How long postpartum period

What to Expect For Your First Period After Pregnancy

Written by WebMD Editorial Contributors

Reviewed by Dan Brennan, MD on March 09, 2021

What to Expect With Your Period After Pregnancy

When will you get your period after pregnancy? Parents who breastfeed all the time usually don't get their period again until they stop nursing. They may also get their periods if they stop nursing partially, especially at night. Parents who bottle-feed, or do a combination of breastfeeding and bottle feeding, may get their periods as soon as five weeks after giving birth.

When you breastfeed full-time, your body produces more prolactin — the hormone that helps you produce milk for your baby. That hormone also stops your period from coming.

According to one study, over two-thirds of parents who don't breastfeed get their first period after pregnancy within 12 weeks of giving birth. Only around one-fifth of breastfeeding parents will get their period within six months of giving birth. If you are a breastfeeding parent, your menstrual cycle will return within one to two months after you stop nursing your child or start significantly reducing the amount you nurse.

Post-birth bleeding. Whether you had a C-section or delivered vaginally, you will have bleeding for six to eight weeks after giving birth. However, this is not considered menstruation. It is called lochia.

In the beginning, your lochia will be deep red, and you may pass a few blood clots. These clots may be as large as a plum. As the days pass, the discharge will become more watery and fade to pinkish or brownish. After a few weeks, the lochia is usually whitish or yellowish and may not be present every single day.

Parents experiencing lochia after giving birth should only use menstrual pads or maternity pads, not tampons. Nothing should enter the vagina within six weeks of giving birth.

You can still get pregnant. Even if you don't get your period after giving birth because you're breastfeeding, there's a small chance you can get pregnant because you might still ovulate during this time. The risk is between one and five percent. Consider which birth control methods you will use to manage this risk.

How your period changes after pregnancy. Once your period returns, it may be different than it was before. It may be heavier. You may have more or less cramping than you had before. Your periods may be irregular, especially if you are still breastfeeding sometimes. At first, you may have some more clotting in your periods than before. Experts recommend seeking medical advice if you have blood clots in your period for at least a week.

Some people find their periods get easier after pregnancy. This may be because the uterus has stretched out and relaxed. Others find they are more difficult, which may be due to the larger, stretched out uterus having more tissue to shed each cycle.

People with endometriosis often experience easier periods after pregnancy. However, this change is usually only temporary, and more painful periods come back after a few months.

Irregular periods. Just having one menstrual cycle after pregnancy does not mean your periods have returned. You may or may not have ovulated. You are more likely to ovulate if you have started to wean your child.

Does Your Period Affect Your Milk Supply?

Your menstrual cycle may affect your milk supply if you get your period. In the time between ovulation and when you get your period, your milk supply may be lower. Experts recommend adding calcium and magnesium to your diet to maintain a steady supply of breast milk throughout your whole cycle.

Having your period can also affect how your breast milk tastes. Your baby may be fussier during feedings while you're menstruating due to a change in taste.

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

The postpartum period - what is it and how long does the postpartum period last - Women's Medical Center MedOK

After the completion of labor and the birth of a child, the woman's body begins to gradually return to its previous state. Involutional changes occur not only with the reproductive organs, but also with the excretory, digestive, endocrine systems, as well as the circulatory system of the woman in labor.

In the postpartum period, the normal tone of the cerebral cortex and subcortical centers is restored. Pregnancy hormones are excreted from the body and gradually the function of the endocrine system returns to normal. The heart, which was slightly displaced earlier (during pregnancy), takes its standard location in the body, the load on it decreases, as the volume of pumped blood decreases. The active work of the kidneys helps to remove unnecessary substances from the body, so the amount of urine in the first days after childbirth is usually increased.

The reproductive system of a woman who has given birth undergoes the most significant changes.

The uterus of a woman in labor daily contracts and decreases in size, for the entire postpartum period its weight decreases from 1000 g to 50 g. hypertrophy of muscle tissue that occurs during pregnancy. After about 6-8 weeks, the size of the uterus becomes the same as it was before pregnancy. Within a few days after childbirth, the surface layer of the inner lining of the uterus is exfoliated and comes out in the form of spotting. Epithelialization (restoration of the mucous membrane and the growth of a new inner layer) of the uterus ends by the second or third week after birth. All these processes are called involution of the uterus and are most accurately expressed by the height of its fundus.

