Chavez: 1032 S. 16th St., Milwaukee 53204 • 414-672-1353

Parkway: 2906 S. 20th St., Milwaukee 53215 • 414-672-1353 Waukesha: 309 E. North St., Waukesha 53188 • 262-408-2530

Postpartum Read the following flyers that are attached to this packet:

Birth Control

Pumping and Storing Breastmilk

Kegel Exercises

Read more about the following topics in your Great Expectations book that you received at your first appointment: Topic Page Breastfeeding Your Newborn 53-58 Time of Awareness 58-59 Common Breastfeeding Questions 60-61

Important Topics in Pregnancy

Chavez: 1032 S. 16th St., Milwaukee 53204 • 414-672-1353 Parkway: 2906 S. 20th St., Milwaukee 53215 • 414-672-1353

Waukesha: 309 E. North St., Waukesha 53188 • 262-408-2530

Planning Your Pregnancy:

Birth Control Hormonal Methods

“The Pill”

(oral contraceptive) 21-day or 28-day

Take 1 pill every day as directed. A period occurs every 28 days. Effectiveness: 92-99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. You do need a prescription.

“Mini-pill”

(progestin-only) 28-day

Take 1 pill every day as directed. A period occurs every 28 days. Good choice for women who cannot take estrogen-containing pills. Effectiveness: 92-99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. You do need a prescription.

Contraceptive patch

Apply to skin and change weekly (or as directed). Worn on the lower abdomen, buttocks or upper arm (or elsewhere on the torso except on the breasts).

Effectiveness: 92-99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. You do need a prescription.

“NuvaRing”

(vaginal ring)

Insert monthly and leave in place for 21 days. Effectiveness: 92-99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. You do need a prescription.

“Depo Provera”

(injection)

Get an injection every 3 months. Effectiveness: 97-99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. Administered by your provider.

Long Acting Reversible Methods

“Liletta”

IUD (hormonal)

Inserted in the uterus and can remain for up to 5 years Effectiveness: 99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. Placed by the midwife/provider in the clinic.

“Nexplanon”

(subcutaneous implant)

Inserted under the skin of the upper arm. Releases progestin for 3 years. Effectiveness: 99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. Placed by the midwife/provider in the clinic.

“Paragard” IUD

(copper)

Inserted in the uterus and can remain for up to 10 years. *Can be inserted within 7 days of unprotected sex as emergency contraception. Effectiveness: 99% STI Protection – NONE Able to Breastfeed – YES

Placed by the midwife/provider in the clinic.

Skyla

Inserted in the uterus and can remain for up to 3 years Effectiveness: 99% STI Protection – NONE Able to Breastfeed – YES, after your

baby is at least 4 weeks old. Placed by the midwife/provider in the clinic

Administrative Offices: 1337 S. Cesar E. Chavez Drive, Milwaukee, WI 53204 • (414) 672-1353 • www.sschc.org

Non-Hormonal / Barrier Methods

Natural Family Planning

Learn to recognize the signs of ovulation, avoid having sex (or use another method) during ovulation (the fertile period of the month). Effectiveness: 75-99% STI Protection – NONE Able to Breastfeed – YES Additional clinic resources exist for this method. Call 385-3754 for more information.

Male Condom

Partner must wear every time during sex. More effective when used with spermicide. Effectiveness: 85-98% (highest when used with spermicide) STI Protection – YES (most)

Able to Breastfeed – YES You do not need a prescription.

Permanent Methods (Sterilization)

Females:

Tubal Ligation

(“Tubes Tied”)

Surgery to cut/block fallopian tubes so eggs cannot travel to uterus. Effectiveness: 99.5% STI Protection – NONE Able to Breastfeed – YES Surgery is performed in the hospital.

Females:

“Essure”

(Implant)

Implants are inserted into fallopian tubes; body makes scar tissue that blocks the tubes (takes ~3 months). **Need to have x-ray test in a hospital after 3 months to confirm tubes have closed**

Effectiveness: 99.5% STI Protection – NONE Able to Breastfeed – YES Procedure is performed in the clinic. (Our clinic DOES NOT offer this)

Males:

Vasectomy

Vas deferens blocked, sperm cannot travel from testicles to the penis. Use another method for the first 3 months. Effectiveness: 99.9% STI Protection – NONE Procedure is performed in the clinic. (Our clinic DOES offer this)

Adapted from Resources: FamilyDoctor.org – Birth Control (http://familydoctor.org/online/famdoces/home/women/contraceptive/016.html) ACOG Patient Education Booklet AB020 – Birth Control (http://www.acog.org/publications/patient_education/ab020.cfm) CDC Reproductive Health – Contraception (http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/Contraception.htm) Planned Parenthood (http://www.plannedparenthood.org/health-topics/birth-control-4211.htm) Reproductive Health Access Project (http://www.reproductiveaccess.org/fact_sheets/bc_choices.htm)

Revised 4/2016

Kegel ExercisesWhat Are Kegel Exercises?

Kegel exercises are simple exercises that youcan do to strengthen your perineal muscles.These are the muscles in the area around thevagina and urinary opening that help tosupport the uterus (womb), bladder, andrectum.

