1St period postpartum

First Period After Pregnancy: What to Expect

Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Chaunie Brusie on February 28, 2018

Overview

From glowing skin to a newfound appreciation for your body, there are many things to love about pregnancy. Another is that you’ll have at least nine months of freedom from your period. But after you deliver, you’re probably curious what will happen with your menstrual cycle.

When your period returns often depends on whether or not you breastfeed. And just like your life after baby, you might find your periods after pregnancy are somewhat different.

When will my period return?

Your period will typically return about six to eight weeks after you give birth, if you aren’t breastfeeding. If you do breastfeed, the timing for a period to return can vary. Those who practice exclusive breastfeeding might not have a period the entire time they breastfeed. “Exclusive breastfeeding” means that your baby is receiving only your breast milk. But for others, it might return after a couple of months, whether they’re breastfeeding or not.

If your period does return quickly after giving birth and you had a vaginal delivery, your doctor might recommend that you avoid using tampons during your first menstruation post-baby.

This is because your body is still healing, and tampons could potentially cause trauma. Ask your doctor if you can return to using tampons at your six-week postpartum checkup.

Why don’t breastfeeding women get their periods as quickly?

Typically, women who are breastfeeding don’t get their periods as quickly because of the body’s hormones. Prolactin, the hormone needed to produce breast milk, can suppress reproductive hormones. As a result, you don’t ovulate or release an egg for fertilization. Without this process, you most likely won’t menstruate.

Will my period affect my breast milk?

When your period does return, you may notice some changes in your milk supply or your baby’s reaction to breast milk. The hormonal changes that cause your body to have your period may also influence your breast milk.

For instance, you might notice a decrease in your milk supply or a change in how often your baby wants to nurse. The hormone changes might also affect your breast milk’s composition and how it tastes to your baby. These changes are usually very minor, however, and shouldn’t affect your ability to breastfeed your baby.

What about birth control?

Some use breastfeeding as a natural birth control method. According to the Association of Reproductive Health Professionals, fewer than 1 out of 100 women will get pregnant annually if they’re engaging in exclusive breastfeeding. Even though breastfeeding reduces your fertility, it’s not an absolute guarantee you won’t get pregnant again.

The key here is exclusive breastfeeding. Other than breast milk, no fluids or solids are given to the baby with exclusive breastfeeding. Even water. Supplements or vitamins don’t interfere and can be given to the baby. Breastfeeding that doesn’t fit this description might not protect against another pregnancy.

If you’re breastfeeding and your period does return, you’re no longer protected against getting pregnant. It’s also important to note that it can be difficult to predict the return of fertility. You will ovulate before your period starts, so it’s entirely possible to get pregnant again before your period returns.

Safe and effective birth control methods are available for those who are breastfeeding. Nonhormonal options such as the copper intrauterine device (IUD), condoms, and diaphragms are always safe for breastfeeding.

There are also some hormonal birth control options that are considered safe during breastfeeding. Your doctor can provide the latest updates on specific types of birth control. In general, low-dose combination pills that contain estrogen and progestin are considered safe after you’ve healed from birth. Progestin-only pills are also safe to use while breastfeeding.

How might my period be different postpartum?

When you do start your period again, chances are the first period after delivery won’t be like your periods before you got pregnant. Your body is once again adjusting to menstruation. You may experience some of the following differences:

cramping that might be stronger or lighter than usual
small blood clots
heavier flow
flow that seems to stop and start
increased pain
irregular cycle lengths

The first period after your pregnancy may be heavier than you’re used to. It might also be accompanied by more intense cramping, due to an increased amount of uterine lining that needs to be shed. As you continue your cycle, these changes will likely decrease. In rare cases, complications such as thyroid problems or adenomyosis can cause heavy bleeding after pregnancy. Adenomyosis is a thickening of the uterine wall.

Women who had endometriosis before pregnancy might actually have lighter periods after giving birth. Light periods can also be caused by two rare conditions, Asherman syndrome and Sheehan syndrome. Asherman syndrome leads to scar tissue in the uterus. Sheehan syndrome is caused by damage to your pituitary gland, which may be the result of severe blood loss.

What causes mildly painful postpartum periods?

