Signs and symptoms of your first period after birth

Overview

After giving birth, your period will return, but the timing varies depending on whether you’re breastfeeding. Breastfeeding moms may experience several months without menstruation, while non-breastfeeding moms might see their period return sooner. Initially, you’ll experience lochia, a heavy postpartum discharge of blood and uterine tissue that lasts about two to three weeks and isn’t a true period. This can be accompanied by cramping as your uterus contracts back to its normal size. Be mindful of blood loss, as excessive bleeding could indicate postpartum hemorrhage. Once lochia ends, your menstrual cycle will resume, though its timing and flow may differ from before pregnancy.

Will my postpartum period feel different?

There is no standard pattern for your first period after giving birth. Some women may experience heavy, painful periods, while others might have lighter, easier flows. It’s not uncommon to notice more blood clots in your postpartum period. Here’s what you can expect:

• Heavier or lighter flow: Your first period after birth may be heavier than before, especially if you’re not breastfeeding. However, if you’re using birth control like the pill, your flow might be lighter.
• Cramping: Cramping may feel the same as before, though some women report less pain, particularly those with conditions like endometriosis. On the other hand, C-section scarring may cause more period pain.
• Irregular cycles: Your first few periods postpartum may be irregular, especially if you’re still breastfeeding. As you wean, your cycle is more likely to become regular.

With approval from your doctor, you can use tampons once it’s been about four to six weeks since giving birth. Menstrual blood should be bright red, gradually fading to brownish-red, and small clots are common. However, if you see large clots (the size of a plum or larger), consult your healthcare provider.

Some people find their periods become easier after pregnancy, possibly due to a more relaxed uterus. Others may find them more challenging, with increased flow and tissue shedding as the uterus returns to its pre-pregnancy state.

In general, your postpartum period may mirror your pre-pregnancy experience, though every woman’s experience is different. If you have ongoing concerns about heavy bleeding, large clots, or irregularities, reach out to your doctor for advice.

When will my periods start again after pregnancy?

The timing of your first period after pregnancy varies between two to 12 weeks after delivery. For most women, it starts between six and 12 weeks postpartum. However, if you’re exclusively breastfeeding, your period might not return until you introduce solid foods or other forms of milk. This delay happens because prolactin, the hormone responsible for milk production, suppresses ovulation by lowering estrogen and progesterone levels. Here’s a breakdown of when you can expect your period to return based on your feeding routine:

• Not breastfeeding: Your period may return as early as four weeks after delivery, although six to 12 weeks is more common.
• Exclusively breastfeeding: Your period could take longer, potentially returning three to six months postpartum, though some women may not menstruate for a year or more.
• Combination feeding: If you’re bottle-feeding and breastfeeding, expect your period to resume around six to 12 weeks postpartum.

While breastfeeding delays your period, this does not mean you cannot get pregnant during this time. Ovulation may still occur even without menstruation, so contraception is important if you’re not planning another pregnancy. Also, while getting your period doesn’t impact breast milk production or quality, you might notice hormonal fluctuations that cause breast tenderness or minor changes in milk supply. Remember, every woman’s body is different, so your postpartum period may return sooner than expected.

What to expect with your period after pregnancy?

Postpartum periods can be unpredictable. Some women experience regular cycles soon after birth, while others deal with irregular periods, which may be influenced by breastfeeding. If you’re still lactating, your periods may be erratic. Over time, your cycle should return to what was normal for you pre-pregnancy, but if you miss periods for months, it’s best to consult your doctor.

Duration and heaviness

The length of your first postpartum period can vary, lasting from a few days to a week. It may take a few cycles for your period to regulate. If you experience heavy bleeding or large clots during your period, it’s important to seek medical advice.

Post-birth bleeding (Lochia)

Regardless of whether you had a C-section or vaginal delivery, you will experience lochia, which lasts about six to eight weeks. This bleeding starts as deep red with possible clots and gradually becomes lighter in color. It’s important to avoid tampons during this period; only use pads until your body has healed.

Breastfeeding and periods

If you’re exclusively breastfeeding, your period might not return until you start weaning your baby or significantly reduce nursing. In contrast, women who bottle-feed or combine breastfeeding with formula may get their periods as early as five weeks postpartum. Even if your period hasn’t returned, ovulation can still occur, so there’s a small chance of getting pregnant during this time.

Warning signs

Heavy or uncontrolled postpartum bleeding, known as postpartum hemorrhage, is a serious condition. Seek immediate medical attention if you notice:

• Soaking through one pad every 1-2 hours
• Sudden increases in blood or large clots
• Bright red blood after it has started to fade
• Symptoms like sweating, dizziness, or trouble breathing

These could be signs of a postpartum complication that requires urgent care.

Can you get pregnant before having your first postpartum period?

Yes, it is possible to get pregnant before your first postpartum period. This is because ovulation happens before menstruation in the menstrual cycle. So even if your period hasn’t resumed, you may still ovulate, which means pregnancy is possible.

If you aren’t planning on having back-to-back pregnancies, it’s important to use contraception when you resume sexual activity — typically four to six weeks postpartum for those who had a vaginal delivery. Most forms of birth control are safe to use while breastfeeding, though your pre-pregnancy contraceptive methods may need adjustments. For example, if you used a diaphragm or cervical cap, your cervix may need to be remeasured by your gynecologist, as pregnancy can change its size.

Choosing the right contraception

Breastfeeding women should avoid estrogen-based contraceptives initially because estrogen can lower milk supply. Instead, your doctor may recommend the “mini-pill” (progestin-only), which is safe during breastfeeding. Combined hormonal methods like the pill or patch, which contain both estrogen and progestin, should generally be delayed until at least three weeks postpartum due to the increased risk of blood clots during this period.

Ovulation before periods resume

If you’re not breastfeeding exclusively and your body has recovered from pregnancy, ovulation can happen before your first period. This means you can get pregnant soon after delivery if you have unprotected sex. Many pregnancies occurring within a year of childbirth are unplanned.

Doctors generally recommend waiting 12 to 18 months between pregnancies to allow your body time to heal and to reduce the risks of complications such as preterm birth, infant mortality, and even autism in subsequent children.

If you’re considering another pregnancy soon after giving birth, discuss a safe plan with your doctor.

When to consult a doctor?

It’s important to reach out to your healthcare provider if you experience any of the following after giving birth:

• Extreme pain or discomfort
• Unusually heavy bleeding that soaks through multiple pads or tampons within an hour
• Blood clots larger than a plum
• Foul-smelling vaginal discharge

These symptoms may indicate complications that require immediate attention. While it’s natural to be concerned about the return of your period after pregnancy, keep in mind that it typically takes six to eight weeks for your first menstrual cycle to resume. For women who are exclusively breastfeeding, it can take even longer. However, if you’re not breastfeeding and your period hasn’t returned after three or more months, it’s a good idea to consult your healthcare provider for further evaluation and guidance.

FAQs about the period after birth