When to Take Birth Control Pills After Giving Birth

If you are asking when to take birth control pills after giving birth, the answer depends on the type of pill and on whether you are breastfeeding. Progestin-only pills (the mini-pill) can usually be started at any time after delivery, even while breastfeeding. Combined pills, which contain estrogen and progestin, should not be started until at least 3 weeks after birth, and most guidelines advise breastfeeding mothers to wait until at least 6 weeks. Because ovulation can return before your first period, it is best to agree on a method with your doctor before the end of the first three weeks.

The short answer by pill type and situation

Progestin-only pills (mini-pill): can usually be started at any time after birth. They are a common choice for breastfeeding mothers because they do not usually affect milk supply.
Combined pills, not breastfeeding: not before 3 weeks after birth. If you have extra risk factors for blood clots, such as a caesarean section, obesity, smoking or heavy bleeding after delivery, your doctor may advise waiting until 6 weeks.
Combined pills, breastfeeding: most guidelines advise waiting until at least 6 weeks, because estrogen can reduce milk supply in the early weeks. Some doctors prefer to keep breastfeeding mothers on progestin-only pills until feeding is well established.
After a miscarriage or abortion: pills can usually be started on the day of the miscarriage or in the few days after it, depending on your doctor's assessment.
Normally, after a period: starting on the first day of your period is the simplest way to be protected from the start.

When do you need emergency help after giving birth?

Before discussing contraception, it is important to know the signs after childbirth that cannot wait, whether or not you are taking the pill. Seek emergency help immediately if you have any of the following:

Heavy vaginal bleeding that soaks a pad in less than an hour, or large blood clots.
Any chest pain or discomfort that is new, pressing, severe, sudden or comes on with effort.
Sudden shortness of breath, or coughing up blood.
Pain, swelling, redness or warmth in one leg, especially the calf.
A severe or sudden headache, a headache with blurred or disturbed vision, or seizures.
Sudden weakness or numbness on one side of the body, or sudden difficulty speaking.
High fever or chills, foul-smelling discharge, or severe or worsening abdominal pain.
Fainting or severe dizziness.
Thoughts of harming yourself or your baby.

These signs can point to postpartum haemorrhage, a blood clot, an infection or dangerously high blood pressure. All of them need urgent emergency treatment, and none should wait for a clinic appointment.

Why combined pills are not started early after birth

In the first weeks after delivery the blood naturally clots more easily, which is how the body protects a woman from bleeding. The estrogen in combined pills adds to this tendency, raising the risk of clots in the veins of the legs or lungs. This is why international guidelines agree that combined pills should not be started in the first three weeks after birth for any woman.

After that, the risk falls gradually, but it stays higher in women with other risk factors, such as:

A caesarean delivery.
Obesity.
Smoking.
A previous blood clot, or a strong family history of clots.
Heavy bleeding after birth or needing a blood transfusion.
Pre-eclampsia or high blood pressure.
Long periods of reduced mobility.

In these cases your doctor may advise delaying combined pills until after 6 weeks, or choosing a method that contains no estrogen.

Birth control pills and breastfeeding

If you are breastfeeding, the type of pill matters. Progestin-only pills do not usually affect milk supply or your baby's growth, which makes them a suitable option for many breastfeeding mothers, and they can be started early after birth.

Combined pills can reduce milk supply in some mothers, particularly if started before breastfeeding is established. Most guidelines therefore advise against them in breastfeeding mothers before 6 weeks after birth, and some doctors prefer to wait longer, until the baby is partly relying on food other than breast milk. If you notice your milk supply dropping after starting any pill, tell your doctor so the method can be reviewed.

One practical point: progestin-only pills need strict timing at a fixed time every day, because taking them late can make them less effective. Ask your doctor or pharmacist how late you can be with your particular pill and what to do if you miss one.

When does ovulation return after birth?

Many women believe they are safe as long as their period has not returned after birth. This is not accurate. Ovulation happens before a period, not after it, so you can become pregnant before you ever see your first period.

In women who are not breastfeeding, ovulation can return as early as around the fourth week after birth.
In breastfeeding women, ovulation is usually delayed, but the timing varies widely and comes sooner as feeds become less frequent or formula is introduced.

That is why it is wise to agree on a contraceptive method before leaving hospital or at your first postnatal check, and to start it before ovulation returns.

Is breastfeeding alone enough to prevent pregnancy?

Breastfeeding can work as a temporary method of contraception, known medically as the lactational amenorrhoea method, but only when all three of these conditions are met together:

You are fully or almost fully breastfeeding, day and night, without long gaps between feeds.
Your periods have not returned.
Your baby is less than 6 months old.

