Setting all the physical ailments of pregnancy aside, one perk is going nine months without a period. After giving birth, all postpartum women bleed for a few weeks to expel all the remnants of pregnancy. This is called lochia, and once lochia dries up after giving birth, you may wonder what to expect from your first period after having a baby.1
Every woman experiences a slightly different return to menstruation postpartum. Still, some commonalities affect when a postpartum woman’s period returns after a baby and what it will be like. Your first period after pregnancy can also play a role in lactation and fertility, which will be examined here.
Quick Contents
When Will My Period Return After I Have a Baby?
During pregnancy, female reproductive hormones go through major shifts and fluctuations. Pregnancy hormones suppress ovulation so that a woman cannot get pregnant while she is already pregnant.2
For your first period to return after your baby is born, these hormones must return to their baseline, non-pregnant state. The time it takes for this to happen varies significantly from woman to woman and is affected by certain factors.3
Factors Affecting Time to First Postpartum Period
Many dynamics influence when a woman’s first period returns after they have a baby. Some factors that are associated with a shorter time to their first period include:3
- Women residing in urban areas
- Women who attended formal education
- Hormonal contraceptive use
Factors associated with a delayed return to menstruation include:3,4
- Women with more children
- Women who breastfeed
- Manual removal of the placenta at birth
Does Breastfeeding Affect Your First Period After Your Baby is Born?
Perhaps the most significant influence on the timing to return of a woman’s first period after her baby is born is whether she is breastfeeding. Non-breastfeeding women will likely experience their first postpartum period between six and 12 weeks postpartum. One study showed that nearly half of the non-breastfeeding women had a period by six weeks postpartum, and almost all had a period by 12 weeks.5
Breastfeeding women may experience a period this early, or they may experience a delayed period. Some women’s periods do not resume until they completely wean their child from breastfeeding, which can be months or years.6
According to the La Leche League, a woman’s period will likely return between nine and 18 months postpartum if still breastfeeding. Completely weaning an infant or child will almost certainly cause a mother’s period to return; however, completing weaning is often unnecessary to begin cycling again. You should contact your provider if you have weaned your baby from breastfeeding and have gone months without a period.6
What is Lactational Amenorrhea?
Lactational amenorrhea refers to the period during which a breastfeeding woman has not yet experienced a period postpartum. An infant suckling at a woman’s breast inhibits the hormones required to ovulate and menstruate. Lactational amenorrhea can be considered an effective method of pregnancy prevention if used correctly. It is 98 percent effective if all the following criteria are met:7
- The baby is less than six months old
- The mother has not experienced a postpartum period
- The mother exclusively or nearly exclusively breastfeeds her infant on demand, both day and night
If any of these criteria cease to be met, lactational amenorrhea can no longer be relied upon for pregnancy prevention.
In one study, breastfeeding reduced the chance of ovulation by 98 to 99 percent in the first six months postpartum if menses had not returned. Even after a woman’s period returned, 94 to 97 percent of cycles failed to achieve ovulation if the woman was still breastfeeding and under six months postpartum.8
Can You Get Pregnant Before Your First Postpartum Period?
Breastfeeding or not, it is possible to get pregnant before your first postpartum period because ovulation sometimes precedes menstruation. According to one systematic review, in women not breastfeeding, first, postpartum ovulation typically occurs between six and 13 weeks after giving birth. A period may return between six and 12 weeks; therefore, it is possible to ovulate before a period.5,9
In another study, ovulation preceded a mother’s first period after their baby in one-third of non-breastfeeding women.9
If breastfeeding, periods before six months postpartum are most likely anovulatory. This means that even if a breastfeeding woman’s period has returned, she is not likely to ovulate before six months postpartum. Fertility is low during this time, and pregnancy is unlikely.7
Even if a woman does ovulate before her first period and that egg is fertilized, chances of implantation are slimmer because the luteal phase is often short, allowing less time for a fertilized egg to implant. However, no matter how remote the chances of conception and implantation are before that first postpartum period, pregnancy is still possible.10
Women who want to avoid pregnancy may not want to rely solely on lactational amenorrhea to prevent pregnancy. They should be aware that they may be able to become pregnant before having a period.
Does Your Period Affect Your Milk Supply?
Some women report a drop in milk supply after they begin cycling again. This supply decrease often occurs between ovulation and their next period or in the second half of the cycle. Some may also experience more discomfort with a latch or during nursing at this point in the cycle. This is caused by hormones and is temporary.6
Some medical professionals recommend supplementation with calcium and magnesium to combat this drop in supply, but you should talk to your provider before adding any supplements to your diet.6
How Might My Period Be Different Postpartum?
There is no one way that periods change after pregnancy. Some women report heavier first periods after they have a baby, while some report lighter. Others report no change from pre-pregnancy.11
Passing increased blood clots during your first postpartum period can be normal. You should contact your provider if they are larger than a golf ball. Postpartum period characteristics and symptoms, like menstrual cramps, typically resemble your pre-pregnancy symptoms. One study showed an increase in menstrual flow and period pain after having a C-section.12,13
It is common for cycles to be longer for the first few postpartum periods, and the earlier your period returns postpartum, the more irregular it is likely to be.5,14
Rare Problems
In rare cases, the first periods after a baby may be extremely light or nearly absent postpartum. If this is the case, you should contact your provider, as you may be suffering from Sheehan’s or Asherman’s syndrome.11
Sheehan’s syndrome happens when severe postpartum hemorrhage causes hypopituitarism. This can cause absent periods and a failure to lactate. If you experienced severe postpartum hemorrhage and are dealing with these symptoms, reach out to your provider.15
Asherman’s syndrome refers to uterine scarring or adhesions because of a dilation and curettage (D&C), uterine fibroid removal, or Cesarean section. Doctors sometimes perform D&Cs after a miscarriage or a delivery, particularly in cases of retained placenta. If you had a D&C or other uterine surgery and are now experiencing light periods, infertility, or menstrual pain, you should contact your provider to rule out Asherman’s syndrome.16,17
Unfortunately, there is no great way to predict when you might get your first postpartum period, as it is affected by many factors, such as breastfeeding and birth control. Your periods may be different than you were used to when they first resumed, but they should eventually return to your pre-pregnancy baseline. If you are ever concerned about your period, your provider is an excellent resource for reassurance or further investigation.
The return of your first period after your baby may also signify a return to fertility, but it is essential to note you may be fertile before that first period. Be cautious if you are sexually active and do not desire another pregnancy. While waiting for your period to return can be a bit of a mystery, rest assured that a delayed postpartum period is often normal, and it will come back eventually. In the meantime, you can enjoy the break from your monthly bleed.
Resources
1. https://my.clevelandclinic.org/22485
2. https://my.clevelandclinic.org/24562
3. https://pubmed.ncbi.nlm.nih.gov/36303667/
4. https://journals.plos.org/pone.0235888
5. https://pubmed.ncbi.nlm.nih.gov/12255260/
6. https://llli.org/rastfdng
7. https://pubmed.ncbi.nlm.nih.gov/9678098/
8. https://pubmed.ncbi.nlm.nih.gov/1967336/
9. https://pubmed.ncbi.nlm.nih.gov/21343770/
10. https://pubmed.ncbi.nlm.nih.gov/7165971/
11. https://health.clevelandclinic.org/dyops
12. https://utswmed.org/123
13. https://pubmed.ncbi.nlm.nih.gov/29055402/
14. https://epublications.marquette.edu/cgi2084&
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183525/
16. https://my.clevelandclinic.org/16561
17. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430995/
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