Periods after pregnancy: when do they start and what to expect?

If you are an expecting woman or a new parent to a just born baby, you might be worried- when will your periods start again? One misconception that most new mothers have is that bleeding right after the birth of your baby is your menstrual cycle. But this is postpartum bleeding, which is a consequence of extra fluid and blood linked to your pregnancy. You may have to deal with your postpartum bleeding for around 6 weeks. And then you’ll get your first periods within a few weeks as this stops.

What all factors influence periods after delivery?
What is the difference between periods before pregnancy and after delivery?
Few warning signs during postpartum bleeding
Takeaway

What all factors influence periods after delivery?

The precise time as to when you’ll get your menses after pregnancy cannot be exactly determined because every woman has different experiences. But there could be several factors that influence the onset of postpartum periods. A few of the factors include.

Influence of breastfeeding on your periods

Most mothers may begin off with their periods again within a month and a half post-delivery if you are not breastfeeding your baby and the baby is on formula-feeding. However, if you are feeding your baby on breastmilk, you might not get your periods until you stop it. Some mothers, however, get their periods after few months post-delivery irrespective of your baby is taking your milk or not.

Research also suggests that women who breastfeed their children have late resumption to periods as compared to the women who do not breastfeed.

(Read more: After delivery care for mothers)

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Role of uterus in periods post-pregnancy

The uterus post-delivery requires three to four weeks to come down to its normal size (as before pregnancy) and functioning. Breastfeeding too is related to the uterine size at three months after delivery.

(Read more: Post-pregnancy diet)

The hormone oestrogen plays a role in your periods

It is also said that your baby's suckling suppresses the hormone, oestrogen, that triggers ovulation. So when you breastfeed, the amount of oestrogen is reduced in your body, making you even less likely to conceive. This is how breastfeeding works as a contraceptive too.

As the process slows down gradually i.e. your baby takes your milk less often now, consider around 3 times a day, you may experience bleeding as "spotting". Experts suggest that serum levels of estrogens and progesterone levels after delivery rise before menstruation.

Other factors that may influence periods after pregnancy are hormonal balance/imbalance and stress levels.

(Read more: Hormonal imbalance causes)

What is the difference between periods before pregnancy and after delivery?

Getting your periods back after childbirth indicates that your body has started ovulating again, however, your menses would vary each time you get your periods. This is because your body is adjusting to the changes in hormones following your child’s birth.

(Read more: Periods during pregnancy)

Heavier periods

You may notice heavier bleeding accompanied by blood clots after childbirth. This is because your increased amount of uterine lining needs to be shed. As the cycle continues, bleeding is likely to lessen gradually. In some cases, a woman might have additional conditions as thyroid or adenomyosis (thickening of the uterine wall) that causes heavier bleeding. Some women may also face lighter periods due to the factors like endometriosis (uterine lining grows out of the uterine cavity).

(Read more: Heavy periods causes)

Irregular periods

While some women would bounce back to the same monthly cycle after delivery, some may not get erratic periods. The factors would include your hormone imbalances, stress or postpartum depression, thyroid problems, with loss or gain of weight.

According to one study, breastfeeding holds the resumption of menstruation to some 8 to 15 months after childbirth. And if you are a mother in your late 30s to mid-40s, you might be experiencing perimenopausal phase. Research says that women have abnormal menstrual bleeding during the early menopause transition as well.

Painful periods

A few women get painful periods post-delivery. You may experience increased uterine cramps due to hormones related to breastfeeding or because the increased uterine lining needs to be shed.

(Read more: Painful periods)

Few warning signs during postpartum bleeding

You should immediately consult your doctor in any of these circumstances:

If you have bleeding so heavy that you need to change pads every 2 or 3 hours. This may indicate placenta pieces still lying in your uterus.
If you have a foul smell coming out of your vaginal blood. This may indicate an infection.
You sense some swelling in your uterus which could be some blood clot.
You have a high-grade fever during your periods. This may indicate infection.

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Takeaway

Post-delivery, you may take some time to resume to normal periods as your body is under the influence of increased levels of prolactin (a hormone that produces milk). Normally, periods start within six weeks after childbirth. But this may vary. You might even take more than this or even a year.

Breastfeeding as a contraceptive cannot be relied upon! Make sure to use contraception.

(Read more: How to have safe sex)

Visit your doctor at the earliest in case of excessive bleeding.