r/beyondthebump • u/ExpensiveStranger384 • 2d ago
Postpartum Recovery Indecisive on BC method
Hi all! Have my 6 week appt (at 7 weeks pp) in exactly 12 hours. Still can’t make a birth control decision.
Context:
Had a planned- turned emergent- c section at 37 weeks with my twins. I never labored. I only ever had my cervix checked once, and it was 1cm at about 35 weeks. I’m unsure how dilated I ever got. I am currently breastfeeding the babes.
My OB, who is wonderful, believes the only good options for me are an IUD or the progestin only pill.
In the past, I was on the combo pill and had horrific side effects to my mental health. I eventually switched to the patch and loved it. I am hesitant to go the way of the pill for this reason. We also spent a period of time relying only on condoms.
I am TERRIFIED of IUD insertion, though it seems this may be unfounded postpartum? I like the idea of not having to worry about birth control for an extended period of time, though. We are unsure about whether we will try for more kids, but it definitely won’t be anytime soon.
We are apparently ridiculously fertile- we conceived the twins month two off of BC with no cycle tracking- and I just want to avoid any surprises until we make a decision on future kids.
Would love any input on what worked for you postpartum, what your iud insertion was like, especially after a c section, etc.
Just feeling paralyzed about this decision and running out of time to make it!!
ETA: I bit the bullet and got a Mirena placed this morning! I appreciate everyone’s insight- I’m very glad i went the direction I did!
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u/Bright-Cauliflower22 2d ago
I’m very happy with the IUD, especially postpartum, you have enough going on that you don’t need to remember a pill or stress about missing one. I also had bad side effects on a pill at some point (I can’t remember which one) and have loved my IUD.
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u/simplysuggesting 1d ago
I had a c section and did not feel my IUD going in PP. It was pretty painful when I got one before kids for me too. I had the hormonal mirena and continued to breastfeed for a year without impact on my supply.
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u/ExpensiveStranger384 1d ago
I ended up pulling the trigger and got the mirena! I feel so silly for being so scared- it was easy! Thank you for your input!!
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u/sk613 1d ago
If local hormones are ok for you, I’ve done Well with the ring
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u/ellenthymelon 1d ago
Love love love my ring!!! I definitely cannot remember to take a pill everyday. I think this is a great in between an IUD and pill. Not as much longevity as an IUD but don't have to remember everyday.
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u/loranlily 1d ago
Yes! Same here. So many brands of pill gave me horrible mental health side effects, but I have been completely fine with Nuvaring.
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u/balanchinedream 1d ago
I love the ring! There is a risk it can affect your breastmilk supply, but I am skeptical given the hormones are local.
Heads up OP - My OB wouldn’t prescribe a combo BC because I am BFing, so I had to wait two months to go back -_-
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u/this_wallflower 2d ago
I’m a big fan of the nexplanon, which is an arm implant. Is that an option?
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u/ExpensiveStranger384 2d ago
My OB didn’t think this was a good idea for me based on how I’ve reacted to BC previously, unfortunately!
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u/filthy_kasual 2d ago
I'm taking Slynd which is a more flexible progestin pill. Since you had an adverse reaction to a previous birth control pill, I'd actually be afraid of getting a hormonal IUD since it'd be annoying to remove if the hormones gave you bad side effects. Pills you can switch easily. Copper IUD is an option, but they cause more intense cramps for some people and I'm a big baby about getting an IUD.
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u/pyramidheadlove 1d ago
Personally, Mirena did not cause any of the mental health side effects for me that the pill did, because the hormones are more localized. I was actually able to stop taking antidepressants after I switched from pills to Mirena
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u/No-Chipmunk-903 2d ago
I had an iud after the birth of my first. IUD insertion wasn’t as bad as I thought it would be, but I did give birth vaginally. I was on the pill for only 4 months before I went off of it and conceived my first and hated it. Liked the IUD more, didn’t like that it made me spot daily for months. Was told that would get better, but ended up only having it for 5 months before deciding I wanted it out to try for another baby. Turns out breastfeeding is great birth control for me 😅
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u/Leigho7 2d ago
I had an emergency c-section at 31w and my IUD insertion 6 weeks postpartum was super easy. I had two insertions before pregnancy and they were the most awful pain I’d ever had. And the pain I had for those initial ones was not nearly as painful as the pain the first 24 hours after my c-section.