Mildly painful postpartum periods can be caused by a combination of several factors. They include:

increased intensity of uterine cramping
the hormones of breastfeeding
the uterine cavity becoming larger after pregnancy, which means there’s more uterine lining to be shed during menstruation

What should I expect from my first period postpartum?

Whether you delivered your baby vaginally or by cesarean delivery, you can expect some bleeding and vaginal discharge after giving birth. Your body continues to shed the blood and tissue that lined your uterus while you were pregnant.

In the first few weeks, blood might be heavier and appear in clots. As the weeks go by, this blood gives way to vaginal discharge known as lochia. Lochia is bodily fluid that can appear clear to creamy white to red in color.

This discharge can continue for about six weeks, which is about the time your period may return if you aren’t breastfeeding. If your discharge had the appearance of lochia, stopped for some time, and then you experienced a return of bleeding, this is likely your period. If you aren’t sure if the bleeding you’re experiencing is pregnancy-related or your period, there are a few ways to tell:

Lochia isn’t usually bright red in color beyond the first week postpartum. It’s usually lighter and can be watery or white in appearance. Bright red bleeding that occurs six or more weeks after delivery is more likely to be your period.
Pregnancy-related bleeding can increase with increased exertion or activity. If your discharge increases with exertion and decreases when you rest, it’s more likely to be lochia.
Lochia also tends to have a distinct odor. Lochia may have a “sweet” smell to it, since it’s mixed with leftover tissue from the pregnancy. Report any foul order to your doctor.

It can also take some time for your cycle to regulate after birth. You might find that you have your first period, skip a cycle, and then have another period that comes sooner than expected.

During your first postpartum year, it can be normal for your periods to fluctuate in length, time between cycles, and intensity of bleeding. This is especially true if you’re breastfeeding.

According to the Cleveland Clinic, most postpartum women will have a “normal” menstrual cycle of 21 to 35 days with bleeding that lasts 2 to 7 days. Period cycles can change from what you experienced before pregnancy.

What postpartum symptoms should I watch out for?

It’s important that you call a doctor if you experience any of the following symptoms:

soaking through more than one pad every hour
bleeding that’s accompanied by sudden and severe pain
a sudden fever
bleeding continuously for more than seven days
blood clots that are bigger than a softball
foul-smelling discharge
severe headache
trouble breathing
pain while urinating

Contact your doctor if you experience these symptoms or anything else that concerns you related to your period. Some of these symptoms may indicate an infection.

The takeaway

A return to your menstrual cycle is just one of the parts of recovery and returning to your prepregnancy body. In some, menstruation may be delayed due to the hormone increases associated with breastfeeding.

Breastfeeding as a form of contraception isn’t foolproof. Having a backup method, such as oral contraception or a condom, can help provide further protection. You can find a great selection of condoms here.

If anything seems out of the ordinary about your first period after pregnancy, contact your doctor. Excess bleeding or indications of infection are especially concerning for a new parent. Listen to your body and play it safe.

Parenthood How-To: DIY Padsicle

How Soon Can You Get Pregnant: After Having a Baby

Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — By Chaunie Brusie on January 25, 2018

After adjusting the monitor on my patient’s stomach so I could hear the baby’s heartbeat, I pulled up her chart to see her history.

“I see here it says you had your first child… [pause]… nine months ago?” I asked, not being able to hide the surprise from my voice.

“Yes, that’s right,” she said without hesitation. “I planned it that way. I wanted them to be really close in age.”

And close in age they were. According to my patient’s dates, she got pregnant again almost the moment she left the hospital. It was kind of impressive, actually.

As a labor and delivery nurse, I saw the same mothers coming back almost exactly nine months later more often than you would think.

So exactly how easy is it to get pregnant right after you have a baby? Let’s find out.

Breastfeeding, in theory, is supposed to prolong the return of the menstrual cycle, especially in the first six months postpartum. Some women choose to use this as a form of birth control called the lactational amenorrhea method (LAM), assuming that their cycle won’t return while they’re breastfeeding.