In the process of healing the inner surface of the uterus, a special postpartum discharge - lochia, which is a mixture of blood, mucus and decidual tissue, flows out of the vagina. The appearance of these secretions during the postpartum period changes: in the first days, the lochia has a pronounced bloody character, there are clots in them; from about the fourth day, their color changes to reddish-brown; starting from the 10-11th day after childbirth, the lochia becomes light and liquid, without blood admixture. The total number of lochia in a woman in the first 8 days after the birth of a child varies in the range of 500-1400 g, from the third week their number decreases significantly, and in the fifth or sixth week they completely stop.

In the first days after childbirth, due to stretching and insufficient tone of the ligamentous apparatus, the mobility of the uterus is significantly increased: it easily shifts to the sides, especially when the bladder and rectum are full. The ligamentous apparatus of the uterus acquires its usual tone by the fourth week after childbirth. Involution of the cervix is slower. As the uterus involutes, other parts of the reproductive system are also restored:

the fallopian tubes also return to their normal position, their swelling disappears;
The ovaries undergo significant changes: the regression of the corpus luteum, which was formed at the very beginning of pregnancy, ends, and the maturation of the follicles begins;
the tone of the pelvic floor muscles is gradually restored;
the tone of the walls of the vagina is restored, its volume is reduced, while the walls of the vagina remain swollen for three to four weeks after childbirth and only then the swelling disappears;
along with a decrease in the size of the uterus, its cervix is formed; the cervical canal gradually narrows, at first (by the end of the first week after childbirth) closing the internal, and then (by the third week after childbirth) and external pharynx;
heal abrasions, cracks and ruptures of the soft tissues of the birth canal that occurred during childbirth.

During the recovery process of the reproductive system, the woman in labor periodically experiences contractions of the uterus, resembling weak contractions. These sensations are intensified during breastfeeding, as the stimulation of the nipple in the blood of a nursing mother increases the level of oxytocin, a hormone that promotes uterine contractions.

In the postpartum period, due to the onset of lactation, the function of the mammary glands, laid down by nature in the body of a woman, begins to be fully realized. The essence of lactation is determined by two main processes: secretion of milk in the gland under the influence of prolactin and emptying of the gland under the influence of oxytocin. Even during pregnancy, under the influence of estrogens, the milk ducts formed in the mammary glands, and under the influence of progesterone, proliferation of glandular tissue occurred. Due to the action of the hormone prolactin in the first days after childbirth, there is an increased blood flow to the mammary glands. The secretion of milk occurs as a result of complex reflex and hormonal influences and is regulated by the nervous system and the lactogenic hormone of the adenohypophysis. The hormones of the thyroid gland and adrenal glands have a stimulating effect on the lactation process. A powerful reflex is realized during the act of sucking. The first attachment of a newborn to the mother's breast triggers the mechanism of lactation.

To date, there are no medications that stimulate lactation, since the secretion of prolactin is dependent on the emptying of the mammary gland. Prolactin analogs are also not synthesized, so the only way to start and maintain lactation is to apply the newborn to the breast in order to stimulate the nipple.

On the first day after childbirth, the mammary glands secrete a special and very valuable liquid for the child - colostrum (colostrum). Preliminary nutrition of the child with colostrum is of great importance, since it is with colostrum that the newborn receives a concentrate of immunoglobulins, including antibodies to infectious agents common to him and his mother. In addition, colostrum prepares the baby's digestive system for the further assimilation of "mature" mother's milk.

The menstrual cycle in non-breastfeeding women is restored after an average of 2 months, in lactating women after about 4 months. Quite often there is lactational amenorrhea, a special condition of the female body, in which, due to the release of a large amount of prolactin, menstruation is absent for many months or even the entire time of breastfeeding (for each woman this is strictly individual).

Postnatal period - Juno

Postpartum period: content of article

Length of the postpartum period

In obstetrics, it is customary to single out the early and late postpartum periods. The early one lasts from 2 hours to a day. Its duration depends on the condition of the woman. Usually the duration of the early period is 6-8 weeks. Normally, the puerperal is transferred to the postpartum department 2 hours after the birth and 6-24 hours after the caesarean section. The time spent in the delivery room or intensive care unit is the duration of the early postpartum period.

