kind of spermicide.
When can you get an IUD after giving birth?
Anytime! In fact, some women have their IUDs inserted immediately after delivery. It's an easy way to check it off your to-do list, and it saves you an extra trip to the doctor. You can also schedule your IUD insertion for your first postpartum checkup (around the three-week mark).
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Can you get pregnant with an IUD?
No form of birth control is completely foolproof. But fewer than 1 percent of IUD users get pregnant, making it one of the most effective forms of birth control.
Does it hurt to get an IUD? What's the procedure like?
The procedure is very quick, normally lasting around five to 10 minutes. The insertion itself can be somewhat uncomfortable, but it shouldn’t be too painful. You may experience a minor backache or cramps (like slightly stronger menstrual cramps), but they should be manageable with OTC pain relievers or a heating pad.
Your doctor may also recommend that you take ibuprofen or another form of pain relief before the insertion, which can lessen any aches and cramps you may feel. Mild spotting is also normal. Within two or three days, you should feel like your normal self again.
However, if you experience any of the following red-flag symptoms following your insertion, call your doctor or head to the ER immediately:
- Fever over 100 degrees
- Chills
- Sudden, sharp stomach pain that doesn’t subside
- Bleeding so heavy that you’re soaking through pads every hour or two
- Faintness or dizziness
Potential IUD side effects
The side effects from your IUD are generally mild and differ depending on whether you have a hormonal or non-hormonal IUD.
Some common side effects of the hormonal IUD include:
- Acne
- Headaches
- Bloating
- Spotting
- Light or missed periods (in fact, many women find their period disappears altogether)
- Hair loss
The most common side effects of Paragard are cramps, heavier periods and spotting between periods. In fact, it’s not uncommon for women who switch from another form of birth control to Paragard to experience heavy bleeding for the first three periods or so.
The good news is that things should eventually settle down a bit and go back to normal. And if you're planning to breastfeed, it's less likely to be an issue since you may not get your first postpartum period for a while anyway.
But if you already suffer from heavy periods, the Mirena or another hormonal IUD may be a better choice. In fact, some doctors use hormonal IUDS to decrease abnormally heavy periods.
Types of IUDs
Wondering which IUD is right for you? Everyone’s birth control needs differ, so think about your lifestyle.
Does the idea of having lighter periods or possibly never having another period again sound like a dream? You might be a good candidate for a hormonal IUD. But if you’d like to avoid hormonal birth control for any reason or you can’t take it for health reasons, Paragard might be a better option.
It’s also helpful to think about if and when you may want to get pregnant. If you know you want to have another baby in three years or less, you might consider opting for Skyla over Paragard, for example.
What to know about hormonal IUDs
There are four types of hormonal IUDs available in the U.S.: Mirena, Skyla, Liletta and Kyleena.
Mirena and Liletta are effective for seven years, Kyleena works for five and Skyla works for three.
Can I use it if I’m breastfeeding? Yes. Hormonal IUDs are progestin-only, meaning they’re completely safe and effective for nursing moms, and there’s no risk of decreasing your milk supply.
What to know about non-hormonal IUDs (Paragard)
It’s effective for 10 years.
Can I use it if I’m breastfeeding? Yes. Because it’s completely non-hormonal, it won’t impact your breast milk at all, making it 100 percent safe for nursing moms.
Risks of IUDs
While IUDs are extremely safe, you do have a slight increased risk of pelvic infection the first three weeks after insertion.
And while getting pregnant with an IUD is incredibly rare, you may be more likely to develop an ectopic pregnancy, which is when a fertilized egg implants outside the uterus.
Ectopic pregnancies are rare — they make up around 2 percent of all pregnancies — but they can be dangerous. If you have an IUD and experience any of the below symptoms, call your practitioner:
- Breast tenderness
- Nausea
- Fatigue
- Vomiting
- Sharp pain in your lower abdomen that doesn’t go away
- Vaginal bleeding or spotting
- A positive pregnancy test
A third, unlikely — but serious — risk is a perforated uterus. While it’s extremely rare, occurring in fewer than 1 in 1,000 insertions, it can happen, and in the event that it does, you’re not protected against pregnancy.
Again, perforation is very rare, and it can cause intense pain, so you’ll likely have an idea that something is wrong. If that’s the case, call your practitioner ASAP.
Finally, keep in mind that it’s possible — though unlikely — for an IUD to be spontaneously expelled. (There's a slightly higher risk of this if the IUD is placed immediately after delivery.)
If you don’t feel the IUD string, call your doctor and use a backup form of birth control in the meantime.
What to know about IUD removal
Whether you’ve decided to have another baby (congrats!), switch birth control methods or have just reached the time limit on your IUD, you’ll probably consider having your IUD removed at some point in the future.
Luckily, the procedure is simple and short, and it’s completely safe to have an IUD removal at any time, regardless of how long you’ve had it.
When to call the doctor
While complications from an IUD are incredibly rare, major warning signs to watch out for include:
- Severe abdominal pain that worsens
- Bleeding while urinating or heavy bleeding outside of your period
- Foul-smelling discharge, which could indicate an infection
- Pain during sex
- You can’t feel your IUD strings, or they feel longer
Call your practitioner if you experience any of the above, whether you have a hormonal or non-hormonal IUD. While they may be unrelated to your IUD, it’s always better to be safe than sorry.
A major benefit of the IUD is that when everything is working as it should, you won’t even know it’s there. If that sounds like the right fit for your lifestyle, you may be a great candidate for the IUD — and if and when you decide you want to grow your family, it can easily and safely be removed.
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