So here's my educational rant about why I hate sex right now.
Other important thoughts to have: Breastfeeding can be heavily impacted by the choice of contraceptives. Hormonal methods especially can be a concern. So here's why I can't find a good method to not get pregnant.
Barrier methods: these put up a physical layer of protection between egg and sperm. All of these are safe for breastfeeding, YAY! Unfortunately you can feel most of them.
Condoms: these suck, need I say more? Now don't get me wrong, I'm super glad they exist. They're nice because they don't require much preplanning as long as you have them. Decent shelf life, relatively cheap and they protect against STDS. That being said, I got married to NOT have to worry about disease and to not have to feel these. I just hate the way they smell and feel. Also, the protection rate isn't amazing.
Female condoms: all of the above disadvantages PLUS they are MORE likely to fail and make a terrible noise while being thicker and therefore MORE desensitizing. An image: a large plastic ring outside the vagina attached to a plastic bag in the vagina. Need I say more? Again, these have the advantage for teens or any more promiscuous person they give the control to the woman which is nice in some situations. For the monogamus married couple? Why have more icky plastic?
Diaphragm: I've never used one, but I have considered them. I like the idea because they can be inserted much ahead of time, so you can be slightly more spontaneous. Pros: you can't feel it, there's no hormones. Cons: effectiveness isn't great, learning curve on insertion, expensive and need a prescription, have to use spermicide with it which can be an irritant.
Paragard: this doesn't EXACTLY belong on this list, but it's non-hormonal and didn't belong on any other list. This is a copper based IUD (intrauterine device). Basically a tiny little piece of T-shaped plastic with copper embedded in it. Copper is toxic to sperm and irritates the uterus to make it even less hospitable to any potential egg. Pros: Non-hormonal (breastfeeding safe), highly effective, good for 10 years, can be ignored most of the time. Cons: needs inserting & removal at doctor's office, associated with significantly heavier periods with more cramping, can puncture uterus or adhere to the side both of which are significantly more likely to happen post c-section and which can result in a loss of fertility.
Hormonal methods: these methods all use hormones to make the women's body either not ovulate, or make the uterus/cervix/vagina inhospitable to sperm and fertilized eggs.
*Some of these are LISTED as safe for breastfeeding however there is still a 25% chance that milk production will be negatively affected.
The pill: this has a synthetic estrogen as well as progesterone. While these are highly effective and relatively forgiving of pill accidents such as taking a pill at the wrong time or on the following day - the estrogen pretty much halts all milk production in its tracks. Pros: effective, safe, and tends towards forgiveness with pill schedule. Cons: Still have to take every day, need to refill prescription regularly, and not breastfeeding safe.
The "mini" pill: this is a progesterone only hormonal pill. Therefore, it IS breastfeeding safe*. However, this pill needs to be taken at the exact same time each day. Deviate by more than an hour and it's effectiveness is greatly reduced. For anyone struggling with a daily routine this can be difficult at best. Pros: easy to adapt to if you're used to the pill, breastfeeding friendly*, if milk production IS impacted you can cease immediately. Cons: very very time sensitive, still not quite as effective as the regular pill.
Ring: this is a progesterone only vaginal ring. It's worn for three weeks and then discarded. For those comfortable inserting it, it's a relatively simple, effective method and you generally can't feel it during intercourse. Pros: only have to deal with twice a month, breastfeeding safe*. Cons: it can slip around so that you feel it during sex, insertion can be tricky, if milk production IS impacted it can take a week or so for the hormones to leave your system.
Patch: this is a progesterone only stick on bandage. Placement is easier than the ring, but it's more noticable visually. Otherwise, it's pretty much the same.
Implant: this is a progesterone only plastic rod inserted under your skin, usually on your arm. This lasts for 3 years. However, you can see and feel it below your skin. Mostly it's the same as the patch or ring but it can take even longer for the hormones to dissipate after removal. On the upside though, you don't have to deal with it monthly.
The shot: this is so much like the implant, but in a shot form. Additional pros: you can't see or feel it. Additional cons: have to go to doctors office once every 3 months, and might take a while to become fertile again after final shot.
Hormonal IUD (Mirena or Skyla): this is the same as the Paraguard IUD, except instead of using copper it uses progesterone. Again, this is supposedly breastfeeding safe*. On the plus side, the side effects are a likely LIGHTER period with LESS cramps. However, it carries all the same potential concerns for mothers post c-section, plus if your milk production is affected, it takes some time to get the hormones out of your system as well.
Natural methods: these include all the options I can come up with for how to not get pregnant with out any special devices or drugs. Some are much better than others, but ALL are breastfeeding friendly :) Plus you definitely can't feel any devices!!!
Pull out: well, it's not the most or least effective thing on the list, but it works for some people. It tends to be messy and can take some of the fun out of the deed - not to mention can be difficult. If you combine this with the FAM (fertility awareness method) below it can be an option for some days. Keep in mind though that even if you're not fertile and if you succeed at the timely withdrawal - there could still have been enough sperm present to knock you up.
