First Postpartum Period
Postpartum hemorrhage is typically caused by what’s known as uterine atony—this means the uterine muscles aren’t contracting normally to tighten the blood vessels after Baby arrives. It can be also caused by other conditions (some of which you were likely diagnosed with prior to giving birth):
Your First Period Post-Baby—What to Expect When Aunt Flo Returns
Pregnancy can have its challenges, but on the celebratory side, you are spared monthly menstrual cycles and the mood swings, cramps, and bleeding that come with them. Of course, now that you’ve had your baby, you may be wondering when your period is likely to return. The short answer is…it depends.
How long does it usually take for periods to return after birth?
The timing of your first period postpartum depends on whether or not you breastfeed. If you’re formula feeding, Aunt Flo should arrive about six to eight weeks after the big day. However, if you’re exclusively breastfeeding—meaning, your baby drinks absolutely nothing but breastmilk (other than vitamins or medicine)—your period will likely be delayed. That’s because prolactin, the hormone released during breastfeeding, delays the restarting of your ovulating. No ovulation = no period.
Some women won’t get a period for the entire time they are breastfeeding. Others will get their period while they are still breastfeeding, particularly after they have introduced bottles of formula, solid foods or when baby starts sleeping through the night.
Can you get pregnant before you have a period?
Yes! Yes! Yes! Once your cycle comes back, you will ovulate two weeks before you get your first period, so you will have no advance warning that you’re fertile! If you’re not ready to get pregnant again, check out your birth control options. Hormonal birth control won’t hurt your baby, but if they contain estrogen they may cause your milk supply to dip. Ask your practitioner about non-hormonal birth control methods—including diaphragms, condoms, certain versions of the pill (progesterone-only pills do not reduce milk supply), and some IUDs—that are totally compatible with breastfeeding.
Can I use breastfeeding as birth control?
In theory, yes, you can use breastfeeding as birth control, but that comes with a big asterisk. Using breastfeeding as birth control is known as the Lactational Amenorrhea Method (LAM), and it relies on the fact that ovulation is delayed if you are exclusively breastfeeding. However, for it to work you must meet certain criteria:
- Your baby should be under 6 months (pre-solid-food-introduction).
- You need to be exclusively breastfeeding and breastfeeding frequently (at least every four to six hours.
- Ideally avoid pacifiers, bottles, and pumping.
If you’re doing all of the above, LAM can be up to 98% effective at preventing pregnancy. Problem is, meeting all three of those requirements can be challenging for some families, so it’s not foolproof. Learn more about using breastfeeding to prevent pregnancy.
What will your first period after birth be like?
Brace yourself…the first period after giving birth is typically heavier than normal because there is extra blood in your uterine lining that needs to be shed. You may enjoy easier periods due to physical changes in the uterus and cervix, although some folks experience stronger cramps.
Here’s another surprise: After your first post-baby period, the next may show up early…or quite late. It can take a few months for your cycle to become regular again. Stash some period protection in your purse so you’re not caught off guard. If you do get your period soon after giving birth, ask your doctor if it’s safe to use tampons. Most women feel that pads are a better option until the vagina is completely recovered from delivery. You’ll typically be cleared to use tampons at your six-week postpartum checkup.
When should you see a doctor about your period?
Though that first period after baby can be a doozy, the flow should not be so heavy that you’re going through one pad per one to two hours. Call your doctor if you’re experiencing any of the following:
- Big blood clots: It’s normal to see small clots in your first postpartum period, but if they are larger than a quarter or last for several days, it could be a sign of a thyroid problem, infection, fibroids, or polyps.
- Heavy flow, pain, and spotting: If you are experiencing heavy, painful periods or spotting between periods, you may have developed adenomyosis, which is a thickening of the uterine wall. While not usually dangerous, adenomyosis can be uncomfortable, particularly during sex. Don’t be shy about asking your doctor or midwife. Depending on the severity, they may want to give you anti-inflammatory medications, hormones, or a minor surgical procedure.
- Prolonged heavy flow: Losing too much blood can cause anemia from iron deficiency. Low iron can make you feel tired, dizzy and irritable. Fortunately, the diagnosis and treatment are pretty simple: if your blood test shows low iron, your practitioner will give you iron supplements and vitamin C (vitamin C helps your body absorb the iron).