But exactly how long breastfeeding can delay the return of fertility varies. It depends how often and regularly a baby nurses, how long the baby will sleep for stretches at a time, and environmental factors, such as:

sleep disturbances
sickness
stress

Every person is different. For example, I didn’t get my period back until eight or nine months postpartum. But one of my friends who also exclusively breastfed got her period at only six weeks postpartum.

Although doctors have confirmed that the delay of the menstrual cycle with breastfeeding can be effective, it’s important to remember that relying on LAM for birth control is most effective if your baby is:

under 6 months old
exclusively breastfed: no bottles, pacifiers, or other food
nursing on demand
still nursing at night
nursing at least six times a day
nursing at least 60 minutes a day

Keep in mind that any fluctuation in the nursing routine, like if your baby sleeps through the night, can cause your cycle to return, too. To be safe, don’t rely on exclusive breastfeeding as effective birth control past nine weeks.

How soon you’ll get pregnant again depends if you’ll be breastfeeding or not.

Breastfeeding and the hormones that go along with milk production can suppress ovulation from returning.

If you’re not breastfeeding, ovulation usually doesn’t return until at least six weeks postpartum for most women. One review from 2011 found, on average, that ovulation returned for nonlactating women on day 74 postpartum. But the range of when ovulation occurred and if that ovulation was functional ovulation (meaning the woman could actually get pregnant with the ovulation) varied greatly.

A woman will ovulate before her period returns. Because of this, she might miss signs that she’s ovulating if she’s trying to avoid pregnancy. This is how some women can get pregnant without even having their periods back between pregnancies.

Ideally, mothers should wait at least 12 months between pregnancies, according to the U. S. Department of Health and Human Services.

Research has found that the risk for premature birth or your baby being born with a low birth weight increased for gaps shorter than 6 months, compared to those of 18 to 23 months. Intervals that are too short (under 18 months) and too long (over 60 months) have been associated with negative outcomes for both mom and baby.

In general, most women won’t start ovulating right away after having a baby, but the return of the menstrual cycle ranges widely for women.

Every woman’s personal cycle is different and factors like weight, stress, smoking, breastfeeding, diet, and contraceptive choices will affect the return of fertility.

If you’re planning on avoiding pregnancy, you’ll want to talk to your doctor about family planning options, especially if you’re breastfeeding and aren’t sure when your cycle will return.

Last medically reviewed on January 26, 2018

Parenthood
Pregnancy

How we vetted this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Cone-Agudelo A, et al. (2006). Birth spacing and risk of adverse perinatal outcomes: A meta-analysis.
ncbi.nlm.nih.gov/pubmed/16622143
Copen CE, et al. (2015). Interpregnancy intervals in the United States: Data from the birth certificate and the national survey of family growth.
cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_03.pdf
Foster C. (2006). Breastfeeding and fertility.
llli.org/nb/nbsepoct06p196.html
Getting pregnant again. (2017).
womenshealth.gov/pregnancy/childbirth-beyond/get-pregnant-again.html
Jackson E, et al. (2011). Return of ovulation and menses in postpartum nonlactating women: A systematic review.
ncbi.nlm.nih.gov/pubmed/21343770
Peterson AE, et al. (2000). Multicenter study of the lactational amenorrhea method (LAM) III: Effectiveness, duration, and satisfaction with reduced client-provider contact.
ncbi.nlm.nih.gov/pubmed/11172792
Wyss P, et al. (1993). The risk of conception during lactation.
ncbi.nlm.nih.gov/pubmed/8119562

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Jan 26, 2018

Chaunie Brusie

Edited By

Ginger Wojcik

Medically Reviewed By

Debra Sullivan, PhD, MSN, RN, CNE, COI

Share this article

Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — By Chaunie Brusie on January 25, 2018

Spotting and Irregular Periods: Normal While Breast-Feeding?
Which Forms of Birth Control Are Safe to Use While Breastfeeding?
Things to Consider When You’re Choosing Birth Control as a New Parent
View all

The first days in the hospital - articles from the specialists of the clinic "Mother and Child"

