It's not true that breast feeding effectively prevents pregnancy. Once you resume sexual relations after delivery, there is a chance you could get pregnant, whether you are breastfeeding or not, with or without having had your first menstrual period.

Unless you don't mind having another baby close to this one, it's a good idea to use contraception right away before you start sexual relations.

During pregnancy you cannot get pregnant because you don't ovulate. The average woman resumes ovulation and becomes fertile again within 4-8 weeks after delivery.

Unfortunately, the false belief that women who breastfeed cannot get pregnant has lead to many unintended pregnancies. It's true that breastfeeding affects fertility for a short time, delaying ovulation on average for only another 4-8 weeks. However, the average breastfeeding woman ovulates within 10-12 weeks after delivery, and by 6 months after delivery the majority of breastfeeding women will have resumed ovulation.

There are individual variations however, and averages can be misleading.

You can't predict exactly when you start ovulating after delivery, and some breastfeeding women have been known to ovulate as early as 4 weeks and as late as 18 months after delivery.

The way you breastfeed establishes fertility to a certain extent, and ovulation and fertility are more likely to return if:

• you are not completely breastfeeding (more than 4-6 hours between feedings) and you are supplementing early, or
• your baby is older than 6 months, or
• your menstrual period has returned

If even one of these events is not met, there is a high risk of ovulating and getting pregnant.

But what about your menstrual period? Can you get pregnant without having had your menstrual period yet? Absolutely!

You see, in order to get pregnant you need to ovulate. And many women falsely believe that if they haven't had their period yet after delivery they haven't ovulated and cannot get pregnant. Nothing is further from the truth.

Ovulation and fertility usually happen before you have the first period after delivery, not afterwards. Your menstrual period usually comes in response to ovulation, not the other way around, so by the time you see your first period, chances are that you have already ovulated. Don't wait for your first menstrual period to start contraception.

If you don't want to conceive shortly after delivery, birth control should be started as soon as you resume sexual relations independent of whether you have had your menstrual period or not.