Along with being one of the biggest joys of a woman's life, many women consider pregnancy to be a 9-month-long vacation from "that time of the month." For many women, that blissful time without a period is one of the most welcome side effects of being pregnant (right up there with the great hair and the ability to eat for two!) Unfortunately, all good things must come to an end, which means that Aunt Flo will come back to visit everyone eventually.
For some women, Aunt Flo comes back with a vengeance, bringing terrible cramps and other PMS symptoms with her. For other lucky gals, Aunt Flo's side effects seem to ease up a little, and some new mom's report easier periods than before they were pregnant. If a woman is exclusively breastfeeding, she could have a longer break from her period than moms that are bottle feeding. Again this depends on the woman.
However, even while breastfeeding, there's still a possibility that menstruation could start again! It's different for everyone, but we're going to give our readers the scoop on what to expect from periods after pregnancy!
What's normal/not normal about bleeding during and after pregnancy? Wondering when the first post-baby period usually shows up? Worried about getting pregnant again? (FYI--it is possible to get pregnant again before that first period comes back, even while breastfeeding!) Want to know what goes down at those postpartum checkups? We've got the answers to lots of post-pregnancy period questions, so keep reading!
15Spotting or bleeding at any time during pregnancy
While one of the most familiar and obvious signs of pregnancy is a missed period, there are some women who still get a period or bleed throughout their pregnancy. It is estimated that 25 percent of women experience some type of vaginal bleeding or spotting in the early or late stages of pregnancy. If there is any spotting or bleeding at any time during pregnancy, it's a good idea to check with a healthcare provider to find out what's going on.
Common causes of bleeding during the first few months of pregnancy are from cervical bleeding, a threatened miscarriage, or an actual miscarriage. Miscarriages can happen in 15-20 percent of all pregnancies and results in vaginal bleeding.
Less common than miscarriages are ectopic pregnancies or a pregnancy where the egg implants somewhere outside of the uterus, like in the Fallopian tube. Bleeding later in a pregnancy can also be a sign of complications such as placental abruption, placenta previa, or preterm labor.
14Lochia, A LOT More Than A Period
Although not technically a period, women experience some degree of bleeding after childbirth. Lochia is vaginal discharge consisting of blood and tissue shed from the lining of the uterus after delivery. For the first few days after childbirth, lochia will probably be bright red and look a lot like a heavy period. It may come out intermittently in small gushes or clots or be a more steady, continuous flow.
Lochia will lessen gradually over the next few days. It will get lighter and more watery. By about 10 days after delivery, it will likely only be a small amount of white or yellowish-white discharge. It will taper off before it stops completely, probably in about two to four weeks, although some women may continue to experience intermittent spotting for a few more weeks.
It's best to use heavy-duty sanitary pads right after delivery, but as lochia lightens, some women find that they can switch to pads for lighter flow or even pantiliners. It's important not to use tampons (for at least six weeks or until the doctor says it's okay) to avoid infection.
13Too Much, Too Soon?
In the first few weeks postpartum, the bloody discharge, or lochia, will likely be heavier than a period would normally be. As time passes, the blood lightens and turns into a white or yellowish-white discharge. This discharge can continue for about six weeks, which is when many women will get their period if they're not breastfeeding.
But what's the difference between lochia and the first menstrual period after delivery?
If the bleeding stopped and the discharge had the white or yellowish-white color of lochia and then bleeding started again, this is probably a menstrual period.
If the bleeding lessened (without stopping) but then started to flow heavily again, it could be a sign that the mom is overdoing it. Bright red bleeding can reappear from time to time throughout the first six to eight weeks postpartum and is usually caused by exercise or increased activity.
If bleeding and cramping seem to increase, it's a good idea to lie down and rest for a few hours. If the bleeding doesn't appear to slow down during a period of rest, then it's probably a good idea to contact the doctor.
12The First Real Period
Whether and how much a woman is breastfeeding are the main factors that affect how soon she will get a period after having a baby. It is important to remember that every woman's body is different, so there's no really reliable way to predict when a woman's period will show up.
The less a woman nurses, the sooner her period may return. If the baby starts sleeping through the night and nursing less often when they are very young, the mom may get her period back sooner.
It's important to remember that ovulation will occur before the return of menstruation, which means that it's possible that a woman could get pregnant again before she even has a period. The chance that a woman will ovulate in the first six weeks after delivery is extremely low, but it could still happen.
The exact time when a woman starts ovulating again is hard to pinpoint, so if she's not considering getting pregnant again right away, it's a good idea for her to start considering contraception methods and discuss them with her doctor at her postpartum checkup.
11Hormones That Continue After Delivery
After the delivery of the baby (and the placenta) a woman's hormone levels drop like crazy. Women react to this change in hormonal levels differently. The most obvious or well-known effect of this drop in hormones is how it can affect a new mom's emotions and her mood.
