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Woman putting a pad in her pocket

What’s the deal with postpartum periods?

Woman putting a pad in her pocket8

August 13, 2019

Reviewed by Kimberly Langdon M.D.

One of the best perks of pregnancy (besides the joy of growing a mini-you) is a 9-month break from Aunt Flo. Of course, you might feel like the postpartum bleeding (aka lochia) and cramping make up for it. But you might be wondering when that pesky period is going to come back. And the answer is… it depends (surprise, surprise).

Lochia vs. Menstruation

Even though it might start out looking like it, lochia is not a period. Lochia is the vaginal discharge that contains the blood and tissue that lined your uterus during pregnancy. It starts after delivery and can last 6 weeks or longer. It starts out heavy and red, but after a week or so it will turn pink or brown. After two weeks, it is often light brown or yellow. The volume should generally decrease, but might ebb and flow (pun intended), especially after exertion.

So then when will my period come back?

Unfortunately, there is a huge range for what’s a normal time for your period to return. But, one of the biggest factors is whether or not you’re breastfeeding. If you’re not breastfeeding or are combo feeding, your period might return around 6-8 weeks postpartum. If you’re exclusively breastfeeding, it could be months later. In fact, some breastfeeding moms don’t get their periods back until after their babies are weaned. If it hasn’t come back after 3 months postpartum (or 3 months post-weaning), it’s a good idea to talk to your doctor.

Related: A step-by-step guide to weaning

If it hasn’t come back, does that mean I can’t get pregnant?

While usually the return of your period coincides with ovulating (when your ovaries release an egg), but not always. Sometimes, you can ovulate before your first period, which means you can get pregnant if you’re not using birth control.

Related: All about postpartum birth control

Will my periods be different than before?

Even if your period was like clockwork before you got pregnant, get ready for some changes. The time between periods may vary, along with the length of the period. Your symptoms, like cramping, may get worse or better. Eventually, they will likely return to your pre-pregnancy norm, though.

When should I be concerned?

When there is a wide range of normal, it’s not always clear when to be worried. If you have any of the following symptoms, call your doctor.

  • Very heavy bleeding that soaks through more than a pad per hour for longer than 2 hours
  • Bleeding that occurs with a fever
  • Intense cramping
  • Clots bigger than a golf ball
  • Bleeding in between periods or bleeding like a period that comes less than 21 days apart

You can also call your doctor with questions about irregular periods, painful periods, or irregular bleeding.

Sources:

Cleveland Clinic. Do Your Periods Change After Pregnancy? Retrieved August 12, 2019 from
https://health.clevelandclinic.org/do-your-periods-change-after-pregnancy/

American College of Obstetricians and Gynecologists. Your Pregnancy and Childbirth: Month to Month, 6th edition. (2016).

The American College of Obstetricians and Gynecologists. (2017). Postpartum Hemorrhage. Practice Bulletin Number 183. Retrieved August 12, 2019 from
https://clinicalinnovations.com/wp-content/uploads/2017/10/ACOG_Practice_Bulletin_No_183_Postpartum-Hemorrhage-2017.pdf

Kimberly Langdon M.D. is a retired University-trained obstetrician/gynecologist with 19-years of clinical experience. She graduated from The Ohio State University College of Medicine and then completed her OB/GYN residency program at The Ohio State University Medical Center. Recently, she founded a medical device start-up company that focuses on non-drug treatment for common maladies.

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