Rhythm method: this is an outdated idea that all women pretty much have the same length cycle plus the same ovulation day and are very "regular". The idea is using condoms/pulling out/abstaining only on the four days immediately before ovulation each month and otherwise doing as you please. They base those days either off a standard 28 day cycle with ovulation on day 14 OR base it off of your standard length cycle (whatever that is) and assuming you ovulate 14 days before the end of it each time. It's got some bases covered, but doesn't really adapt for women with irregular cycles, which are especially common postpartum and/or while breastfeeding. It also doesn't take into account months with multiple ovulations - which some women are more prone to. Even if you are regular and only ovulate once a month and guess correctly on your ovulation days, this still involves using another method when your fertile (aka more likely to be frisky).
FAM (fertility awareness method): this uses tracking different fertility signs and symptoms to predict ovulation and therefore to abstain or use other methods on your fertile days. I'm not going into the whole thing but here's a link for more info. It involves checking out your cervial mucous, checking your body temp everyday and other lovely signs to predict ovulation and making sure to not be unprotected on those days. Plus sides: this method teaches you to be aware and you can also use it to PLAN a pregnancy later, it's easy enough to learn, breastfeeding friendly, very cheap, takes into account your specific cycle! Cons: again with forcing you to abstain or use something on your most fertile & frisky days, takes some training, still involves some predictive guesswork, and all of your fertile signs can be obscured or changed while breastfeeding - making it harder to do correctly.
Breastfeeding: in an of itself, breastfeeding can suppress ovulation in some circumstances. You have to exclusively breastfeed with no supplementing, your period still has to be gone, and you have to feed your baby every 4 hours maximum during the day and 6 hours maximum overnight. It can also be used for only 6 months, after that the likelihood of your period staying away diminishes and the likelihood of you spreading out feeds AND starting your baby on solids goes way up. This is the option I was planning on if I had had a vaginal birth. I did not have to be as worried about baby spacing in that case, so I would have felt safe enough with this as the primary plan up until 6 months. Effectiveness rates are around 98% for 6 months, assuming you follow all the guidelines!
Abstinence: this is by far the safest and most effective method out there. Sometimes, for a period of time after birth, this is by far the best option. I'm not judging! However it's not the best long term solution for a married couple - most likely.
So, what am I to do?
Well, considering that too early of a pregnancy can result in a traumatic uterine rupture, I'm VERY scared to get pregnant soon. Also considering my fear of another c-section I REALLY want to not conceive for at least 10-12 months after Legan's birthday. I am breastfeeding and due to his intolerance to milk entirely the idea of him potentially needing formula is AWFUL as most formulas are cow's milk-protein based. Either he'd be sick most of the time or on an expensive specialty formula. No thank you! So therefore I'm really uneasy with even the 25% chance of milk reduction for any hormonal method. I've fallen into so many extremely small statistics lately during pregnancy and birth that I don't trust those odds at all. I don't trust the effectiveness rates of pulling out, diaphragms, or the tracking methods mostly because my body is NOT anything like it used to be. I don't trust myself to effectively read the fertility signs everyday when I can't figure out what the new normal is.
That leaves icky condoms, abstinence, and Paragard. With the much worse period PLUS the potential for adhesion to my internal scar or popping right through my uterus and total fertility loss - I really can't find any way to be OK with Paragard. When I decide for sure that I'm done having kids and assuming I haven't had any further c-sections by then, I'm willing to consider an IUD because then if any of the bad complications happen it doesn't affect me as strongly, and maybe I'd be willing to chance the terrible periods. Condoms are so....SO....SO gross. And for me, they really ruin the sex. Not only do they remind me of high school, but they take SO much feeling out of it and add SO much smell factor. I just don't like meat shrink-wrapped, and I honestly don't really trust the effectiveness rates all that much. I'm willing to go along with it DURING my safe 6 month breastfeeding time. After that...I don't know what I'm going to do. Maybe I can try the mini pill once Legan starts solids, so that if my supply has issues it's not as big of a deal for us. But, I'm only willing to try that if he's also on something of a routine by then, because I'm not at all OK with setting an alarm for either first thing in the morning or last thing at night and chancing waking me up when I'm trying to eek out more sleep. I'm also really not confident in setting an alarm during the day at a random time and just taking it always at 2 pm or something because I don't carry a purse at all and frequently don't have pockets so I have no good way of making sure that they're always on my person and available for the taking.
So I guess in short - I HAVE NO IDEA OF WHAT IS A GOOD WAY TO KEEP FROM GETTING PREGNANT TOO SOON other than to just not have sex at all. So, divorce I guess?
Just kidding! He's too good of a guy to divorce me just for cutting him off for 10-12 months. But honestly, I'd like to make sure I have some leeway to make other mistakes still.
So I'll keep searching for other options. I can't imagine how badly I would handle it if I managed to get pregnant too soon.