But these hormonal changes can also affect women physically. There will still be a lot of relaxin, the hormone that helps the muscles stretch and deliver the baby, left in the body. This can make a woman more prone to sprains and injuries. Prolactin, the hormone that helps with milk production, can stimulate the appetite.
The hormones that give many women a luxurious head of hair during pregnancy will diminish, and the hair may end up falling out or shedding a few months after the baby is born. Also, as estrogen levels drop after delivery, most women find that their libido tanks, too. As hormonal levels stabilize, a woman's menstrual cycle will eventually return.
The return of the menstrual cycle is part of recovery and the body returning to its pre-pregnancy condition. In some women, menstruation may be delayed due to the increase of hormones that come along with breastfeeding.
10Breastfeeding Affects Periods
Usually, women who are breastfeeding don’t get their periods as quickly after giving birth. This has to do with the body’s hormones. The hormones needed to produce breast milk (known as prolactin) can suppress reproductive hormones. As a result, women don’t ovulate or release an egg for fertilization. Without this process, women most likely won’t menstruate.
If a woman is breastfeeding and her period finally returns, it may be very erratic at first. It may last way longer than a normal period (sometimes as long as two weeks!) and then it might disappear again for a month or two. Some mothers won't start menstruating again until their baby is weaned from breastfeeding completely. It could take several months or even a year.
The important thing to remember is that even if a woman's menstrual cycle seems to be all out of whack, she could still be ovulating, which means she could still get pregnant. If another baby isn't in the plans right away, then make sure to use a reliable form of birth control!
9Contraception Needs May Have Changed
Many women are so accustomed to whatever form of birth control that they (and their partner) had previously been using, that they don't consider how their birth control methods may change after pregnancy and childbirth. Some women may just be able to go back to using the birth control method they used in the past, or they may decide it's time to give something new a try.
For example, it's usually suggested to wait four to six weeks after delivery to start using methods of birth control that contain estrogen (combination birth control pill, the ring, and the patch) because estrogen can increase the risk of blood clots during the early postpartum period.
Estrogen-based birth control isn't recommended for moms that are nursing, either, because estrogen may reduce the amount and quality of breast milk that is produced.
The doctor can try fitting a patient for a diaphragm at her six-week postpartum visit. Even if the woman has used a diaphragm before, she will need to be fitted again because she may need a different size after pregnancy and childbirth.
It is recommended to wait a while before using other birth control methods as well. For instance, it's best to wait for three to four weeks before having a birth control implant inserted. It's also suggested to wait for 10 weeks before using a cervical cap.
Other birth control methods can be used right away. The IUD can be inserted right after delivery. Condoms, both male and female, can be used as soon as the woman is ready for intercourse.
8 Same or Different Periods
Some women may get their periods again after the birth of their baby and find that everything is back to normal. Same flow, same length as before.
Then there are some women who experience completely different - and much worse - periods after they have a baby. Some women complain that periods are heavier or last longer and that PMS symptoms like cramps are worse. A lot of times, periods may return with a vengeance, but will eventually lighten up over the next few months.
If periods don't seem to regulate after a few months, or if the periods are very heavy for more than two or three cycles, it's a good idea to let the doctor know. The doctor will be able to check for uterine or hormonal issues that could be the cause of the heavy flow.
Other differences that can be experienced:
- cramping that might be stronger or lighter than usual
- small blood clots
- heavier flow
- flow that seems to stop and start
There are also some women who are lucky to find that their periods are much lighter and easier to manage than before they were pregnant.
7Can Take a While to Regulate
Some women may find that their menstrual cycles bounce right back to normal once they start up again after having a baby, but others discover that their cycles have become more erratic. It could be that their hormones are still returning to their previous normal levels. Other factors like thyroid conditions, weight loss, and weight gain can also be possible causes for messed-up menses.
Stress can cause menstrual cycles to become irregular too, and what new mom doesn't feel tired and stressed out at some point?
Something else to keep in mind is that some women may enter perimenopause as early as their mid-30s, though it usually begins in a woman's mid-40s. During perimenopause, a woman's estrogen levels will rise and fall unevenly, causing her menstrual cycles to lengthen or shorten. It's around this time that a woman might also start to experience menopause-like symptoms, like hot flashes and sleep problems.
6PMS Symptoms Might Change
Everyone already knows that having a baby will change everything. For some women, childbirth can even change PMS symptoms. For many women, PMS symptoms can get worse postpartum. PMS is triggered when chemicals in the brain respond differently to fluctuations in hormones.
When a new mom is tense, anxious, and tired, her brain chemicals may send her PMS symptoms surging through the roof, even if they had always been pretty mild before pregnancy. Some suggestions if it feels like PMS symptoms are worsening:
- Eat a healthy, well balanced diet. Talk to the doctor about how to increase calcium and magnesium intake; many experts believe these nutrients can help alleviate PMS symptoms.