- No period: If your period hasn’t returned three months after giving birth or three months after stopping breastfeeding, talk to your practitioner. This is often totally normal, but there are two rare conditions that can cause your periods to disappear:
- Sheehan’s Syndrome: Your pituitary gland was damaged during delivery, which disrupts your period. It is treated with hormone therapy.
- Asherman’s Syndrome: The development of scar tissue in the uterus, often resulting from a D&C (dilation and curettage) procedure done after a miscarriage. Asherman’s can cause fertility issues, so a woman with this syndrome who wishes to become pregnant again may need a surgical procedure called an operative hysteroscopy.
When should I worry about a heavy period after pregnancy?
For the most part, a heavy flow comes with the territory of your first postpartum period. However, a small percentage of folks who give birth experience a postpartum hemorrhage (defined by the loss of 500 mL of blood or more), which can happen anywhere from 24 hours to 12 weeks after giving birth.
Postpartum hemorrhage is typically caused by what’s known as uterine atony—this means the uterine muscles aren’t contracting normally to tighten the blood vessels after Baby arrives. It can be also caused by other conditions (some of which you were likely diagnosed with prior to giving birth):
- Placental abruption (when the placenta separates early from the uterine wall)
- Placental accreta, placenta increta or placenta percreta (when the placenta grows too deeply into the uterine wall)
- Placenta previa (when the placenta sits low enough to cover the cervix)
- Uterine inversion (a rare condition where the uterus turns inside out following birth)
- Uterine rupture (a rare condition when the uterus tears in labor)
While it can strike without warning, there are certain risk factors associated with postpartum hemorrhage, such as:
- Long labor
- Fast labor
- History of postpartum hemorrhage
- Labor induction
- Episiotomy
- Preeclampsia
- Larger uterus (could be from a big baby, carrying multiples, or having excess amniotic fluid)
- C-section
- Hispanic or Asian ethnicity
- Chorioamnionitis
If you experience these signs of postpartum hemorrhage, call your provider immediately:
- Heavy bleeding that doesn’t slow or stop
- Drop in blood pressure
- Blurry vision or chills (could be the result of a drop in blood pressure)
- Nausea
- Pale skin
- Pain or swelling around the vagina or perineum
Final Thoughts on First Period After Birth
Though you may wish your period would just stay away forever, remember that it’s a sign of your body functioning normally after pregnancy. Practice self-care by getting plenty of rest, taking walks to relieve cramps, and snacking on healthy fats (hello, avocado toast!) and iron-rich lentils, prunes, meats, and foods cooked in a cast iron skillet.
Read more about postpartum life:
- Healing and Recovery After Birth
- Weird Things That Happen to Your Body After Birth
- Sex After Birth—Your Questions, Answered!
- Vagina Changes After Birth
About Dr. Harvey Karp
Dr. Harvey Karp, one of America’s most trusted pediatricians, is the founder of Happiest Baby and the inventor of the groundbreaking SNOO Smart Sleeper. After years of treating patients in Los Angeles, Dr. Karp vaulted to global prominence with the release of the bestselling Happiest Baby on the Block and Happiest Toddler on the Block. His celebrated books and videos have since become standard pediatric practice, translated into more than 20 languages and have helped millions of parents. Dr. Karp’s landmark methods, including the 5 S’s for soothing babies, guide parents to understand and nurture their children and relieve stressful issues, like new-parent exhaustion, infant crying, and toddler tantrums.
Have questions about a Happiest Baby product? Our consultants would be happy to help! Connect with us at [email protected].
Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider.
First Postpartum Period
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on August 26, 2021
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While you most likely enjoyed the break from your period during pregnancy, now that baby has arrived, your monthly visitor will soon return. Here’s what you need to know.
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In This Article- When should you expect your first period after giving birth?
- Will your first postpartum period be heavy?
- Can you get pregnant before you get your first postpartum period?
- Postpartum period vs. lochia: What’s the difference?
- Is it normal to have irregular periods after giving birth?
One of the perks of pregnancy is nine-or-so months of skipping your monthly flow, but after the baby is born, it’s only a matter of time before you’re back in pads or period underwear.
If you’re breastfeeding your baby, you might experience many menses-free months, especially if you are nursing exclusively. If not, Aunt Flo could pop back sooner rather than later.
So when will your period return, and how heavy will it be? Here’s what you should know about your first postpartum period.
When should you expect your first period after giving birth?
