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Period after pregnancy,pregnancy,childbirth

First period post pregnancy: what is normal and what is not?

During pregnancy – starting with conception and extending over around 40 weeks, a women’s period stops completely. For most women, the absence of menstrual periods during this time might seem like a welcome relief.

While for some, it may mean a break from debilitating period cramps, for others, it could just be the liberating feeling of not having to worry about changing tampons or pads.

After a rather lengthy hiatus, however, when a woman experiences periods after delivery, it is not unusual for them to be caught off-guard or unprepared.

This is because most first-time mothers are not well-informed about what to expect from the first period after delivery.

To keep you from being surprised and to help you prepare yourself, we give you some straightforward information on how to take on your first period after pregnancy.

What to expect?

Before we can tell you what to expect for your postpartum period, here’s something you need to know. Every woman’s body is different, so every woman’s first period after delivery will vary.

When your period returns after pregnancy, it is unlikely that it will be the same as before. The duration of your period, the length of your cycle, and even the intensity of the flow can change after birth.

Some women may experience painful and extremely heavy periods after pregnancy. For others, their periods may be shorter, lighter, and less painful after pregnancy. Whatever the case, knowing what is normal will help you feel more prepared.

Some women also tend to confuse lochia or vaginal discharge during the postpartum period with their menstrual period. Lochia, however, is not a period and is simply the body’s way of getting rid of excess tissue, blood, and mucus from the uterus.

This typically appears in the first few weeks after delivery and will happen irrespective of whether you have had a caesarian or a normal delivery.

What distinguishes lochia from a regular period is the fact that, although lochia is initially bright red, it progressively gets lighter and waterier.

When to expect your first post-pregnancy period?

It is normal to be nervous about when your first period will arrive after giving birth to your baby. However, there is no certain way to know when you will experience normal periods after pregnancy.

The National Health Service (NHS), UK, suggests a link between breastfeeding and periods after pregnancy.

Based on their findings, women who bottle-feed their baby or practice bottle-feeding, combined with breastfeeding, could get their first period as soon as 5 to 6 weeks after they give birth.

If you fully breastfeed your baby, however, there is a possibility that your periods may not start again until you have stopped breastfeeding. This happens because prolactin, the hormone that produces breastmilk, can inhibit the menstrual cycle directly.

If you experience your period during breastfeeding, you may notice some changes in your milk supply. The hormonal changes may cause you to produce lesser breastmilk, and it may change the composition and taste as well.

These changes are, however, usually very minor and unlikely to interfere with your ability to breastfeed your baby.

What should you know about your first menstrual period after birth?

Your first postpartum period is likely to be quite heavy. You have a larger uterine cavity now, and there is an increased amount of uterine lining that needs to be shed.

Some women may also experience intense cramping, but these symptoms may gradually subside with each subsequent period. As your body tries to restore hormones to get you back on a regular menstrual cycle once again, here are some differences that you may notice with your first period after giving birth:

  • You may experience a heavier flow
  • Cramping can be worse or, in some cases, milder than usual
  • You may pass small blood clots
  • Your period may start and stop every once in a while
  • Your menstrual cycle may not be easy to track, as your body may take a few months to fall back into rhythm

If you have had a normal delivery and your period returns early, try to avoid using tampons for the first period after pregnancy.

Your doctor may advise this, too, as it can aggravate any trauma or scarring in the vagina that you may have experienced during delivery.

How long will your period last?

According to the Cleveland Clinic, most women will return to their normal cycle after giving birth. If your period is ‘normal,’ it will occur every 21 to 35 days, while the bleeding may last anywhere between 2 to 7 days.

However, ‘normal’ here may also relate to what you were experiencing before your pregnancy. If you have a history of painful periods or endometriosis, for example, you will likely continue to have painful periods over time.

What are some potential causes for concern?

If you experience any of the following symptoms with your first menstrual period after birth, contact your gynecologist immediately:

  • Sudden fever with no obvious source or apparent cause;
  • Persistent bleeding that lasts for more than a week;
  • Bleeding accompanied by sudden, sharp or severe pains;
  • Foul-smelling vaginal discharge;
  • Having to change tampons or pads every 1 to 2 hours because of soaking;
  • Severe headaches;
  • Difficult or fast breathing;
  • Pain or discomfort when urinating; and
  • Passing clots of blood that are larger than a golf ball.

Apart from these symptoms, if your periods have been absent for more than three months after you have stopped breastfeeding or if you notice that your menstruation is relatively scarce, you should talk to your doctor immediately.

Concluding thoughts

In the weeks after birth, your body is still as fragile as it was during pregnancy. While you may be eager to return to your regular routine quickly, you must take things slow.

Avoid heavy lifting or doing any strenuous exercise, and do not insert anything in your vagina for at least the first six weeks.

Most importantly, follow all your doctor’s instructions for recovery and ensure that you go for your postnatal checkups regularly. A comprehensive postpartum checkup should be done within 4 to 6 weeks after giving birth.

Author: Dr Astha Dayal
Dr. Astha Dayal is an esteemed obstetrician and gynaecologist in Gurgaon. She cleared her MRCOG certification in London, UK, and is a member of the Federation of Obstetric and Gynecological Societies of India. She has over 16 years of experience in the medical and surgical management of women’s health with an emphasis on high-risk pregnancies as well as advanced laparoscopy.