Bogomolova Marina Vadimovna

Embryologist

Clinic "Mother and Child" St. Petersburg

Immediately after childbirth

Immediately after the birth of the child is placed on the mother's stomach , then the umbilical cord is cut and the baby is applied to the mother's breast. Then the skin of the newborn is cleaned, its length and weight, head and chest circumference are measured. The doctor examines the birth canal, if necessary, sews up tears in the soft tissues of the birth canal, assesses the tone of the postpartum uterus, and helps the woman empty her bladder. But even after all these standard manipulations, the mother is not transferred to the postpartum ward, another for two to three hours, the puerperal stays in the maternity block . Why? In the first two hours after childbirth, some complications are possible, primarily uterine bleeding or an increase in blood pressure. Therefore, during these two hours, the mother lies on a stretcher or a bed in the maternity ward, since doctors and midwives are constantly there, and the operating room, in which case, is also located nearby. The child at this time is usually taken to the children's department, where he most often sleeps. And only two hours later, if everything is fine, the mother is transferred to the postpartum ward.

How does a woman feel at this time? Chills may occur, abdominal pain may occur, especially in multiparas.

What should a woman do at this time? Relax and unwind. Take shelter so as not to freeze, especially if chills appear. Place an ice pack on the uterus. If possible, ask the midwife to bring hot tea.

1st day after birth0009 postnatal midwife . She will tell you about the arrangement of the department (where the shower, toilet, dining room are), about the daily routine (the time for visiting doctors, eating) and will help the young mother, if necessary, to empty the bladder using a catheter. If a woman lies together with the baby, then immediately after the transfer to the postpartum ward, the child will be brought to her. The midwife will help the mother to properly attach the baby to the breast and start breastfeeding. Then nurse will come and show you how to swaddle your baby and explain how to take care of him. Do not be afraid that after childbirth there will not be enough strength for the child: most newborns sleep most of the day and wake up only for feeding. In addition, in the maternity hospital, the child is usually washed and dressed by nurses, so that the woman will have enough time to relax. If there is no joint stay of mother and child in the maternity hospital, then every three hours they will bring him to the ward for feeding, and then take him back to the children's department. Over time, the woman herself will pick up and carry the child.

How does a woman feel at this time? On the first day after giving birth, women feel differently. Some experience an incredible elation (this is due to the release of endorphins into the blood - the hormones of pleasure), while others, on the contrary, feel very tired. Some want to call all their friends and announce the birth of a child, they are inspired, full of energy and ready to take care of the baby on their own. Other mothers want to be alone and come to their senses, they still do not have the strength to constantly be with the child.

What should a woman do at this time? In any case, immediately after childbirth, as after any heavy load, you need to restore strength: first eat, and then go to bed or just relax. By the way, the following situation is possible: the birth occurred in the evening or at night, and dinner time has already expired; therefore, in order not to starve, you need to bring something light for a snack (cookies, bread rolls) with you to the hospital in advance.

6 hours after birth, the mother can usually get out of bed.

In general, if the childbirth went without complications, then you should start getting up as early as possible, first with the help of a midwife, and then on your own.

This helps to improve blood circulation, normalize the functioning of the urinary system and intestines, and accelerate healing processes. In addition, very soon the baby will require more attention.

Important point: After childbirth, the tone of the bladder decreases, so the urge to urinate may be absent or it may become painful and frequent. However, you should go to the toilet at least four times a day. Urination can be caused reflexively by opening a tap with water, this helps many people a lot. In the absence of the desired effect, urine is removed by a catheter. Most often there is no stool on the first day after birth.

Next days

Every day, the mother will be examined by an obstetrician-gynecologist : he will evaluate the contraction of the uterus, the condition of the sutures and the amount of discharge, see if colostrum is secreted. The midwife will regularly measure the temperature, pulse, blood pressure and treat the external stitches with disinfectant solutions several times a day. Also, every day the baby will be watched by a pediatrician, after which he will tell his mother about the condition of the child. After a normal birth, a woman, as a rule, is discharged on the 3rd-4th day (after a caesarean section - on the 5th-6th).

How does a woman feel at this time?

After childbirth, a woman may experience pain in the abdomen due to uterine contractions, as well as slight muscle pain in different parts of the body. On the face and on the whites of the eyes, a “rash” may appear - pinpoint hemorrhages that appear due to the fact that small capillaries burst during attempts from tension. Blood pressure can be lowered, so dizziness is possible (to avoid it, you should get up smoothly, without sudden movements). There may be pain in the perineum, even if there were no tears and its incision (pain appears because the perineum was severely stretched during childbirth). If the perineum is sutured, then it will not be possible to sit for at least the first two weeks. Sometimes after childbirth, varicose veins appear in the anus (hemorrhoids), which means discomfort in this place.

What should a woman do at this time? Mom needs to continue to rest and gain strength. And you should also follow the rules of personal hygiene: often change postpartum pads, do air baths for seams (if any), take a shower daily, wash yourself every time after a bowel movement. Well, the most important thing is to establish breastfeeding and learn how to take care of the baby in practice.

Time in the maternity hospital flies very quickly. Try to spend it usefully - restore your strength and acquire useful skills: at home, all this will be very useful to you!

REMINDER

Things to do at the maternity hospital

Have a good rest: sleep all your free time and eat well.
Get complete information about your child's condition: so ask your pediatrician all your questions.
Establish contact with the child: therefore, spend as much time with the baby as possible, ideally being with him all the time. Take the baby in your arms, unfold the diapers, carefully examine the baby without clothes.
Learn how to take care of your baby: so ask your baby nurse to show you how to wash your baby, change clothes, swaddle, change diapers, clean ears and nose, cut nails.
Establish breastfeeding: To do this, feed your baby on demand. Ask the midwife to show you how to properly hold the baby at the breast, how to give and take away the breast.

Make an appointment

to the doctor - Bogomolova Marina Vadimovna

Clinic "Mother and Child" St. Petersburg

Cryopreservation of embryos, eggs, spermJoint consultation of a reproductive specialist and embryologistEmbryology

By clicking on the send button, I consent to the processing of personal data

Attention! Prices for services in different clinics may vary. To clarify the current cost, select a clinic

Clinical Hospital MD GROUP LAHTAK Clinic "Mother and Child" St. Petersburg

All directionsSpecialist consultations (adults)Specialist consultations (children's)Laboratory of molecular geneticsGeneral clinical examinationsProcedural roomOther gynecological operationsTelemedicine for adultsTherapeutic examinationsUltrasound examinations for adults

01.

Specialist consultations (adults)

02.

Consultations of specialists (children)

03.

Laboratory of molecular genetics

04.

General studies

05.

Procedure cabinet

06.

other gynecological operations

07. 9000. 9000.

Adult Telemedicine

08.

Therapeutic Research

09.

Adult Ultrasound

Nothing found

The administration of the clinic takes all measures to timely update the price list posted on the website, however, in order to avoid possible misunderstandings, we advise you to clarify the cost of services and the timing of tests by calling

Recovery after childbirth - where to start

MainLibraryWomen's HealthRecovery after childbirth: terms, specialists , procedures

Childbirth is over, you have become a mother. And ahead is a new life: with new emotions, sensations, new questions and, first of all, with a new perception of oneself. But how can one feel this incomparable happiness if the body hurts, it is unpleasant to move, it is impossible to sit, every now and then it throws you into a fever and for some reason not everything is as smooth and joyful as you would like?

This is normal. These changes are necessary and important. What happens to the female body during this - the postpartum period, for which nature has given us 6-8 weeks? Within a few hours (!) after childbirth, the nervous, cardiovascular and other systems of the female body begin to rebuild, and hormones are tuned to a new stage - lactation. At the same time, a woman needs to comprehend what happened, get used to new feelings and sensations - this is also an important psychological stage. This is a multi-stage and difficult process, on the “quality” of which the psycho-emotional stability of the mother depends. And her condition, in turn, affects the adaptation and development of the child (for example, some psychotherapists believe that certain areas of our brain are formed in the first six months of life and directly depend on the emotional relationship with the mother in these months).

Previously, it was believed that after giving birth, the mother should not be disturbed, she is tired, she needs to rest, she has to adapt to a new life, she has no time for doctors, procedures, etc. ...

Significant changes are taking place in a woman's body, and they are a big burden on the body. Therefore, if in the very first postpartum week you gently and correctly “intervene” in the restructuring process, then the postpartum period will be much easier. You have to listen to your body and prioritize correctly.