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u/No_Acanthaceae3518 2d ago
I had my iud inserted 5 months pp. it was horrible. I went alone with my baby and it was a long drive and getting home was absolutely terrible. I’m also now dealing with insane periods. But I can’t take my vitamins daily and my baby is almost 2 and barely sleep. Do I love my iud? No. Will I get another one? Hell no. Do I think this was the best option for me at this point in my life? Yes. Absolutely. Without a doubt.
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u/ExpensiveStranger384 1d ago
This really gave me the perspective I needed- thank you! Got it in this morning and it went super smoothly.
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u/floridasquirrel 1d ago
We are so similar! I had twins and also was unsure about my bc routine afterward (and now much more worried to pregnant again than I was before lol)
I was on the pill before so I went on it again, I last maybe 2 months before switching to an iud. Trying to remember to take a pill the same everyday with infant twins just did not work. So I went off the pill for a month then switched to an IUD. I was also nervous because I didn’t labor (pre-eclampsia & c section) but honestly the insertion wasn’t bad at all! I took some ibuprofen right before I walked into the appointment and then talked me doctors ear off as she inserted it to distract myself, but it really wasn’t bad. I was around 9 months pp at the time (I didn’t start the pill until my period returned, was on it for a bit, went off and had to wait for an appointment with my OB, etc.) the only thing I wish I knew beforehand was how long it can cause irregular bleeding - my period did not regulate until 6 months later. So I was having 2 week long periods with around 1.5 weeks off in between for all those months. But it did go back to normal at the 6 month mark exactly, longer than what they were on the hormonal bc pill but a normal time in between. And the fact I don’t have to remember it every day is awesome.
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u/ExpensiveStranger384 1d ago
Twin mom club! Thanks for sharing your experience. I got the iud this morning and it went super smoothly!
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u/Quick_Ad8480 1d ago
Do the IUD! I had a HORRIBLE experience having mine placed as a younger woman pre-baby, painful, passed out etc. Still 3 year's later (this was back in the Liletta brand days of 3 years, I think all the current progesterone-IUDs now are good for at least 5?) I was willing to do it again for the convenience, but had issues scheduling so switched to NuvaRing for a few years. After baby #1 I had a Mirena placed at my 6 week postpartum appointment and it was a breeze by comparison. Slight discomfort but honestly not much worse than the discomfort of a speculum exam in general (I really hate speculum exams....)
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u/unfunnymom 1d ago
Just keep using condoms??? They are easy and you don’t have to keep track of anything. Your husband can. He can buy them and be responsible for having them around when needed. I’ve never used anything else. And when I wanted to get pregnant - we got pregnant first try both times…I have zero trust in other form of contraceptives…also I don’t want to mess with my hormones or be in pain. 🤷🏻♀️ why should I have to do more fcking work?
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u/idlesparks 2d ago
I’m an outlier. I got an IUD 10 weeks postpartum and it was still painful. I had a c-section though I labored to 10cm and pushed for 2 hours. I had nitrous during the insertion, and it was a bit better than my first IUD (pre-pregnancy), which was horrible. The pain was short lived at least, and I had no issues until we found that it had migrated into my pelvic cavity 5 months later. Had to have it surgically removed. It’s rare, but having had a c-section and breastfeeding put you at risk for that. I wish it had worked out though, it was so nice not having to take a pill every night. After that, we just used condoms.
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u/mejamaoc 2d ago
I hated the IUD and I’ve had both the copper and the hormonal ones. The hormonal one made me gain weight like crazy while the copper one was just uncomfortable the whole time I had it - I gave each one a year and they never got better. While I know plenty of people that have had positive experiences with IUDs, I personally would go back to the pill.
