So you just had a baby, and life is pretty different and all about feeding schedules and new sleeping habits. Through all that new mama craziness (and joy!), you have a ton of questions about the weird body stuff happening to *you* in those first months, too. Example:
Your body will be adjusting back to not being pregnant for the first month or two after giving birth, and you’ll experience pretty consistent bleeding. But that’s actually your period returning to its pre-baby schedule. The first period after pregnancy will likely take a couple of months to get back on track, though it varies from person to person, and on whether or not you’re breastfeeding. And in some cases it may be different than your periods were before pregnancy.
Ahead, an ob-gyn explains everything you should know about postpartum bleeding, and what to expect from that first real period after pregnancy.
The immediate bleeding after you have a baby isn’t actually your period, FYI.
While it might feel like you’re having one long period (and using a *ton* of pads) after giving birth, the bleeding you experience is not actually your period. This post-birth bleeding, called lochia, is your uterus shedding all of the lining that was built up during pregnancy. “The blood, mucus, and discharge that makeup lochia can last up to six to eight weeks after birth,” explains Dr. Kameelah Phillips, an ob-gyn and founder of Calla Women’s Health.
Lochia can ebb and flow (pun intended) during this postpartum period, Dr. Phillips says. It tends to start out red in colour, and then progress to pink, and then turns to a yellowish-white colour. After that progression, which typically takes a month and a half or two, you may notice your period returning, which will generally be back to bright red or the colour you’re used to seeing. Or, in other cases, it’ll take longer before you menstruate again.
When your actual period returns may depend on breastfeeding.
“The return of your menstrual period depends on the individual, and regularity of breastfeeding,” Dr. Phillips says. Sometimes, the longer you breastfeed, the longer it takes for your period to return to schedule. That’s because breastfeeding releases a hormone called prolactin, which can send a message to the brain to delay the hormonal process of ovulation (because you’re literally feeding a baby at the moment).
“Lactational amenorrhea, which is the absence of the period due to breastfeeding, can last up to a year or longer, depending on the individual,” adds Dr. Phillips. Some people consider lactational amenorrhea a form of birth control (that is if your baby is under six months, doesn’t eat solid foods or formula at all, and you don’t start getting your period), but it’s *not* considered a secure method of preventing pregnancy.
Other people will get their period back quicker, even if they do breastfeed. Your period doesn’t typically affect your milk supply, Dr. Phillips says (but, if you’re struggling with milk production or with feeding, it’s best to contact your ob-gyn, who can refer you to a lactation consultant). It does mean that as soon as your period returns, you can get pregnant; you’ll likely start ovulating regularly as soon as your period is back on schedule.
When your first postpartum period does arrive, you can expect it to return to what it was like before you had your baby, though potentially a little heavier.
Initially, your first postpartum period might be heavier, especially if you had a C-section, Dr. Phillips says. The uterus may still be shedding its lining from pregnancy, so there might be additional blood.
There is not usually an increase in pain with your postpartum periods, though, Dr. Phillips says. The period of lochia discharge usually involves cramping, as your uterus is contracting and returning to its regular size. But often, your period, once it arrives, will be about the same in terms of pain, cramps, and PMS symptoms as it was before you gave birth (unfortunately for some people).
In terms of regularity, you’ll most likely experience regular periods after birth, Dr. Phillips says, with a cycle of about 21 to 35 days in length (or whatever “regular” means for you). But this, too, can fluctuate based on breastfeeding; sometimes your period will stop and start a few times before getting back to normal. Your second period after birth will tend to be more like your pre-pregnancy periods in terms of flow and length, however.
You can typically get back on birth control six to eight weeks post-delivery if you want to.
Getting back to birth control really depends on you and what birth control you were on (or weren’t on) before getting pregnant. But it’s entirely possible that after lochia ends, you could bounce right back and get pregnant again within the first couple of months of giving birth — whether you plan to or not.
If that’s not something you’re trying to do, talk with your ob-gyn about birth control options. “We typically start birth control six to eight weeks after delivery,” says Dr. Phillips, “but depending on the patient, we may initiate birth control immediately postpartum.” It’s entirely individualized to the patient — you have to decide what works for you, whether or not you want to use hormonal birth control, and how you’d like to space out births if you want more children.
It’s important to have a thorough conversation with your health care provider about postpartum birth control, because it will affect your menstrual cycle and may change your bleeding patterns, too, Dr. Phillips adds.
Ultimately, there’s a wide range of what’s considered “normal” for both postpartum bleeding and your first real periods after pregnancy.
There’s usually no reason to worry if your periods don’t look or feel totally like what you were used to pre-baby. But if you experience any of the below symptoms, it’s a good idea to check in with your doc.
- Heavy bleeding. It’s common to experience heavier bleeding within the first couple of weeks after birth. However, if the heaviness continues beyond that six-to-eight week period, give your health care provider a call.
- Large clots. Passing clots is also normal, but if clots are accompanied by abnormally heavy bleeding and are larger than a walnut, it could be cause for concern, Dr. Phillips says. Pay attention to the heaviness of the blood as well as the size of the clots.
- Bleeding through multiple pads. You’re going to be using quite a few pads, both during the lochia period and once you start your period. But if you need two pads at a time post-birth (during lochia or once your period starts back up) and are still bleeding through them, talk to your doctor.
- Lightheadedness or fainting. If you’re feeling particularly weak, lightheaded, or experiencing fainting during the postpartum period, it might be due to the heavy bleeding. This could be a sign of anaemia, so check in with your ob-gyn to have a blood test.
The bottom line: Most women start to menstruate again about a month and a half to two months postpartum, though it can vary and depend on breastfeeding. Your periods may initially be heavier and more irregular, too, but will likely return to what you experienced pre-pregnancy.
