It is known that after giving birth, a woman’s body needs some time to normalize those organs and systems that underwent changes during pregnancy and childbirth. This usually takes 6-8 weeks. The exception is the mammary glands and the hormonal system. They need more time for recovery. And it is well-known that restoration of the menstrual cycle is associated with hormonal changes. So, what a woman should know about period after birth? This complex process deserves a detailed discussion.
Postpartum Recovery and Period After Birth
The recovery process is individual for each woman, and the restoration of ovarian function and cyclical changes in the uterus depends on many external circumstances and health status. Some women have their first period after birth, and the ability to conceive a baby within two to three months after the delivery. Others have no menstruation for more than a year, especially against the background of active breastfeeding. The recovery of the period after birth largely depends on the dynamics of changes in the reproductive sphere and the normalization of hormonal balance after childbirth.
Against the background of pregnancy, physiological amenorrhea is typical – no cyclical changes in the uterus and bleeding take place from the very first weeks of pregnancy and until the birth. After childbirth, as the uterus returns to its original size and its functional layer is restored, hormone levels gradually return to normal. At the same time, cyclic changes in the balance of hormones and endometrium are formed again, leading to bleeding associated with rejection of the endometrium that has lost its functional value. Regular and not painful menstruation of physiological volume means that reproductive functions after childbirth have fully recovered. Still, this does not happen in all women and not always. In some cases, pathologies associated with inflammatory or dishormonal processes are possible. In addition, menstruation may not come due to repeated pregnancy.
Period After Natural Birth
Postpartum regenerative processes in the genital area take place on average from 6 to 8 weeks. All this time the woman usually has discharge, which varies in intensity, nature and color. They have no relation to menstruation – these are lochia. After about two months, the uterus and ovaries return to their physiological state and size, which means that period after birth can start again. Thus, a woman can expect the first menstruation from the 2-3rd month after birth.
Features of Menstruation in Women After Giving Birth
After childbirth, both the duration of the cycle and the volume of secretions often change. This is associated with a postpartum change in the balance of hormones. So, often the cycle can lengthen or vice versa, get shorter. Usually it becomes regular and painless. Doctors attribute this to the fact that after carrying the baby and delivery, the genitals finally “mature”. The phenomena of infantilism, bending of the uterus and some dishormonal processes are eliminated. It is important that those indicators of the duration of secretions and the duration of the cycle itself fall within the boundaries of physiological norms.
The first period after birth may be more plentiful, but it should not exceed the physiological volumes of blood loss. This is 100-150 ml. For about 3-6 months, the cycle is being established. Fluctuations in its duration are permissible in the range from 21 to 35 days, sometimes a little longer.
If a woman does not breastfeed, she should expect the first discharge by the third month after giving birth. But during lactation it is difficult to predict when the first period after birth will appear. The so-called lactational amenorrhea (lack of ovulation and menstruation) depends on the level of lactation hormones – that is, how often and how intensively the baby sucks. With exclusive breastfeeding, it is possible to suppress ovulation and menstrual function before the introduction of complementary foods, and sometimes longer, up to a year or more.
The blocker of ovulation and menstruation in nursing is the hormone prolactin, actively secreted by the pituitary gland during breastfeeding. It inhibits the maturation of the follicles in the ovaries and the functioning of the corpus luteum, which synthesizes progesterone. This, in turn, does not allow the formation of cyclic changes in the uterus and ovaries. Accordingly, if there is no ovulation, there can be no new pregnancy. The method of protection against conception – lactational amenorrhea is based on this fact. However, obstetrician-gynecologists warn that this is by no means a 100% method of preventing pregnancy. Thus, if a woman does not want to get pregnant again so early, she should use barrier methods of contraception (for example, condoms) or consider oral contraceptives that are acceptable when breastfeeding.
With mixed feeding, the first period after birth is expected from 3 to 4 months after delivery.
Period After Cesarean Section
The return of menstruation in this case depends on the level of hormones and the degree of restoration of the reproductive organs that were damaged due to incisions during surgery. Therefore, the period after pregnancy depends on how quickly the healing process of the scar will go and how well the pituitary gland normalizes after childbirth. Dates usually coincide with those in natural births. In many respects they depend on whether the mother is breastfeeding or not.
Against the background of artificial feeding, due to the lack of stimulation of the nipples (in which the synthesis of oxytocin, which reduces the uterus, is activated), recovery can go slightly slower. Plus there is still a scar on the uterus. Therefore, the restoration of period after birth may occur a little later.
Can A Woman Get Pregnant?
Many women mistakenly believe that if they do not have menstruation after giving birth, they don’t’ need protection from pregnancy, and they will not be able to get pregnant before their first menstruation. Some breastfeeding mothers believe in lactational amenorrhea, which, due to active breastfeeding, will protect them from pregnancy for as long as the baby is breastfed. And often these misconceptions lead to another pregnancy. This is due to the fact that the process of ovulation – the first after birth, is formed before the first menstruation. This ovulation with unprotected intercourse can give life to another baby. If a woman doesn’t breastfeed, she should think about protection after childbirth right away, from the very first sexual contact. Keep in mind that the dynamics of the restoration of reproductive functions is different for everyone. 6-8 weeks after the birth and the first ovulation is already can take place.
And for nursing mothers who have heard about lactational amenorrhea and plan to use this method to protect themselves from pregnancy, it will be useful to recall some facts:
Even with all the rules regarding lactational amenorrhea, its effectiveness in healthy women is only 94%. That is, about 6% of perfectly healthy mothers have a chance of becoming pregnant even if they breastfeed. Also, against the background of taking certain drugs, hormones or existing abnormalities in the ovaries, this method may not work at all. What’s more, if the intervals between feedings exceed 2-4 hours, the baby is given a pacifier, fed with a mixture or the baby sleeps for 4-6 hours at night, this method will not work. If there is still no menstruation, this does not mean that pregnancy is impossible. Don’t forget that ovulation for the first time after childbirth occurs before the first menstrual bleeding.
Therefore, nursing mothers, even in the first six months, when the efficiency of lactational amenorrhea is high, should use additional barrier methods of contraception, or consult a gynecologist to choose drugs that are safe for lactation to protect against unwanted conception.