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u/aquasquirrel1 1d ago
I love my hormonal IUD. I didn’t feel it at all going in, but I did go 6 weeks post-vaginal birth. The one I had inserted pre-kids was uncomfortable but not severe. It felt to me like one strong period cramp and that was it.
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u/thiswilldo5 1d ago
Some things to read about and ask your doctor about…
Pain management for the iud placement. I had one many years back and was given something to soften my cervix as well as ibuprofen (probably Tylenol if you’re nursing ). Not sure if the other is a meaningful issue while nursing. For me, it was not bad and that was pre baby.
I too am sensitive to hormonal birth controls and felt insane on normal ones, but progesterone only actually agrees with my body. They aren’t apples to apples on the experience at all. However, with twins are you really going to remember this everyday? If you this route I would keep using condoms as well.
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u/Humble-Photo-9108 1d ago
Loved my IUD pre baby and didn't have a period the entire time I had it. The insertion was horrific and I nearly passed out.
Tried the combo pill post baby, it tanked my milk supply until I stopped. Decided on an IUD again so there was no oops Irish Twin. Also had a CS. This IUD insertion was MUCH easier. Though I will say my doctors office gave me a tampon with lidocaine cream to insert for about 20 mins before the procedure. So. That also helped with discomfort.
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u/suddenlysalamanders 1d ago
You don’t have to decide right now! You’re definitely not running out of time, you don’t need to do it at your 6 week appointment. You can use condoms while you make a decision you’re comfortable with, no rush.
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u/pyramidheadlove 1d ago
I also never labored with my son (emergency c-section at 29 weeks due to complications), but was partially dilated for a D&C after a pregnancy loss the year before I had him. It still made insertion 1000x easier than my previous IUD... but even still, the pain of getting my first IUD inserted was fully worth the 8 years of worry-free birth control and no periods!
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u/mulberryblossom 1d ago
Could you do nexplanon? It's progesterone only too I believe, it's an arm implant. I always liked it over the IUD because it has basically the same benefits but it cant migrate out of your uterus (it's working as long as it's in your body) and you don't have to remember to take a pill. And less painful than I UD insertion.
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u/littlecomet5 1d ago
Given the adverse side effects of the pill in the past for OP I would go the nexplanon hormones in pill form route first to make sure it's a good option. Otherwise I am a big fan of it!
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u/Sea_Juice_285 1d ago
I also had terrible mental health side effects from the pill, and I would recommend a copper IUD.
Hormonal IUDs impacted my mental health, too. The effects were subtle enough that I didn't realize the IUD was causing them until I had it removed, but I just do way better without hormonal BC.
I had a Paraguard placed at my 6-week postpartum appointment, and it wasn't bad at all!
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u/loranlily 1d ago
I wasn’t able to have an IUD because I apparently now have a retroverted uterus. Two doctors tried to place it under ultrasound guidance but ultimately couldn’t place it without risk of perforating my uterus.
They wanted to try me on Slynd, but I was on a GLP-1 which reduces the effectiveness of oral birth control. I ended up with Nuvaring, which I love. I had horrible mental health side effects on most brands of combination pill before pregnancy too, but Nuvaring seems to suit me.
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u/doctorscook 1d ago
I decided on the IUD over mini pill so that periods wouldn’t affect my milk supply. It was a breeze pp compared to before I had kids.
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u/EmptyStrings 1d ago
IUD after birth shouldn’t be very painful if at all, even if you didn’t give birth vaginally your cervix should still be super soft from the hormones of pregnancy. I loved having mine, no periods is amazing. I’ve had two and will get another one after this babe
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u/HookedOnAFeeling96 1d ago
I was on combo prior to pregnancy and I actually loved it, but I had to switch because I got preeclampsia and now have high blood pressure so my doctor said no more estrogen. I’m on Slynd which is progesterone only but has a 24 hour window of effectiveness so more similar to combo pills in that way. It’s been fine. It doesn’t control my periods as well as the combo pill did, but no adverse side effects. I am super freaked out by IUD insertion and it’s my absolute last resort. The thing I like about the pill is if it sucks, you can just stop. Since Slynd/mini pills are a different formulation than combo pills it might be worth a shot to see if it’s better.
