Everyone knows a pregnancy means you stop getting your period for a while. And honestly, it might have been a welcome break. But once the baby comes, you will probably start to wonder what to expect from your period after having given birth.
The answer to this question will vary for everyone, and that’s perfectly normal. Each body and menstrual cycle are different! But regardless of when your first period postpartum comes, it’s a good idea to know what to expect. Here are some questions you might have about having your first period after giving birth.
Absolutely. Even if you’re in great shape and well-prepared to give birth, your body will need to go through a major recovery process. Labour is the ultimate workout, so your muscles will be achy. If you had a vaginal delivery, you’ll be extremely tender, and if you had stitches, they will be painful and take time to heal. During the first four weeks postpartum, you will notice a pink-brown discharge called lochia. This is totally normal. Even though it might look like a period, it isn’t – just the natural process of your uterus shedding blood, mucous, and tissue after you’ve given birth. Just be sure to wear a pad and change it often.
In the weeks following the birth, you might also feel something similar to menstrual cramps, but it’s usually not your period. During pregnancy, your uterus would have been stretched far beyond its normal size. Post-pregnancy, it shrinks back to about the size of your fist, causing a bit of cramping in the process. Afterpains are most common in women who breastfeed and who have already had one or more babies.
Good question. Having a C-section or vaginal delivery does not affect how quickly your period will come after pregnancy. However, your first postpartum period does depend on whether you breastfeed exclusively – that is if you nurse your baby every four hours during the day and every six hours at night. If you bottle-feed, your first period after having your baby may come as soon as a month after delivery but normally comes within two to three months. If you breastfeed exclusively, your period might not come until after your baby is weaned. This is because prolactin, the hormone that’s in charge of your body’s breast milk production, suppresses ovulation in your body.
Postpartum periods may also affect your breast milk supply. It’s not unusual for your supply to go down during your period or for your baby to notice a different taste. It might be a bit uncomfortable to breastfeed during your first period after pregnancy.
When your first postpartum period does come, there’s a good chance your flow could be a little different to what you’re used to – it could be heavier, lighter, longer or shorter than your pre-baby periods. The blood might even be a different colour or texture. You might notice different premenstrual symptoms or miss a period. Don’t worry, these changes are temporary and usually normal; your hormones are still figuring out your post-baby body.
Doctors recommend waiting six weeks before inserting anything into the vagina. That means you should never use tampons for lochia or a period that comes early – it could cause trauma to the sensitive tissue. It’s a good idea to play it safe and wait for your doctor to give you the go ahead using tampons post-childbirth.
Once you start using tampons again, you may need to use different absorbency than what you did before. And if you had a natural birth (i.e., gave birth vaginally), you might want to use a larger tampon for a few months. Your vaginal muscles just pushed out a whole baby, after all, and your pelvic floor needs time to recover! Consult your doctor about pelvic floor exercises that will help speed up this process. The angle of your vagina can also change, so you may need to adjust your insertion technique.
Because many women experience a heavier or more unpredictable period right after pregnancy, they often opt for a pad when their first postpartum period comes. This is also a good way to monitor the quantity or texture of your flow, if that’s something you’re worried about. A pantyliner might also come in handy the first few times you use a tampon after giving birth while you adjust to your changing flow.
Many women actually rely exclusively on breastfeeding to prevent pregnancy. It’s an official form of contraception that actually has a name: lactational amenorrhea method. Because breastfeeding exclusively (and it really needs to be exclusive) naturally inhibits ovulation, the chances of getting pregnant while breastfeeding are extremely low – about two out of 100 women who use breastfeeding as a contraceptive method will get pregnant in the six months after giving birth. (Just bear in mind that after six months or the introduction of foods to supplement breast milk, lactational amenorrhea becomes less effective and reliable.)
Of course, many women don’t breastfeed, or want to be extra-careful; it’s not easy to exactly predict when you’ll be fertile again. When it comes to choosing a contraceptive method, you should avoid one that contains oestrogen for the first 42 days postpartum because of an increased risk of blood clots. If you are breastfeeding, the oestrogen in hormonal contraception can also significantly reduce your breastmilk supply. After those 42 days, your options open up, so consult your doctor about what would be best for you. But be warned: even if you're not menstruating regularly while breastfeeding, you can still ovulate and get pregnant. So be sure to take the proper precautions.
If your period hasn’t started three months after giving birth (or three months after you stop breastfeeding), it's definitely time to see your doctor. Missed periods, spotting, or periods that last less than two days could signal a hormonal imbalance or a thyroid issue. On the other hand, some people notice heavier bleeding and increased cramping during their first few periods postpartum. But give your doctor a call if you’re bleeding through a tampon or pad every hour or less, if your period lasts for more than seven days, or if you notice clots larger than the size of a golf ball – those could be signs of cysts, polyps, or fibroids. Also alert your doctor if you get a sudden fever during your period or if you notice any foul-smelling discharge, as these could be signs of an infection.
The bottom line: postpartum recovery is a huge physical transition, so be patient with yourself. Your body and your hormones are adjusting to a new normal. Chances are, it’ll all settle down – just remember listen to your body.