When will it arrive? And what will it be like? Here's what you can expect when your period returns.
Last month, after nearly two long years, I got my first visit from Aunt Flo—after a long delay brought on by breastfeeding my one-year-old son. I was fine with it, but I had questions. Lots of questions. Would my flow be the same? How long would it take for me to be regular? Would I be in more pain? I was disheartened by the lack of personal accounts to give me a sense of what's normal. Want to know what to expect? You're in luck. Here are five things you should know about your post-baby period.
1. You don't need to stress about it
Many moms stress about what to expect with the first menstrual cycle post-baby. But there's definitely no need to.
"Sometimes the first period can be surprising, as it can come unexpectedly and may be slightly heavier than your periods from before pregnancy," says Jessica Shepherd, MD, MBA, assistant professor of obstetrics and gynecology at the University of Illinois College of Medicine at Chicago. "But the first period after delivery is not always as bad as it may seem."
Many women expect that the return of menstruation means the return of fertility. But keep in mind that it is possible to become pregnant before your period arrives, and to take precautions if you aren't ready to get pregnant again right away. "Typically, we like to put everyone on birth control [shortly after birth] whether they are breastfeeding or not," Shepherd says. "We can't say just because you are breastfeeding means you can't get pregnant. For women who are breastfeeding, we ofter progestin-only birth control pill (minipill), and for women who are bottle feeding, we can put you on any birth control." Most new moms should consider waiting to get pregnant for at least 18 months, Dr. Shepherd says.
2. There are a lot of factors that could go into when it returns
Breastfeeding mothers have a longer window between birth and their first menstrual cycle than non-breastfeeding women. There's no one "right" time for your period to come back, and the biggest factor in how soon is likely how you're feeding your baby. "For mothers who are bottle feeding, the average return to periods is six to eight weeks, however, it can return as quickly as four weeks post delivery," Dr. Shepherd says. "Mothers who are breastfeeding exclusively and have the baby get their only source of nutrition from the breast can go as long as six months or longer until the use of supplementation is used. Some women have had their periods not return until a year or more after delivery. The hormone prolactin, released with breastfeeding, inhibits the period from returning."
3. It may come...and then go
I've heard of moms who start their period, then have them leave for another month or two. That lack of regularity is due to hormonal changes as your body transitions to its new normal, according to Dr. Shepherd. "Many times the hormonal balance after delivery can be a little different and therefore cause the periods to fluctuate, as hormones try to develop and maintain a new equilibrium."
Delays in regulation have many causes, so it's important to consider your specific circumstances before freaking out. "Delays can be caused by hormonal imbalances, another pregnancy, diseases from the pituitary gland or thyroid, premature menopause and scarring inside the uterus if there was any dilation and curettage after the delivery."
4. You may experience more cramping
If you are wondering what causes extremely painful cramps, you can blame the hormone-like substances known as prostaglandins. "Pain can be correlated often to the amount of blood that is being shed from the uterus, and is because of the prostaglandins released from the body during a menstrual cycle," Dr. Shepherd says.
5. You should see the doctor if something seems off
Whether it's more painful cramps or a lower flow, changes to your period are likely, at least for those first few cycles. "Embrace the changes after a delivery and know that the first period may not indicate a long-term change," Dr. Shepherd says. "If the changes are drastic and last longer than three months, it is important to talk to your gynecologist about the changes."
And if your period doesn't return for quite a while after you have your baby, it's definitely time to consult your OB/GYN. "If your period doesn't return six months after you have stopped breastfeeding, you should contact your doctor. For women who are exclusively bottle feeding, if your period hasn't returned in six months you should contact your doctor."