Everyone knows a pregnancy means your period goes into hiding for a while. And honestly, it might have been a welcome break. But once the baby comes, you will probably start to wonder: What will happen with my period after giving birth?
The answer to this question will vary for everyone, and that’s perfectly ok. Each body and menstrual cycle are different! But regardless of when your postpartum period comes, it’s a good idea to know what to expect. Here are some questions you might have about your first period after birth.
Is Spotting and Discharge Normal After Birth?
Absolutely. Even if you’re in great shape and well-prepared to give birth, your body will need to go through a major recovery process. Labor is the ultimate workout, so your muscles will be achy. If you had a vaginal delivery, you’ll be extremely tender. And if you had stitches, they will be painful and take time to heal. During the first four weeks postpartum, you will notice a pink-brown discharge called lochia. This is totally normal. Even though it might look like a period, it isn’t—just the natural process of your uterus shedding blood, mucus, and tissue after birth. Just be sure to wear a pad and change it often.
What Causes Postpartum Period Cramps (Afterpains)?
In the weeks after birth, you might also feel something similar to menstrual cramps — but it’s usually a fakeout. During pregnancy, your uterus was stretched way beyond its normal size. Post-pregnancy, it shrinks back to about the size of your fist, causing a bit of cramping in the process. It’s most common in women who breastfeed and who have already had one or more babies.
So When Can I Expect My First Period After Birth?
Good question. Having a C-section or vaginal delivery does not affect how quickly your period will come after pregnancy. But your first postpartum period does depend on whether you breastfeed exclusively—that is, if you nurse your baby every 4 hours during the day and every 6 hours at night. If you bottle-feed, your first period after baby may happen as soon as a month after delivery, but should happen within 2 to 3 months. If you breastfeed exclusively, your period might not show up until after your baby is weaned. That’s because prolactin, the hormone that’s in charge of your body’s breast milk production, suppresses ovulation in your body.
Postpartum periods may also affect your breast milk supply. It’s not unusual for your supply to go down during your period or for your baby to notice a different taste. It might be a bit uncomfy to breastfeed during your first period after pregnancy.
When your first post-baby period does show up, there’s a good chance your flow could be a little wonky compared to what you’re used to — it could be heavier, or even lighter. It could be longer or shorter than your pre-baby periods. The blood might have a different color or texture. You might notice different premenstrual symptoms. Your period could show up, skip a cycle, and start again. Don’t worry, these changes are temporary and usually normal; your hormones are still figuring out your post-baby body.
When Can I Use a Tampon After Giving Birth?
Doctors recommend waiting six weeks before inserting anything in the vagina. That means you should never use tampons for lochia or a period that comes early—it could cause trauma to that very sensitive tissue. It’s a good idea to play it safe and wait for your doctor’s green light before trying out a tampon post-childbirth.
Once you venture back into tampon insertion, you may need to use different absorbency than what you used before. And if you gave birth vaginally, you might want to use a larger tampon for a few months. Your vaginal muscles just pushed out a whole baby, after all, and your pelvic floor needs time to recover! Check in with your doctor about pelvic floor exercises that will speed up this process. The angle of your vagina can also change, so you may need to adjust your insertion technique.
Because many women experience a heavier or more unpredictable period right after pregnancy, they often opt for a pad when their first post-partum period comes. This is also a good way to monitor the quantity or texture of your flow, if that’s something you’re worried about. A pantyliner might also come in handy the first few times you use a tampon after birth while you adjust to your changing flow.
What About Birth Control?
Many women actually rely exclusively on breastfeeding to prevent pregnancy. It’s a form of birth control so official that it has a name: lactational amenorrhea method. Because exclusive breastfeeding (and it really needs to be exclusive) naturally inhibits ovulation, the chances of getting pregnant while breastfeeding are extremely low—about 2 in 100 women who use breastfeeding as birth control will get pregnant in the six months after birth. (Just keep in mind: After six months or the introduction of foods to supplement breast milk, lactational amenorrhea becomes less effective and reliable.)
Of course many women don’t breastfeed, or want to be extra-careful; it’s not easy to exactly predict when you’ll be fertile again. When it comes to choosing a birth control method, you should avoid one that contains estrogen for the first 42 days post-partum because of an increased risk of blood clots. If you are breastfeeding, the estrogen in hormonal birth control can also significantly reduce your breastmilk supply. After those 42 days, your options open up, so consult with your doctor about what would be best for you. Also, a warning: Even if you're not menstruating regularly while breastfeeding, you can still ovulate and get pregnant! So be sure to take the proper precautions.
When Should I Worry About a Postpartum Period?
If your period hasn’t started three months after giving birth (or three months after you stop breastfeeding), it's definitely time to check in with your doctor. Missed periods, spotting, or periods that last less than 2 days could signal a hormonal imbalance or a thyroid issue. On the flip side, some people notice heavier bleeding and more cramping during their first few post-pregnancy periods. But give your doctor a call if you’re soaking through a tampon or pad every hour or less, if your period is going full-blast for more than 7 days, or if you notice clots larger than a golf ball—those could be signs of cysts, polyps or fibroids. Also alert an MD if you get a sudden fever during your period or if you notice any bad-smelling discharge. Any of these could be a warning sign of infection.
Bottom line: Postpartum recovery is a huge physical transition, so be patient with yourself. Your body and your hormones are adjusting to a new normal. Chances are, it’ll all settle down—just remember listen to your body.