The lowdown on periods after pregnancy
Your body goes through some pretty extreme changes during pregnancy, and these changes don’t just stop after giving birth. There is still a lot that your body needs to do, both to recover from pregnancy and labour, but to nourish and nurture your new baby too.
One thing that doesn’t really get discussed too often, is what happens to your periods after birth. How does your cycle change? Are those changes long-lasting? What can you expect from your period moving forward as a new mum?
We spoke to Dr. Brooke Vandermolen recently, to get you the lowdown on everything about periods after pregnancy. Dr. Vandermolen, The OBGYN Mum, is an Obstetrics and Gynaecology doctor, medical writer and blogger, and we put some of our burning questions to her during an Instagram live.
What is the first period after pregnancy like?
Immediately after birth, you’ll experience postpartum bleeding, which is usually quite heavy. Postpartum bleeding can last for up to six weeks, but the flow tends to slow down after the first two weeks. This blood flow is made up of a mixture of blood, mucus and uterine tissue. It’s not a period though.
So once postpartum bleeding has finished and our cycle returns, what can we expect our first period post-pregnancy to be like? Dr. Vandermolen told us that the first period after birth could actually be heavier than your periods were before pregnancy.
This can be down to the uterus lining that thickened up and then formed the placenta to nourish your baby throughout your pregnancy. Not all of that blood sheds with postpartum bleeding, so some of it will still be a bit thickened. It’s normal for your first period after giving birth to be a bit heavier.
However, some people find it’s really light and their first period is a bit of spotting, it goes away, they have nothing else for a while, and then they get another period and it’s different. It’s variable, so don’t be worried if it's very heavy or very light.
When should I expect my period if breastfeeding?
If you choose to breastfeed your baby, you might not get your period back straight away after pregnancy. Dr. Vandermolen explained that a lot depends on what happens in your birth, what kind of birth you have too.
When breastfeeding, this sends a signal to the brain that releases a hormone called prolactin. It helps you to produce the milk and for bonding with your baby. Whilst your breastfeeding, that high hormone level prevents you from ovulating. If you don’t ovulate, then you don’t see your period. So, if you’re breastfeeding or if your prolactin levels are high after giving birth, you won’t see your period for a little while.
For the majority of people who are breastfeeding, they’ll find that their periods may come back anywhere between 9 months and 18 months after pregnancy. Some people find that their periods don’t come back at all while they are breastfeeding – so, if they breastfeed their baby until they are 2 years old, they won’t see any periods.
Others, though exclusively breastfeeding, may see their period after 6 weeks. There’s no knowing which category you will fall into. It’s normal if your periods don’t come while you're breastfeeding.
It’s also normal if they do return. Many women find that as their baby gets older and starts taking less milk, prolactin levels start to drop and ovulation begins again, signalling the return of their period.
Can post-pregnancy weight gain affect periods?
Gaining weight during pregnancy is not only normal, but expected. Not only are you guaranteed to gain at the very least the weight of your unborn baby, but you’re also likely to gain weight due to extra fat stores that are needed to produce breastmilk after birth.
There’s also weight gain due to growth of your uterus, breasts and the placenta- plus there’s extra blood and fluid in your body, not to mention amniotic fluid taking the scales up too. So yes, weight gain during pregnancy is normal, and it’s also normal not to return to your pre-pregnancy weight straight away after birth too.
Dr. Vandermolen told us that this weight gain can also have an affect on our menstrual cycle.
If you have irregular periods or heavy periods, your weight could be a factor. It’s important to build in exercise and do as much as possible to nourish your body with healthy, homemade food, especially if you’re breastfeeding your baby as well.
A lot of people find that, due to the calorific demand of breastfeeding and passing those high fats on to your baby through milk, it does help to lose some weight.
If you have a higher BMI (body mass index) than before your pregnancy, this can impact ovulation. It’s the same in people who aren’t pregnant or haven’t recently given birth. If your weight is higher, it can mean that the fat tissue can affect hormone levels going round your body.
For example, people with a BMI of above 30 may experience more irregular periods and can find it harder to get pregnant.
