Natural contraceptives: which ones are effective after the birth of a baby?

Natural birth control methods are on the rise. Following the various health scandals of the 3rd and 4th generation pills, by rejection of the chemical or the IUD, many women are turning to so-called “natural” contraception. We talk about “natural methods” to evoke the fact of identifying fertile periods and avoiding having sex at these times. The enthusiasm is such that the National Federation of Colleges of Medical Gynecology became concerned last year. In a press release, the federation warns that "these methods, badly applied, have a failure rate between 17 and 20%". This concern is largely fueled by the fact that smartphone applications and "home methods" are multiplying on social networks to offer alternatives to traditional contraception. You should know that some of these techniques are not reliable. Others are, but are not suitable for post-baby contraception. We take stock with Audrey Guillemaud, trainer in natural contraception and author of a book on the subject*

Fertility monitors: we forget!

First method that will not be suitable after a birth: electronic fertility monitors: "Most are not suitable for irregular cycles (which is specific to postpartum cycles), since their software does not 'often analyzes only the temperature and does not note the return of fertile and blood loss, which alone sign the opening of the fertility window'. If you used this software before having a baby, it may include a prognostic calendar calculation on previous cycles. As everything changes after pregnancy, they cannot be applied after childbirth. Normally, this information is on their leaflet.

Only the temperature method: no!

Another variant: the “temperature only” method (taking your body temperature every day when you wake up). It is not suitable for breastfeeding. Audrey Guillemaud explains: “We cannot observe a rise in temperature as long as we are breastfeeding because breastfeeding blocks ovulation (this is the case for many women). The woman could then take her temperature "for nothing" every morning for weeks without it rising (and making a big mistake: thinking that she will not be fertile until her temperature has risen). This would be a mistake because you can become fertile again at any time during breastfeeding: as soon as pre-ovulatory cervical fluid reappears (whatever it looks like) or as soon as any bleeding appears. The losses - seen or felt - are therefore the sign of the return of fertility and always occur BEFORE the thermal rise. The loss of blood or mucus is then a sign that the woman can then finally start taking her temperature again. Because fertility is restarting! »

Calendar method: deprecated

Among the poor students of contraception, we also find (unsurprisingly) "the calendar method or Ogino method". Indeed, this method can only work on completely regular cycles, since it is a calculation based on previous cycles, and not a self-observation of its current cycles, in the present. However, after a baby, we are on 100% irregular and unpredictable cycles... Even outside the postpartum period, this method of calculation on the calendar is "not recommended because it is unreliable" according to Audrey Guillemaud.

Withdrawal: it doesn't work!

Another even more disastrous method: "withdrawal", which consists of the partner interrupting coitus before the end of the sexual intercourse. Indeed, the “seminal fluid, which already contains sperm, is produced long before ejaculation. These sperm are fertilizing and can cause pregnancy at any time. A method which, according to Audrey Guillemaud, is more like "Russian roulette" and which would be more suitable for "a couple potentially open to a new birth" or for a couple who "accepts what comes".

Diaphragms: pay attention to size

As for barrier methods, for postpartum, Audrey Guillemaud advises against the majority of diaphragms within 3 months after childbirth. “In some women, the vagina enlarges and the muscle tone of the latter is less good. In this case, the diaphragm sometimes holds less well. In others, a space that is too small or too large at the level of the cervix appears: if a certain type of diaphragm was used before, it may no longer correspond to the correct measurement. Audrey Guillemaud's advice? “Six weeks after delivery, it is a good idea to “re-measure” the space around the cervix with the midwife to find out if the diaphragm is still the right size”. Note: if there was a descent of organs during childbirth, it can press on the diaphragm, or move it, hence the importance of an examination and a good follow-up with the sage. -female.

What reliable methods after childbirth?

If neither chemical nor mechanical contraception is desired, Audrey Guillemaud advises applying the “symptothermal method adapted to postpartum”. That is to say, an observation of the cervical mucus seen and felt, and blood loss. Or the Billings method (detailed here). “The symptothermia protocols adapted to the postpartum period are very practical for detecting all the signs indicating the real return of fertility. In particular because the famous "return of diapers" may have taken place with or without prior ovulation. Signs of mucus and bleeding are then valuable. »

The condom: effective as a barrier method

Finally, according to her, it is better to return to traditional barrier methods such as the use of condoms - by being strict about romantic relationships before putting on the condom (!). Some brands offer "ecological condoms", with organic or ecological lubricating gels to avoid harmful chemical substances which could disturb the vaginal flora. They are widely recommended. Look for RSFU and organic labels and read the compositions carefully, avoiding the addition of chemical substances.

For all of these methods, it is important to include the spouse. To prevent the mental burden of contraception from resting solely on the woman, it must be a couple's project.

The boulocho: kezako?

On this subject, Audrey Guillemaud also suggests exploring another natural method, special for men: thermal heated briefs, "testicle lifts" or "boulocho". “The brief itself does not heat up. The testicles are simply brought closer to the body and body heat acts. Pressing the testicles against the abdomen raises their temperature to 37°C, which blocks spermatogenesis. This device is kept several hours a day to be effective and is placed under the usual underwear.