Why Are These Exercises Important?

The perineal muscles can become weakenedby:

•childbirth•decreased estrogen levels during and

following menopause• increased pressure on the muscles, such

as during running and coughing

When the perineal muscles are weakened,you may notice any of the followingproblems:

•an uncomfortable feeling of pressure orheaviness

• leaking of urine when laughing, coughing,running, or doing exercise

•bulging of the bladder into the vagina(cystocele)

•bulging of the rectum into the vagina(rectocele)

•dropping of the uterus into the vagina

How To Do Kegel Exercises

You can find the perineal muscle by trying tostop and restart the flow of urination. If youcan do this, you can control and strengthenyour perineal muscle.

Exercise 1 Tighten the muscle, hold it tightfor two to three seconds, thenrelax.

Exercise 2 Tighten the muscle and releasefive times as quickly as you can.

Try to do each exercise 100 times each day.

Good pelvicfloor supportwith a firm

base, organsin place

Inadequatesupport and

the hammocksags, contents

descend

Kegel exercises can be done anywhere at anytime. Nobody can see you doing theexercises. You can exercise while watchingTV, driving a car, doing housework, lying inbed, or while you’re at work.

Developing a routine helps you to becomemore consistent, e.g., do the exercises duringevery stop light, during commercials on TV,after using the bathroom, etc.

While these exercises may seem difficult ortiring at first, with practice, the muscles willget stronger.

•Try to tighten the muscles a little morestrongly each day.

•Keep the muscles of the abdomen, thighsand hips relaxed.

•Do not skip a day.• If continuous exercise causes fatigue, try

exercising for one or two minutes, thenrest for several minutes before continuing.

91660 (REV. 1-97) ESPAÑOL AL REVERSO

Pumping and Storing Breastmilk for Your Baby

The Basics

The amount of milk you produce depends on several things, including:

Time of day Eating and drinking enough

Stress level Getting enough sleep

Pain or illness

At the Beginning

Tips to help your milk “come in” (called let-down) or flow easier if you are having trouble In the beginning (day 1 of pumping) only a few drops might be made. After a few days, more will come out Get comfortable and avoid distractions

Drink a cup of tea Use a warm blanket

Take a few good deep breaths Try taking a warm shower or use warm compresses on your breasts before pumping

Look at a photo of your baby, call your child’s daycare or keep a piece of your baby’s clothing close

Listen to music or read a book/magazine

When to Pump

If your baby is 0-6 months old, pump every 3 hours With an older baby, pump in the morning and at breaks during the day

Breastfeed your baby as much as possible while you are home (mornings, evenings and weekends)

How much to Pump and Store?

Breastfed babies drink between 19 and 30 ounces of milk (570-900 mL) each day. Remember - every baby is different!

The amount of milk you make can change when your baby grows quickly: At about 3 weeks, 6 weeks and 3 months old

Try to pump and breastfeed MORE during these growth spurts. Your body will learn to make more milk - try to be patient!

Newborns

2-5 oz each time (60- 150 mL)

5 to 6 months old

5-7 oz each time (150 - 210 mL)

2 to 4 months old

4-6 oz each time (120 - 180 mL)

Older than 6 months

10 - 30 oz per day (plus solid foods)

Safe Storage of Breastmilk

Milk can be stored safely in either the refrigerator OR the freezer. Normal, safe expressed milk can be bluish, yellowish or brownish. Store milk in clean dry bottles (plastic or glass) Label each bottle with the date

Put small quantities of milk in each bottle (enough for feeding about 2-4 oz) Try to use the freshest milk first

Store milk no longer than: 6-8 hours at room temperature

5-7 days in the refrigerator 3-6 months in the freezer (if it is separate from the fridge)

Thawing Frozen Breastmilk

Storing milk in the freezer for “emergencies” (illness or being away from your baby for a long time) is recommended. When thawing this milk for feedings, please consider the following:

Thaw frozen milk in the fridge overnight (12 hours) or under cool running water Gently heat milk under warm water from the faucet or place the bottle in a pan of warm (not boiling) water on

the stove Use thawed milk for feedings within 24 hours Gently swirl the milk if layers have formed (fats will rise to the top and should be mixed gently with the rest of

the milk) Test the temperature of the thawed milk before offering it to your baby to prevent burns DO NOT:

Heat the milk directly in a pan on the stove Put the bottle in the microwave

Re-freeze thawed milk

Helpful Resources

Sixteenth Street OB Case Managers | Outreach Workers Chavez: 414-897-5289 20th Street: 414-897-5288 Sixteenth Street - WIC Breastfeeding Coordinator 414-897-5461 Sixteenth Street - WIC Breastfeeding Classes 414-643-7554 Sixteenth Street - WIC Breastfeeding Peer Counselor 414-897-5476

National Breastfeeding Helpline 1-800-994-9662 La Leche League Leader | Milwaukee

Sources for Handout: La Leche League International, Inc, Calculating Milk Intake

Sixteenth Street Community Health Centers Women’s Wellness Department

414-672-1353 www.sschc.org/medical/womens-wellness

facebook/sschc • @16thStreetCHC