22 Nov 2018 | 3 min Read
Dr Nikhil Datar
Author | 6 Articles
Pregnancy in itself is a dynamic phase involving many emotional and physical changes that one just about forgets to take notice of the long break from menstruation. To optimize the health of women and infants, a good understanding of menses after childbirth and appropriate care thereafter should become an ongoing process tailored to each woman’s individual needs.
After delivering, you do not have a period immediately, but your body continues to lose the blood and tissue that lined your uterus while you were pregnant. From the third day, this blood gives way to clear or creamy white to red vaginal discharge called lochia, which stops in a few weeks.
The absence of menstruation (amenorrhea) generally lasts six weeks. Amenorrhea may be extended by the practice of breastfeeding, most times lasting until the duration of lactation. In certain cases of prolonged breastfeeding, this period of amenorrhea may last from 18 to 24 months.
The commencement of the first menstruation after pregnancy is highly variable and is greatly influenced by breastfeeding the infant. The woman who breastfeeds her infant exclusively has a longer period of amenorrhea than the mother who chooses to use formula. The mother who does not breastfeed may have regular periods as early as 27 days after delivery. Generally, women have their first menses after childbirth by 12 weeks; the average time to first menses is 7-9 weeks.
Amongst the breastfeeding women, the return of regular periods after delivery is highly variable and depends on a number of factors:
Approximately 50% to 75% of women who breastfeed return to periods within 36 weeks of delivery.
Once they do resume, your periods may be inconsistent, especially if you are still producing milk (lactating). The duration of menstruation can also change and it is quite common to skip a period or even for the next one to be delayed by a few months.
A return to regular periods after delivery is just one of the stages of recovery and returning to your pre-pregnancy body. If you notice anything out of the ordinary like heavy, persistent postpartum bleeding, urinary incontinence or any signs of infection, a consultation with your physician is recommended.
References:
https://www.aafp.org/afp/2005/1215/p2491.html
https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Optimizing-Postpartum-Care
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279173/
https://emedicine.medscape.com/article/260187-overview
http://science.sciencemag.org/content/200/4346/1155/tab-pdf
https://health.clevelandclinic.org/will-your-periods-change-after-pregnancy/
https://www.healthdirect.gov.au/breastfeeding-and-periods
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