For a couple of weeks after childbirth, every woman has a postpartum vaginal discharge called lochia. This discharge contains blood, mucous, as well as placental tissue. Normally, women continue to spot for up to six weeks after pregnancy. However, there is no hard and fast rule about when the menstruation cycle will start again. It depends on many factors.
Menstruation Cycle After Pregnancy
Every woman has unique hormone levels, and hence, it is very difficult to predict when a woman will resume menses after childbirth. On one hand, there are cases where menstruation has started within a month of childbirth; and others where it has not started even twelve months after childbirth. According to health researchers, a majority of the women resume their menstrual cycle between 42 and 56 days after childbirth, provided that there are no factors affecting their health. There are no specific signs for menstruation after childbirth seen in women. The signs differ from one woman to another.
There are many factors which influence the menstrual cycle post pregnancy.
- The factors which influence a woman's health, and hence menstruation, after childbirth, include stress, activity levels, medication, diet, and excessive amount of weight loss or gain.
- Breastfeeding affects the onset of ovulation due to feedback inhibition. Breastfeeding interrupts the ovulation cycle, which causes irregular menstruation. When the woman is breastfeeding, the pituitary glands secrete greater amounts of prolactin, which suppresses the functioning of the ovaries. However, there are women who ovulate irrespective of this. At the same time, there are others who do not ovulate at all.
Changes in the Cycle Post Childbirth
In a number of cases, there have been unexpected changes in the menstrual cycle post pregnancy. The change is usually related to flow and volume. The first menses are normally heavier than expected. The duration of the first menstruation may also be longer than the normal period. There is also a possibility of a few menstrual blood clots in the first period. In most cases, the flow returns to normal in the subsequent periods.
If the postpartum bleeding lasts longer than six to eight weeks, it is recommended to get a health care professional's opinion about the same. Similarly, if the bleeding lasts longer than eight days in length per cycle, or if it is heavy, with or without clotting, it is important that the health care professional is notified about the same.
Menstruation and Fertility Post Childbirth
Most obstetricians and gynecologists recommend not resuming intercourse prior to the six week postpartum visit. However, there are women who do feel good enough and re-initiate intimacy on their own. It is, however, important to take the required measures for birth control. This is because, even though a woman may not have resumed her menses, it does not mean she has not ovulated. There have been a lot of cases where women have been pregnant during their first postpartum visit to the obstetrician and gynecologist due to unprotected sex during this time.
Talking to the obstetrician and gynecologist regarding oral contraceptives is recommended. You should not choose birth control pills yourself. Pills containing estrogen or progesterone are not favored for lactating women.
You can talk to your health care professional about the onset of menstruation after childbirth in your case when you visit her for the first postpartum visit, which is about six weeks after childbirth. It is important not to get excessively worried about menstruation, as stress can lead to a delay.