While it’s impossible to pin down the timing with any certainty, your first postpartum period may hinge on your breastfeeding regimen. The reason? It’s a hormonal thing.
Women who breastfeed exclusively and frequently do not, in most cases, ovulate. And if you’re not ovulating, you’re probably not having a period. (You can still get pregnant while you’re breastfeeding and before the return of your period, though. More on that below.)
Generally speaking, here’s when you can expect your period to resume:
- If you’re not breastfeeding, your period could return as soon as four weeks after giving birth, although that’s not typical. Six to 12 weeks is about average. Most new moms are back on track by week 24 postpartum.
- If you’re breastfeeding exclusively, you’ll likely have a longer break from your monthly cycle than other new moms. Look for your cycle to restart in three to six months. That said, there’s a lot of variability. It’s completely normal for women who breastfeed exclusively to have their first postpartum period six weeks after delivery or a year or more later — even 18 months after giving birth.
- If you’re breastfeeding some of the time, you might see your period return sooner. Women who combine bottle-feeding and breastfeeding often see their periods return six to 12 weeks after giving birth.
Will your first postpartum period be heavy?
In short, there’s no typical pattern for the first period after having a baby. Some women may have heavy, painful periods. Others may enjoy light, easy periods. Many women are surprised to find that their first period after baby has more blood clots in it. You can use tampons once it’s been four to six weeks since you gave birth and with your doctor’s okay.
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Your postpartum flow may depend on your choice of birth control. If you’re not breastfeeding and decide to go back on the pill after giving birth, you may have a lighter period.
Can you get pregnant before you get your first postpartum period?
Even before your period resumes, you can get pregnant again — and don’t let anyone tell you otherwise. That’s because ovulation precedes menstruation in the monthly cycle.
So unless you’re planning on back-to-back babies (and doctors advise against that because of the possible risks), you’ll want to use birth control as soon as you start having sex again — which likely won’t be for at least four to six weeks postpartum if you had a vaginal delivery.
All types of contraceptives are safe to use while you’re breastfeeding. But keep in mind that your contraceptive needs may have changed.
For example, if you used a diaphragm or cervical cap pre-pregnancy, you’ll need to have it refitted by your gynecologist, as your cervix may no longer be the same size. It can take six weeks after the birth of a child for your cervix to return to normal.
Because estrogen can reduce a woman’s milk supply, birth control methods containing the hormone aren’t recommended until breastfeeding is well-established, around six weeks after giving birth. Instead, your practitioner may prescribe what’s known as the “mini pill,” which is considered safe during breastfeeding.
It’s also best to wait at least three weeks before starting a birth control method that combines estrogen and progestin, like the pill or the patch. The reason? Women are already at greater risk of developing blood clots in the postpartum period. These combined hormonal methods can up the risk.
Postpartum period vs. lochia: What’s the difference?
Don’t confuse the heavy bleeding after giving birth with your period. Your body is still shedding the blood, tissue and mucus that lined your uterus while you were pregnant. It’s called lochia, and it’s not the same as your period.
Lochia starts out bright red and often contains many blood clots. The flow will be heavy for three to 10 days after delivery. As it tapers off, the color morphs from red to pink to brown and then a yellowish-white hue.
Light bleeding can continue for a month or longer, so keep a supply of sanitary pads handy. By the way, moms who have C-section deliveries may have less lochia than women who deliver vaginally.
Contact your doctor immediately or call 911 if you experience any of these signs of postpartum hemorrhage, a dangerous type of bleeding that can occur up to 12 weeks after giving birth:
- Heavy bleeding that doesn’t slow or stop, like soaking more than one pad an hour for several hours in a row
- Blurry vision
- Chills
- Clammy skin
- Rapid heartbeat
- Dizziness, faintness or confusion
- Nausea
Is it normal to have irregular periods after giving birth?
There are no guarantees when it comes to your period after pregnancy. You could start having periods like clockwork — two to seven days of bleeding every 28 days, on average.
Or they could be irregular, meaning the length or duration of your cycle is longer or shorter than usual. You might even miss a period. Again, your breastfeeding status can play a role. If you get your period back but you’re still lactating, for example, you can have irregular periods.
Over time, it’s a good bet that your period will return to what used to be normal for you. But if your period goes missing for months, or if you have questions or concerns about your post-pregnancy body, it’s best to check in with your practitioner.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
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