The late period begins from the moment the mother is transferred to the postpartum ward. The duration is determined by how quickly the reproductive organs recover, in particular, the uterus shrinks to normal size.

Physiology of the postpartum period: what changes occur in the body

During pregnancy, a woman's body is seriously rebuilt, changing its usual state. After childbirth, all organs and systems undergo tangible physiological changes:

The placental circulation stops, the number of heartbeats decreases. Normally, the indicators of the cardiovascular system should be restored by 10-14 days after childbirth.
The bladder restores tone after 3-4 weeks, the blood flow in the kidneys is restored within 6 postpartum weeks.
Gastrointestinal motility returns to normal levels within a month on average.

The nervous, cardiovascular, endocrine, and immune systems are also rebuilt. The most pronounced reverse restorative changes occur in the genital organs, especially in the uterus.

What happens to the uterus

The most intense involution (contraction) is observed within 8-12 days after delivery. The pace depends on the number of pregnancies and childbirth, the degree of stretching, breastfeeding. The uterus contracts faster in primiparous women, in those who breastfeed their babies. In multiparous, as well as in those who carried a large child, the uterus contracts longer.

After a caesarean section, the uterus contracts longer, and more careful care is also required.

Start of breastfeeding

Lactation is initiated and maintained by hormones such as prolactin and oxytocin. Early attachment to the breast (within an hour after childbirth) has a good effect on lactation and uterine contraction. In order to have enough milk, you need to regularly feed the baby on demand.

In the first 2-3 days after childbirth, colostrum is released from the breast. It differs from milk in having less fat and carbohydrates, but with a higher content of proteins and salts. The product has a high energy value, it also contains a lot of immunoglobulins that protect the body of a newborn.

From 3-4 days, milk begins to be produced, and its amount increases every day. This is the optimal food for babies, containing the necessary amount of nutrients.

Mammary glands

Under the influence of hormones, the milk ducts are formed and the blood rushes intensely to the glands. The breast becomes heavy, sensitive and "poured" with the arrival of milk. Discomfort may appear - pain, tingling, swelling. When breastfeeding improves, the discomfort will pass.

If there is a lot of milk, and the breast "swells" too much, you can express until relieved. Be sure to wear comfortable underwear, apply the baby more often. Remember that active lactation helps the female body recover faster.

Vagina and perineum

During natural childbirth, the area between the vagina and the anus is stretched. At breaks or cuts, stitches are applied. During the healing period, swelling and pain are possible. The muscles of the perineum are restored within 10-12 days, the anterior abdominal wall - by the 6th week.

About 2-3 weeks after childbirth, the walls of the vagina are edematous, then their normal state is restored. The lumen of the vagina often does not recover, especially after repeated births - it becomes a little wider.

Ovaries in the postpartum period

Follicle maturation begins in the ovaries. Lactating women, against the background of prolactin production, do not have menstruation for several months, and sometimes until the end of lactation. In non-breastfeeding women, menstruation begins after 6-9weeks after childbirth.

The first menstruation after childbirth often occurs without ovulation. In the future (from 2-3 cycles), the ability for a new pregnancy is restored.

Postnatal care and care

The postpartum stage is a time of adaptation. The mother needs to be ready for certain changes and even discomfort. A new mother may be concerned about:

Abdominal cramps. The uterus contracts, which causes pain. More often, pain is disturbed when feeding - try to choose a more comfortable position.
Discomfort when urinating. This condition usually lasts for the first few days after childbirth. Warm water will help alleviate the condition - you need to water the vaginal area with it while visiting the toilet.
Swelling of the legs. The phenomenon can last as long as the normal functioning of the kidneys is restored. It is advisable to raise your legs more often.
Constipation. Some women are simply afraid to push, in addition, the abdominal muscles weaken, the hormonal background changes, which causes a delay in defecation. You need to eat more vegetables, fruits, drink plenty of water.
Severe sweating is especially pronounced at night and is associated with a changing hormonal background. Ventilate the room and wear cotton underwear.

Other possible problems include hemorrhoids, decreased libido, stretch marks, and hair loss. It is logical that the newly-made mother is very tired. Childbirth and the postpartum period is a serious physical and emotional stress. It is important to adhere to hygiene recommendations.