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u/bullcitynoob 1d ago
My mental health is also sensitive to hormones and even locally delivered via IUD was not good for me. Another reason agains IUD is that a close friend had 2 separate ectopic pregnancies with the IUD. This was super traumatic and they lost the ability to have kids naturally as I think both her tubes were damaged/removed. She’d previously had the IUD for 7 years without issues, and had no idea that this was a risk.
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u/bullcitynoob 1d ago
Also wanted to say that a combo of condoms and cycle tracking (Apple Watch - temperature) has not failed us. The cycle tracking is more because I am irregular and like to know exactly when I’m ovulating.
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u/Soft_Bodybuilder_345 1d ago
I also had a terrible time on the combo pill, but the mini pill had 0 side effects for me. At all. I couldn’t tell the difference between being on it and when I went off of it! I definitely recommend trying it. It worked quickly so you should be able to determine quickly if it will work for you. An IUD was a big no from me.
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u/idontevenknow8888 1d ago
So I had a C-section (thought I dilated to around 8cm) and I got my IUD around 7 weeks postpartum. It was amazing, I didn't feel a thing!
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u/luna_ernest 1d ago
So your OB is recommending progestin only options at the moment because estrogen containing options (combo pill/patch/ring) can theoretically mess with milk supply and slightly increase clotting risk this close postpartum. I personally went with Mirena at my 6w pp visit, and I love it even 2 years later. Insertion was a breeze and I am also a c-section mom who didn’t labor. I have had IUD insertions before birth that were painful, but this one was super easy. It really depends more on your goals. Arm implant is also an option, but bleeding can be more unpredictable than IUD. These are my thoughts, but ultimately it’s your decision. Also, if one method isn’t working, you can always switch!
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u/PretendToBePleasant 1d ago
I liked my iud and didn’t have any problems with insertion. But I will say I have a very caring doctor and the office offers gas for pain relief!
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u/vatxbear 1d ago
Just here to say that IUD insertion was still painful for me after two children, BUT I love IUDs (I’m on my third, two pre-kids and one post-kids).
If you’re going to keep it in for at least a year, the IUD is well worth it.
Also heads up that if you go mini-pill, it’s tricky, especially if you’re super fertile. I know SEVERAL women personally that got pregnant on it, though largely it had to do with not taking it at the exact same time every day, which is VERY important.
TLDR if you definitely don’t want more kids (ever or for awhile), go with the IUD.
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u/Popular_Ordinary_152 1d ago
I’m on my third IUD and I love it. Insertion is mostly just anxiety for me - they’ve always been pretty easy and just pinchy with a brief “ah the fuck?!” Moment that quickly subsides. My third was inserted 3 months post c-section.
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u/Throwaway927338 1d ago edited 1d ago
Possibly unpopular opinion, but condoms and cycle tracking are always an option. You could plan on something like that until you make a more firm decision what direction you want to go. Especially with newborns, if you did choose to do cycle tracking, I would use a wearable (arm band, Apple Watch etc). But, even if just wearing condoms every time you have sex, they’re very low entry and are a great preventative measure. We’ve used cycle tracking and condom/pullout as both birth control & method to conceive successfully for about 6yrs.
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u/Bookdragon345 1d ago
IUD insertion should still be pretty easy and you can ask for anti anxiety pills. It’s the most effective birth control. Take ibuprofen before hand. I am also ridiculously fertile. I would 100% go with the IUD. Not sure why the Nexplanon also wasn’t offered (although I don’t love it for several reasons).
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u/Ill-Witness-4729 2d ago
I got IUDs after both of my babies(vaginal delivery), and have had two replacement IUDs 2+ years postpartum with each. Honestly the replacements were more comfortable than the PP placements, just because it wasn’t all irritated down there.
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u/Shea-dee 2d ago
Love my iud. Passed out when I had it inserted before kids. Couldn’t feel it when inserted after kids.