Return of menstruation after birth

You may have forgotten about your menstrual cycle, at least for the nine months of your pregnancy, but now that baby is here, you need to think about your period. After the glorious period-free months, your body will start to settle back into a regular menstrual cycle and fertility returns once again. While you were pregnant, high levels of the hormones oestrogen and progesterone supported your growing baby and this stopped your period. After giving birth, levels of these hormones fall rapidly, and eventually menstruation re-starts. Some women are caught unaware by resumption of their periods and it is important to be prepared to ensure no accidents happen such as unexpected pregnancy or embarrassing spotting on your dress.

When should you expect your period back?

According to Dr. David Kiragu, a gynaecologist and obstetrician, your first period will happen any time from five weeks to 18 months after your baby is born. But this varies considerably from one woman to another. This is because heredity also plays a part. Most girls start their period at the same age as their mother did and their return after giving birth is most likely to follow the same pattern.

Your general health and lifestyle also play a part. “If you are eating, sleeping and feeling well, your periods will probably return earlier than when you are exhausted, not feeding or sleeping well,” says Dr. Kiragu.

“The period also takes longer to return for breastfeeding mothers than those who don’t,” he adds. This is because breastfeeding mothers produce high levels of the hormone prolactic, which stimulates milk production and reduces levels of the hormones that trigger ovulation (the release of eggs). Many women do not ovulate or menstruate while breastfeeding, but prolactic levels fall as your baby grows, so you can still get pregnant. Breastfeeding is, therefore, not a reliable contraceptive.

It is worth noting that ovulation takes place about two weeks before your period, hence it is possible to get pregnant before your period resumes. Doctors advise that you use a reliable birth control method when you start to have sex again after giving birth, irrespective of whether you are breastfeeding or not.

Bleeding after delivery

It is normal to continue bleeding or spotting for up to six week after giving birth. This bleeding is called lochia. It starts heavy, often with clots, and then turns yellowish-pink before clearing. Your doctor will doctor will have discussed this with you while preparing you for delivery and will tell you what to expect after you leave hospital and before your first post-delivery check, usually on the sixth week.

It is important for you to know that this bleeding is not related to your menstrual cycle but a way of the uterus cleaning itself to ensure no placenta tissue is left behind. If this bleeding does not clear up in six weeks or you notice clots after the first two weeks, or a smelly discharge, you will need to see a doctor. You could be having an infection or any other after birth complication. You should only use sanitary pads after giving birth and not tampons to avoid infections.

Changing cycles

Many women who had irregular periods before becoming pregnant find that their cycle becomes regular.  If your periods were heavy, you could be in for a pleasant surprise, as it’s not uncommon for them to become lighter and shorter. However, the reverse can also happen, with some new mothers experiencing heavier, longer periods.  But if your periods are significantly heavier and more painful than before, make sure you see the doctor.

When your periods are painful… 

Exercise regularly:  Try swimming, brisk walking or dancing, all of which have potential to lift your spirits and this will ease the pain.
 Take vitamin B6 and magnesium supplements:  These may help alleviate cramps and bloating.
Take a painkiller  such as paracetamol.
Relax in a warm bath with lavender oil and snuggle up with a hot water bottle resting on your tummy.

 Published in June 2012