Postpartum hygiene

To avoid problems with health and well-being, follow the rules of intimate and personal hygiene:

Wash your face several times a day, preferably in the morning, evening and after going to the toilet.
Before hygiene procedures, be sure to wash your hands with soap and water, wash from front to back. Wash your anus last.
Avoid direct water jet into the vagina, use only hands - no sponges or other objects.
Dry skin and mucous membranes with a disposable towel (or individual).
Use baby or hypoallergenic intimate soap as a cleanser.
Change maternity pads after 2-4 hours, regardless of fullness.
Refrain from bathing for 6 weeks postpartum. There is a risk of infection because the cervix is ajar.
Stitches after caesarean section can be washed, but should not be rubbed with a washcloth. It is necessary to treat them with brilliant green or antiseptics until a crust appears.

Do not wear tight underwear, as it puts pressure on the crotch. Try to wear only cotton things, change bed linen every 5 days, underwear - daily. Sexual rest is about 1.5-2 months. You can return to intimate life, provided that there is a desire, at the same time the discharge has ended and nothing causes concern.

Discharge and bleeding in the postpartum period

The endometrium (the tissue that lines the uterus) and blood are shed after childbirth. Such secretions are called lochia. In the first 2-3 days they have a bright red color, as they have a blood character. By day 4-5, they become bloody-serous, with a brown or yellow tint. After about a week, mucus appears in the discharge, and the color changes to a more transparent, white one. With a physiological course, lochia has a specific rotten smell.

Retention of lochia in the uterine cavity is a pathological condition called a lochiometer. It is dangerous for the development of infection and inflammation. Therefore, if the discharge stops abruptly, this should alert. No less dangerous and abrupt bleeding, or simply an increased amount of discharge. In case of any concerns, you should immediately contact the doctor.

When do you need to visit the doctor for the first time and what will he do?

If the postpartum period proceeds normally, an examination by a gynecologist should be completed approximately 2 months after childbirth. The management of women after the maternity hospital is carried out by a women's consultation.

If you had a caesarean section, then you should go to the doctor 1-2 weeks after the operation to check the condition of the suture. When you go to the doctor, prepare a list of questions, take a referral for tests and other examinations.

Postnatal care

At the first visit, the doctor will ask how the birth proceeded, how long it lasted, and also conduct an examination on the armchair. The examination usually includes:

Assessment of the condition of the external genital organs. The doctor will see if there are any fistulas, if the walls of the vagina have recovered.
Examination of the cervix. The doctor checks for tears or broken sutures, assesses the need for a colposcopy.
Smears and cytology. They allow to detect inflammatory processes and infections.
Palpation of the ovaries and uterus. The doctor evaluates the size, elasticity. A flabby, enlarged uterus can be a sign of endometritis.

If necessary, the doctor additionally prescribes an ultrasound examination, which determines whether there are any remains of the placenta or blood clots in the uterus.

When is a doctor needed immediately?

In obstetrics, there is a certain set of symptoms that indicate postpartum complications. Urgently call an ambulance or urgently consult a doctor if:

Increased body temperature. This happens during the development of lactation, but it is important to exclude inflammation in the uterus or the suture area.
Bleeding. You can do a test: if the pad gets completely wet in 30-60 minutes, this is a sign of uterine bleeding.
Change in the nature of the discharge (unpleasant smell, pus).
Unusual pain in the lower abdomen or in the area of the postoperative suture.
Swelling of the suture after caesarean section or its weeping.
Sharply painful lumps in the chest with temperature.
Pain in the legs, the appearance of swelling, hot to the touch (risk of thrombophlebitis).

If something is bothering you, don't wait. Delay is very dangerous - call the doctor immediately at the slightest suspicion of a pathology. You do not have the right to be denied either in the maternity hospital or in the antenatal clinic.

Postpartum depression and its prevention

The physiology of childbirth is such that they greatly affect the psychological state of a woman. Every third woman in labor experiences bouts of sadness and sadness. Euphoria, typical for 1–2 days after childbirth, is later replaced by uncertainty, confusion, and emotional discomfort. Especially at risk are impulsive, suspicious, anxious women. Unfavorable ground can also be created by problems with the health of the child or the mother herself.

Sometimes the blues can turn into a severe chronic form of depression. In this case, a woman is not happy with her maternity leave with a child, obsessive frightening thoughts arise or, conversely, complete apathy. It is already difficult to cope with such a state.

To prevent the development of postpartum depression, try to adhere to the following recommendations: