Whatever the duration of pregnancy – whether leading to the delivery of a healthy full-term baby, preterm delivery or ending in stillbirth – certain changes are bound to take place in a woman’s body.
Regardless of how long the pregnancy lasts, it results in suppression of ovulation. The resumption of periods after pregnancy will depend on the time it takes for ovulation to start again, which varies considerably among women.
It is difficult to predict the onset of the first menstrual period after childbirth since it is never the same in all women or even in different pregnancies for the same woman.
A blood stained vaginal discharge known as lochia is normal after delivery, continuing for a week or two and usually disappearing by about 6 weeks. It may be mistaken by some women as menstruation.
Lochia is actually the sloughed off tissue from the endometrial lining of the uterus mixed with blood and mucus, which comes out after delivery. In the first few days it may be bright red in color and looks like menstrual blood but the lochial discharge gradually diminishes and becomes lighter in color until it stops completely. Lochia is not a period.
Periods after Childbirth
It is possible for a woman to get her periods as early as 6 to 8 weeks after childbirth or it may come after 6 months or even later.
Onset of the first period after childbirth depends upon various factors, the most important of which is whether the woman is breastfeeding or not. If she is breastfeeding, the next consideration is whether she is feeding her baby exclusively on breast milk or if she is giving other supplementary feeding as well.
Only Bottle Feeding
A woman who is not breastfeeding her child at all, for whatever reason, can expect her periods to resume earlier than women who are breastfeeding. This could be as soon as 6 to 8 weeks after delivery.
If a woman is breastfeeding her baby exclusively without any supplementary feeding, she may not get her periods as long as she is feeding the baby. She is likely to get her periods as soon as she stops or within 6 months of stopping breastfeeding or starting supplementary feeding along with breast milk. This, however, is not a hard and fast rule since it is possible for a woman to get her periods even while breastfeeding.
Breast and Bottle Feeding
In most cases, a woman may get her periods three to four months after delivery if she is intermittently breastfeeding her baby, alternating with bottle-feeds or other supplementary feeding.
Changes in Menstruation after Pregnancy and Childbirth
A aignificant variation may be seen from normal periods in the first few cycles after delivery. Usually after one or two cycles, the periods revert back to the pre-pregnancy state but sometimes the changes continue for a longer period of time.
Some of the following changes may occur but should not be permanent.
- The initial periods may come as spotting or light bleeding, especially when the mother is intermittently breastfeeding the baby (breast and bottle feeding).
- The bleeding may be heavier in the first few cycles after childbirth. However, if the bleeding continues to be heavy, it is advisable to consult with a gynecologist
- Periods may become irregular.
- The cycles may be of longer or shorter duration.
- Painful menstruation (dysmenorrhea) may occur where previously there was no pain during periods.
- Premenstrual syndrome (PMS) may occur in some women, recognized by nausea, fluid retention and edema (swelling of the body), dizziness and emotional changes prior to onset of periods.
Reasons for Post-Pregnancy Changes in Periods
Hormonal changes following pregnancy, childbirth, and breastfeeding result in the changes in period around this time.
- Prolactin is secreted by the pituitary gland, which helps in secretion of breast milk as well as in suppressing ovulation.
- Estrogen suppression by prolactin results in irregular periods or cessation of menstruation during breastfeeding (lactational amenorrhea).
It is advisable to use some form of contraception after childbirth once a period starts. Although lactation gives some protection against pregnancy, it is possible to conceive even while breastfeeding. It should also be kept in mind that ovulation may occur in spite of lactational amenorrhea. It is therefore possible that a woman may fall pregnant even though she has not had her periods after delivery (childbirth).