Written by : Dr.M.D.Mazumdar, MD
When does the period return or occur again after childbirth?
The time of the first period depend on two factors:
In women who are breastfeeding exclusively and where the baby gets its entire nutritional needs from the mother's breast, the period may return only 6 months after the childbirth - around the time when the baby is put on supplemental feeds. In some women however, the periods may be delayed as much as 1 year or 2 years even after supplementary feeds have been added. For some rare women, the periods may return only after breast-feeding has been stopped.
The periods usually return about four to ten weeks after the baby's birth if a woman is bottle-feeding, or combining breast and bottle.
In women who do not breastfeed and prefer to bottlefeed the baby from the time of childbirth, the periods may return as early as one month after delivery. But in most cases, it occurs within 3 months.
A woman's personal hormonal make up also affect the occurance of the first period after childbirth.Every woman is unique and responds to the changing levels of hormones in her body in her own way. Some women, even those who are exclusively breastfeeding may find that they get their first period within 1 month. This is uncommon but can occur. In most women though, it occurs within 7-10 weeks after childbirth.
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The first period after childbirth is usually very heavy. There may be heavy bleeding with passage of large clots. Tampons plus heavy duty pads may be necessary. But it should be noted that if the bleeding is heavy enough to soak through a maxipad or tampon in less than an hour, it is too heavy and a medical checkup is necessary.
Instead of a heavy blood flow in the first period, some women may have irregular spotting in the 1-2 months before she gets her first period. Spotting is a light and irregular period that usually appears as spots of blood. As the number of breastfeeds decreases, the level of hormones like prolactin decreases in the blood - this can lead to irregularity of hormonal levels of estrogen and progesterone causing withdrawal bleeding on and off - hence the spotting.
Fertility usually returns before the period.
Fertility in women is most effectively suppressed when the gap between feeds is no longer than 4 hours during the day and 6 hours at night. But the mother's own hormonal pattern also has an effect on the fertility.
Immediately after the delivery and for about 4 weeks after the delivery, there is the flow of vaginal discharge known as lochia. Once this decreases, women will not have bleeding again until the period returns. Some women however may have spotting from time to time within this period.
The first period may occur without an ovulation but usually ovulation occurs first followed by a period in about 2 weeks. Women may thus fall pregnant again after a childbirth without a return of their periods. Often, light bleeding or spotting is the first indication of the return of fertility.
Some women depend on breastfeeding as a method of contraception. But this is very risky and failure rates are high. Ovulation can occur even in women who are on exclusive breastfeeding even wthout return of the period. The chances of ovulation are very low in the first 6 weeks after delivery.
Suckling a the breast sends a signal to the pituitary gland to release the hormone Prolactin. Since prolactin can suppress ovulation, the more often the baby suckles, the more is the amount of prolactin released and the longer it takes for ovulation to occur.
The longer breastfeeding continues and the lesser feeds the baby has, the more is the chance of ovulation. Some women may not ovulate until they stop breastfeeding altogether.
Nevertheless, chances of pregnancy are less if:
Breastfeeding can delay menstruation and ovulation for around 20 weeks or more, but there are great variations among different women. Each woman is unique and responds to the hormonal levels after childbirth and the postpartum in her own unique way.
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