“In my opinion, recovery after childbirth should be started as early as possible - in the very first days after the hospital,” says obstetrician-gynecologist and hirudotherapist Nina Alexandrovna Antonova. – A woman experiences this restructuring not only at the physiological level, she lives through it very emotionally. In Israel, studies were conducted: mothers asked the same questions - immediately after childbirth and 20 years later. The only question, the answer to which has not changed over the years, sounded like this - “what day in motherhood do they consider the most difficult?”. All mothers both times answered so - this is "the day of return from the hospital." To overcome the many stressful situations of postpartum life, we will show you what is going on and which specialists can be helpful.

1. The uterus shrinks and returns to its original size, its mucous membrane is restored (after childbirth, the uterus weighs 1000 grams, and after 6-8 weeks - 50-60 grams). For successful contraction of the uterus, it is very important to attach the newborn to the breast within the first hour after birth, and frequent feedings after (once every 2 hours during the day, and a little less often at night). Breastfeeding stimulates the production of oxytocin, which helps the uterus contract, which, by the way, a mother can even feel during feedings - when sensations resembling contractions appear in the lower abdomen. Herbal preparations of shepherd's purse, nettle, yarrow or birch leaves can also help reduce the size of the uterus. Until it has decreased, one must be very careful with physical activity, exercises - not all of them will benefit. Do not strive to regain your former harmony in the very first postpartum weeks - now you and your body have completely different tasks.

Who can I contact?

The gynecologist (in the first month) will check the contraction of the uterus, see if there are any blood clots, possibly an ultrasound.
A hirudotherapist will also help to speed up the healing of injured soft tissues, reduce edema, and raise the general (and local) immunity of the mother

2. Due to hormonal changes, ligaments change their elasticity after childbirth, so bones and joints become less mobile. After them, the internal organs, which were displaced due to the large size of the uterus (stomach, lungs, intestines, bladder, etc.), take their former position. All these changes can be accompanied by pain, and in the future, pathological fixation may occur, leading to a constant feeling of discomfort, for example, in the back.

Who can I contact?

Osteopathic appointment is useful for any woman after childbirth for full recovery and lactation, we especially recommend visiting him if there was a long or rapid birth, if a large child was born, there were gaps in childbirth or pain persists, there is pain in the sacrum.

An osteopath will also help a mother with lactostasis (and a newborn - with an inability to properly grasp the nipple when sucking).

3. There are changes in the endocrine system: the work of hormones is now aimed primarily at ensuring breastfeeding. But it often happens that by the end of the first week milk does not come in sufficient quantities. Or disappears in a month at all (the so-called lactation crises, which not everyone manages to survive). Or, on the contrary, there is so much of it that mastopathy threatens.

Who can I contact?

Lactation Consultant will help you improve lactation, tell you how to stimulate milk production, teach you how to put the baby to the breast so that there are no cracks in the nipples, that is, help organize feeding so that it brings joy and satisfaction to mom and baby. The psychologist will consult on the main psychological aspects of the postpartum period, breastfeeding, the first year of your child's life, and the features of relations with your spouse after childbirth.

4. Mom's emotional state changes: postpartum euphoria can be replaced by irritability or unreasonable sadness, indifference or, on the contrary, impulsiveness. If a mother cries or regrets something on the first day after birth, then, according to perinatal psychologists, this may be a manifestation of postpartum depression. Emotions during this period have a great influence on the process of postpartum recovery - help him or, conversely, slow him down.

Who can I contact?

A homeopath will help you balance your emotional mood and harmonize your general state. The psychologist will tell you what's new with the body, with the mother's psyche, what tasks are relevant at this stage. What needs to be done to prevent postpartum depression, where, in what or "in whom" to look for resources for recovery. And if depression does come, it will help to cope with your condition and return to a full life.

Meetings with specialists or lectures on children's issues will help you switch to solving new pressing issues: how to organize a daily routine, how to learn how to relax, how to travel with a baby, as well as solve a number of "pediatric" problems (from vaccinations to hardening or treatment non-drug means - for example, our "School of moms and dads").