If any of these conditions changes, for example you start formula, night feeds drop off or your period returns, protection falls sharply and you need to switch to another method.

When to take birth control pills after your period

Outside the postpartum period, if you are starting the pill for the first time or after a break, there are two common approaches:

Starting on the first day of your period: the simplest approach, which usually gives protection from the start without needing extra contraception.
Starting on another day of your cycle: possible as long as pregnancy has been ruled out, but protection is not immediate, and you will need an additional method such as condoms for a period your doctor or the patient leaflet specifies. That period differs between combined and progestin-only pills.

After childbirth specifically, there is no need to wait for your first period before starting the pill. You can start at the right time for your pill type once pregnancy has been ruled out.

When to take birth control pills after a miscarriage or abortion

After a miscarriage or abortion in early pregnancy, ovulation returns quickly and can happen within a few weeks. Combined or progestin-only pills can therefore usually be started on the day of the miscarriage or in the few days after it, without waiting for the next period. The earlier you start, the sooner you are protected.

If the pregnancy loss happened later in pregnancy, or there were complications, your doctor will judge the right timing for your situation. After a miscarriage or abortion, seek emergency help immediately for heavy bleeding that soaks a pad in less than an hour or large clots, high fever or chills, foul-smelling discharge, severe or worsening abdominal pain, fainting or severe dizziness, or any of the emergency signs listed above. If you start later than the first few days, you may need an additional method for a period your doctor specifies.

It is also worth talking to your doctor about when to plan the next pregnancy, as the body and mind sometimes need time to recover first.

What about a caesarean section?

A caesarean delivery is an extra risk factor for blood clots, so your doctor may advise delaying combined pills until after 6 weeks, even if you are not breastfeeding. Progestin-only pills can usually be started early, as after a vaginal birth. It is best to discuss contraception before leaving hospital, because you may resume intercourse before your six-week check.

When combined pills may not be suitable

There are situations where a doctor may consider combined pills unsuitable, or need to assess you carefully before prescribing them, including:

A personal history of a blood clot in the leg or lung.
Uncontrolled high blood pressure.
Migraine with aura (visual or neurological symptoms before the headache).
Smoking, especially over the age of 35.
Certain heart or liver conditions.
A history of breast cancer.

In these cases there are many alternatives, such as progestin-only pills, a copper or hormonal IUD, contraceptive injections or an implant. Your doctor can help you choose what suits your health and circumstances.

Practical tips before starting the pill after birth

Ask about contraception during pregnancy or before leaving hospital, rather than putting the decision off.
Tell your doctor whether you are fully or partly breastfeeding, and about any complications during pregnancy or delivery.
Check which type of pill you have been prescribed, progestin-only or combined, because the rules for starting, late pills and missed pills differ.
Take the pill as your doctor prescribes, at a fixed time that is easy to remember, such as a particular feed.
Read the patient leaflet to know what to do if you miss a pill or have vomiting or severe diarrhoea.
Do not start combined pills on your own in the early weeks after birth, even if you used them before pregnancy without problems.
If you think you might be pregnant before starting, take a pregnancy test or speak to your doctor.

Choosing the right time to start birth control pills after birth protects you from an unplanned pregnancy, safeguards your health while your body is still recovering, and protects breastfeeding for your baby.

Frequently Asked Questions

When should I take birth control pills if I am starting them for the first time?

The simplest approach is to start on the first day of your period, which usually gives protection from the start without extra contraception. You can start on any other day once pregnancy has been ruled out, but you will then need an additional method such as condoms for a period your doctor or the patient leaflet specifies. Take the pills as your doctor prescribes, at a fixed time.

When should I take birth control pills after my period, and can I start on any day?

Starting on the first day of your period is preferred because it usually gives protection from the start. You can start on another day of your cycle as long as pregnancy has been ruled out, but you will need an additional method for a period your doctor specifies, and that period differs between combined and progestin-only pills.

When should I take birth control pills after a miscarriage or abortion, and can I start the same day?

Yes, pills can usually be started on the day of the miscarriage or in the few days after it, without waiting for the next period, because ovulation can return within a few weeks. If the pregnancy loss happened later in pregnancy or there were complications, your doctor will decide the right timing for your situation.

When should I take birth control pills after giving birth if I am still breastfeeding?

While breastfeeding, progestin-only pills are the most common choice and can usually be started at any time after birth, because they do not usually affect milk supply. Most guidelines advise breastfeeding mothers not to start combined pills until at least 6 weeks after birth, because they can reduce milk supply and raise the risk of blood clots in the early weeks.