What you can do: Of course, if you’ve got a newborn baby, it may not be as easy as before to attend an exercise class on your own. Perhaps try regular walks or a buggy walk class near you – this could be an added bonus from a social perspective as well.
What period protection should I use after birth?
Postpartum bleeding can be a lengthy process compared to your usual period, but the NHS advises that tampons should not be used during this time. This is because after you give birth, there could be tears or cuts in and around your vagina, plus you’re also healing internally where the placenta was joined to the uterus wall.
Using a tampon too soon after birth can increase the risk of infection. It’s important to allow the blood to flow out easily without obstruction, so menstrual cups are also not advised at this time.
WUKA Period Health Expert Dr. Brooke Vandermolen says:
‘I always encourage people to pack period underwear in their bag or to take to hospital, because I think it’s a fantastic thing to use for postpartum bleeding. If you can find something to absorb that away safely, then period underwear could be something to try.’
What you can do: Although your postpartum list might be slightly shorter than your baby’s, reusable period underwear can make those initial post-birth days (and weeks) a little more comfortable than maternity pads, like very thick sanitary pads. WUKA postpartum period pants are a comfy, convenient and sustainable option.
You don't need to worry about changing your underwear often or leaking on the sofa with WUKA'S Postpartum Pants. What's more, they can absorb 60ml of blood, the equivalent of 12 regular tampons.
How do you know you’re ovulating in the postpartum period?
Your periods after birth can tell you a lot about your body. The best way of knowing if you are ovulating again is if your periods become regular. If you, in general, begin to have a period where the cycle is 28-29 days (varying by a day or so either side) for 3-4 months, this is a good indicator that you are ovulating. Each time you ovulate, your period comes 14 days later. If there are big differences every month, this could mean you are ovulating at random times.
Something to be aware of is that you might have worse premenstrual syndrome (PMS) after pregnancy. This can be due to the shift in hormones. Your oestrogen and progesterone levels may be higher during pregnancy and then they drop, so it can take some time for things to settle back down after a while.
The bottom line on periods after pregnancy
👉 A lot of people may find that their first few periods after pregnancy are heavy. You could have heavy or irregular periods after birth.
👉 Add WUKA Super Heavy Flow Period Pants to your postpartum shopping list (they might be useful for absorbing increased milky discharge in the third trimester too).
👉 Learn about common postpartum period symptoms and what to do about them. If you’re worried about discomfort or heavy periods, call your healthcare provider.
How long does it take for your period to be normal after giving birth?
If you choose to breastfeed your baby, you might not get a period for a few months after giving birth. Some women who exclusively breastfeed don’t get their period back until they stop completely.
If you don’t breastfeed, your period could return as soon as 5-6 weeks after giving birth. We’re all different though, and our bodies take varying times to recover after pregnancy and childbirth, Remember that there is still a chance that you could get pregnant even if your cycle hasn’t returned to normal.
Do periods change after having a baby?
Your first period after having your baby can be very different than before you were pregnant. Lots of women experience irregular periods and heavier bleeding for the first period. Some also experience an intensity of period pains too.
This should settle within a few months, but do speak to your GP if you’re concerned or if you’re passing more blood clots than you would usually during your period.
Does the menstrual cycle change after giving birth?
Your menstrual cycle will always remain the same in terms of each phase that it goes through once per month (roughly every 21-35 days). But the timings of these phases and the symptoms you experience can be different after giving birth.
Some women experience more irregular periods, with heaver or lighter blood flow and a change to PMS symptoms and period pains. If you track your period, keep an eye on the changes and speak to your GP if things don’t settle down and you’re concerned.
About Dr. Brooke Vandermolen:
Dr. Brooke Vandermolen is an NHS doctor currently working and training as a Registrar in Obstetrics and Gynaecology and mother to 2 babies. Brooke founded her educational platform ‘The OBGYN Mum’ to share insights and tips around pregnancy, birth, fertility, menopause and more through social media and blog posts. Her research in the fields of maternal medicine and high-risk pregnancy has been presented at major international conferences and published in prominent medical journals.
Find out more about our WUKA Period Health Experts here.