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Any new mom will tell you there’s a lot of time, energy, and dirty diapers that go into caring for a newborn. Add in exhaustion from lack of sleep and you have the most effective form of birth control after pregnancy — abstinence. While sex probably isn’t on your mind immediately after bringing home your newborn, it will come up before too long.

It’s important to consider your options for birth control after pregnancy before the mood strikes. That’s especially important if you’re not planning another pregnancy anytime soon. Here’s what you should know about your contraception options after birth and which might be safest for new moms.

Natural Family Planning After Birth

You won’t know when you will start ovulating again after giving birth. That means it’s possible to get pregnant even before your period returns when you start having sex after birth. The only natural way to prevent ovulation is exclusive, frequent breastfeeding — and even that isn’t 100% effective.

Exclusive breastfeeding means you can only feed your baby from your breast without supplementing formula. Also, the time between feedings shouldn’t exceed four hours during the day and six hours throughout the night.

When you breastfeed that often, it’s unlikely that you’ll ovulate which will reduce your risk of getting pregnant. This method is free and effective, but it’s very demanding on a new parent. Exclusive, frequent breastfeeding is often not practical. You’ll likely feed less often when your baby starts sleeping longer or if you need to return to work.

If you’re planning to use formula or pump and feed your baby with a bottle, consider other forms of birth control after pregnancy.

Contraception Options After Birth

There are many contraception options after birth, but there is no one-size-fits-all option. The best birth control after pregnancy depends on your body and needs. Talk to your doctor about your options and what’s best for you.

Here are some effective contraception options and their pros and cons:

An IUD

An IUD (intrauterine device) is a small, T-shaped plastic or metal device that a doctor inserts in your uterus. It releases a small amount of progestin (a hormone) or copper. This prevents the egg and sperm from joining.

This method of birth control lasts for years. Your doctor can insert an IUD after birth or at your postpartum checkup. An IUD has a few possible risks and side effects, including:

• In about 5% of users, an IUD may come out of the uterus and your doctor will have to reinsert it.
• The hormonal IUD might cause breast tenderness, headaches, mood changes, spotting, or bleeding in the first few months.
• The copper IUD might cause bleeding between periods or more menstrual pain, but these side effects usually go away after a few months. It may also cause heavier periods while in use.

A birth control implant

The birth control implant, Nexplanon, is a flexible rod about the size of a matchstick that lasts for up to three years. It stops the release of an egg, thickens the cervical mucus to restrict the passage of sperm to the uterus, and thins the endometrium.

Your doctor inserts it under the skin in your arm. They can insert it anytime, including immediately after giving birth. Possible side effects of a birth control implant include:

• Irregular bleeding
• Mood changes
• Headaches
• Acne

Birth control shots

Depo-Provera is a hormone injection that prevents ovulation. It’s very effective when used as directed, and you can get it right after giving birth. But you have to get it on schedule every three months.

The downsides of the Depo-Provera shot are:

• You might develop bone loss while getting the shots, but your bone should grow back after you stop the shots.
• It could cause irregular periods, longer but lighter periods, or weight gain.

Mixed hormonal methods of birth control

These birth control methods contain a mix of estrogen and progestin to prevent ovulation. If you use combined hormonal birth control methods correctly, they’re very effective. Combined hormonal birth control methods include:

• The pill, which you take every day.
• The vaginal ring, which you insert once and leave in for 21 days.
• The patch, which you apply once a week for three weeks.

Hormonal birth control methods have benefits, including:

• Lighter, shorter periods.
• Fewer cramps.
• Improved acne.
• Fewer menstrual migraine headaches.

But there are potential downsides such as:

• They increase the risk of blood clots in your legs immediately after giving birth. You should wait at least four to six weeks after delivery to use them.
• If you’re breastfeeding, these might decrease your milk supply. It’s best to wait to use these methods until your milk supply is well-established — about four to six weeks after giving birth.
• They might cause bleeding between periods, breast tenderness, and nausea.
• There is a small increased risk of having a heart attack or stroke with these birth control methods. It’s important to talk to your doctor about your risk factors.

Barrier methods of birth control

As the name suggests, barrier methods form a barrier between the sperm and egg so the egg doesn’t get fertilized. Barrier methods include:

• Condoms
• Cervical cap
• Diaphragm
• The sponge
• A spermicide

These contraception options are slightly less effective at preventing pregnancy but don’t involve hormones or prescription medicines. You’ll need to visit your doctor to get fitted for a cervical cap or diaphragm. The others are available over the counter at a pharmacy, other stores, and online.

If you want to use a diaphragm, cervical cap, or sponge, you should wait until six weeks after giving birth. That’s when your uterus and cervix return to their usual size. If you used a diaphragm or cervical cap before you got pregnant, your doctor will need to refit you because our uterus may have changed after childbirth.

All of these birth control methods are safe for new moms to use, but it’s best to discuss them with your doctor before you give birth. They can advise you how long you should wait before using birth control after pregnancy and when you can start. They can also evaluate your lifestyle and health history and recommend the safest option.