There are many reasons why you might consider ditching hormonal contraceptives. For many people, coming off of the birth control pill is the first step to trying for a baby.

“How long do I have to wait to try to conceive?” is one of the most common questions about transitioning. This is what you need to know about trying to get pregnant after the pill:

The official answer is that you don’t have to wait at all. BUT this is not the advice that I give to my clients.

The Case for Waiting

There are several reasons why you may want to wait when trying to get pregnant after the pill or another form of hormonal contraceptive.

Past users of hormonal contraceptives may experience difficulty conceiving.

Recent studies have shown that women are twice as likely to have difficulty conceiving after long-term contraception use. This may be caused by the weakened connection between the ovaries and brain. This causes low levels of progesterone, the pregnancy hormone. Nutritional deficiencies may also be a contributing factor. Additionally, many women are prescribed the birth control pill for irregular periods or conditions like endometriosis and PCOS. These women who may have had difficulty ovulating (and therefore conceiving) before pill use, will find that the underlying issues still exist and may have worsened when they go off their hormonal contraceptive.

There may be an increased risk of miscarriage.

Doctors will often point out that many women are able to conceive within six months after terminating pill use. However, some studies indicate that women who conceive soon after going off the pill have an increased risk of miscarriage. There is also an increased risk of neural tube defects. These defects can cause miscarriage or children born with conditions like spina bifida.

The birth control pill can compromise our own microbiome.

The pill has a somewhat antibiotic effect on the body. Babies have their microbiome, especially the bacteria in their gut, populated by the bacteria they encounter as they pass through the vaginal canal. Several studies have shown that oral contraceptives, and some other contraceptives such as the IUD, alter the composition of bacteria in the vaginal canal. This makes women prone to conditions like candidiasis. Gastrointestinal problems in children with microbiome deficiencies has been linked to autism. This is another reason why it may be better to wait a few months to address your gut health when trying to get pregnant after the pill.

The pill may contribute to postpartum and mood issues.

Additionally, moodswings, morning sickness and issues during the post-partum period may be exacerbated by hormonal contraceptive use. For instance, nutrient deficiencies created by the pill, particularly reduced B-vitamin stores, may contribute to adverse symptoms during pregnancy, such as nausea and vomiting. Other studies have shown that nutrient depletion during pregnancy may affect post partum depression. You will be better off getting pregnant after you are able to address nutrient deficiencies created by the pill. The pill depletes, B vitamins, magnesium, zinc and selenium.

Yes, it is definitely possible that you could experience none of these adverse affects. But what’s the harm in taking some time to really take care of yourself so that you can start your journey as a mama in really excellent shape?

HOW LONG SHOULD YOU WAIT?

For all of these reasons I highly recommend that women wait at least 3 months post-hormonal birth control to conceive. Ideally, you should wait until your cycle stabilizes. Then wait for three healthy cycles before trying. Three cycles is about the time it takes to a mature an egg follicle. The right lifestyle, nutrition and supplementation adjustments during this time will have a huge impact on your egg quality!

Women with digestive issues may wish to wait until those issues are resolved. This may take longer than 3 months. It is well worth it when you consider that it is very difficult to get the appropriate nutrition needed for pregnancy when you cannot digest your food properly! Additionally, if a microbiome imbalance is at the root of your digestive issues, you may risk passing those issues onto your child. Baby-approved probiotics are recommended for babies born by C-section.