- Try to sneak in exercise wherever possible. The endorphins released during physical activity can reduce PMS symptoms.
- Take a break if needed. The stress and fatigue that women feel when caring for a newborn can make PMS symptoms worse, so don't be afraid to ask for help if necessary.
- Discuss possible medication options with the doctor. Hormonal birth control methods like the Pill help some women manage their PMS symptoms because the Pill lessens or stops monthly fluctuations in hormones. Antidepressants can also regulate chemicals in the brain to help the body balance itself out again.
5Can Get Pregnant Right After Birth
As mentioned earlier, it is possible to get pregnant again before the return of menstruation. Although some women consider breastfeeding a natural form of birth control, it's still possible to ovulate while nursing. It's a good idea to consider a backup method of birth control if it's not the right time for another baby just yet. Talk to the doctor about what birth control methods are safe to use while breastfeeding.
Using breastfeeding as a birth control method is known as the lactational amenorrhea method. If a woman is exclusively nursing (and her baby is not drinking milk from bottles or eating other foods) her body will not release an egg, or she will not ovulate. Pregnancy cannot happen if ovulation doesn't occur.
If done correctly, the lactational amenorrhea method is very effective. Less than 1 out of 100 women who strictly follow the lactational amenorrhea method will become pregnant.
4The First Postpartum Checkup
After 9 months of pregnancy and hours of labor and delivery, most women are pretty used to going to the doctor for their tests and check-ups. The first postpartum checkup, which usually occurs around six weeks postpartum, is an important one. Things that the doctor will most likely check:
- The mother's general health measurements like blood pressure, pulse, and weight
- The mother's incision from episiotomy or c-section if it was necessary
- The mother's reproductive organs (through a routine pelvic exam)
- The mother's breasts to check for blocked milk ducts
- The mother's mental state, to make sure that she is taking care of herself and adjusting to her new role as a mom
At this appointment, the doctor may give a woman the go-ahead to resume normal daily activities. After a c-section, a woman may be limited to not lifting anything heavier than her baby or not being able to drive a car for a few weeks. At this time, the doctor may decide that it's safe for a woman to resume having sex again. If that's the case, the doctor may also want to discuss plans for contraception.
3Not Breastfeeding Also Affects Periods
A woman’s period will typically return about six to eight weeks after giving birth if she is not breastfeeding. If a woman is supplementing her breast milk with formula, she may start menstruating as early as 12 weeks postpartum. If the baby is exclusively formula fed, a woman's period could return as early as four weeks postpartum.
It's believed that menstruation can start again a few months after delivery if the mom does not breastfeed. Menstruation can also return a month or so after weaning from the breast, decreasing the amount of time spent nursing, or switching from nursing to pumping. Pumping doesn't stimulate hormone production the way a baby nursing does.
If a woman is not nursing and doesn't get her period by three months postpartum, she should talk to her doctor. The doctor may want to check for secondary amenorrhea (that's when women with previously normal cycles don't have a period of three months), pregnancy, or other issues.
2Heavier Bleeding Than Before
Some women may experience heavier bleeding during their periods after baby. Sometimes the bleeding lightens up and a woman will find that her cycles have returned to normal. However, if heavy bleeding persists month after month,it might be a good idea to visit the doctor to check for hormonal imbalances and other health conditions. Some women may also need to get tested for anemia.
There are many conditions that can cause heavy bleeding during periods. One condition is the growth of uterine fibroids or noncancerous tumors that grow in and on the lining of the uterus. Pelvic inflammatory disease, infection, abnormal thyroid function, and changes in hormone levels can also cause heavier bleeding.
Some women also experience heavier bleeding for a while after delivery simply because the uterus expanded so much throughout pregnancy; with more uterine surface area to be shed during menstruation, there's simply more/heavier bleeding each month until the uterus has fully returned to its pre-pregnancy size.
1Other Causes for Concern
Women may experience prolonged and heavier bleeding after a long or difficult labor, giving birth to a large baby or multiple babies or suffering from complications such as a placental abruption when the placenta detaches from the uterine wall before delivery. Some women may have abnormal bleeding if the placenta or amniotic sac is left behind after delivery.
Even a small amount of tissue left attached to the uterine wall can lead to quite a bit of continued bleeding.
If the lochia still appears to be bright red at six weeks, or lightens up and then becomes red again, it might be time to call the doctor. Although it can be normal to pass clumps or clots, if there are clots larger than the size of a golf ball, it could be a sign of a postpartum hemorrhage, and again, it would be wise to alert the doctor.
If anything seems out of the ordinary about that first period after pregnancy, or if the bleeding is still continuous six weeks postpartum, contact the doctor. Excess bleeding can be an indication of infection or other health problems.
Sources: What to Expect, Babycenter, Parents, Today's Parent,
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