In addition to the well-known parental leave, there is another one: nature has planned for the female body a break in the ability to conceive after pregnancy and childbirth, so that the mother can fully recover and feed the baby. A break in monthly ovulation means a pause in menstruation. But the duration of such a natural vacation depends on many factors, and the main one is breastfeeding the baby. MedAboutMe tells when the menstrual cycle can resume after childbirth, what features of the first menstruation are normal for new mothers.
When to wait for menstruation after childbirth with different types of feeding a child?
The recovery time of the menstrual cycle differs depending on the individual characteristics of the woman, and on some hereditary factors, and on the accompanying circumstances. However, there are average indicators that are based on the timing of the return of hormone levels in the body to the balance that it was before pregnancy.
The main factor that affects the hormonal level, and, therefore, the ovulatory and menstrual cycle, is breastfeeding. With the constant production of prolactin, the hormone responsible for the production of breast milk, ovulation is suppressed. Without the release of the egg from the ovary, the change of the endometrial layer in the uterus does not begin, which is accompanied by menstrual bleeding.
If breastfeeding is not practiced by the mother, then from the date of birth to the onset of menstruation, it can take from 1 to 2 months, depending on how quickly the body stops producing prolactin. If there is partially artificial, partially breastfeeding (mixed type of child nutrition), then everything also depends on prolactin and the amount of breast milk in the child’s diet. With mixed feeding, the period of absence of menstruation ranges from several weeks to several months.
If breastfeeding is active and full, the mother feeds the child on demand and does not avoid «morning» feedings (4-7 in the morning, when breast stimulation causes the greatest production of prolactin), then the menstrual cycle is on average absent until the child is 6 months old. Often the onset of menstruation follows a period of active introduction of complementary foods to the baby, but the absence of menstruation during the entire period of breastfeeding is also considered the norm.
Is a new pregnancy possible before the start of menstruation?
There is a widespread misconception that pregnancy does not occur while breastfeeding. This opinion can be heard from experienced mothers, and even from nurses in maternity hospitals, which makes women who have recently given birth to listen to «authorities». Some, however, are advised to do a pregnancy test every month, although «no need to protect yourself.» Sounds pretty counterintuitive, doesn’t it?
Nature really designed it so that during active breastfeeding, ovulation does not occur. However, a decrease in prolactin production cannot be noticed immediately, its first clear sign is the resumption of the menstrual cycle. At the same time, ovulation and the ability to conceive precede menstruation, ahead of them by two weeks. This means that even against the background of the absence of menstruation, it is quite possible to be pregnant again, especially if mixed or artificial feeding and refusal of protection are practiced.
But even constant and active breastfeeding of the baby does not protect against re-pregnancy. In some cases, the body tends to return to its previous state much faster than the average time, and the restoration of hormonal balance proceeds at an accelerated pace. So, some young mothers discover the onset of pregnancy after a rather short time: theoretically, the body can again be ready for conception already 3-4 weeks after birth.
To avoid such an incident, protection from unwanted pregnancy is necessary. The most common choice for breastfeeding is the use of condoms. Contraceptive pills and female barrier methods must be selected together with the gynecologist, taking into account the presence or absence of breastfeeding, hormonal changes and the physiological characteristics of the body after childbirth.
What will be the menstrual cycle of a new mother after childbirth?
The menstrual cycle after pregnancy and childbirth can differ in almost all respects. The duration of the periods themselves, the interval between them can be longer, shorter or unchanged, as before. Pain during menstruation is also variable, due to changes in the size of the uterus during pregnancy. Even premenstrual syndrome (PMS) after childbirth can suddenly manifest itself with all its might or, conversely, subside.
In most cases, changes in the amount of discharge and pain are not for the better noted by women who gave birth for the first time, who before gestation resorted to hormonal contraception: oral contraceptives, hormonal spirals, capsules, injections. The second factor influencing the increase in discharge and pain in the first periods is childbirth through a caesarean section. And the sooner menstruation begins after abdominal surgery, the higher the level of pain during menstruation, this is an additional reason for breastfeeding: the menstrual pause will allow the mother’s body to recover from surgical childbirth.
Some young mothers note the changed sensations from the use of tampons during menstruation, but the myths about the need to change the size of vaginal tampons for those who have given birth are untenable: in the vast majority of cases, size changes are not required if the bleeding is not stronger than in the pre-pregnancy period.
The norm is the establishment of the periodicity of the menstrual cycle within six months after the first menstruation, which is associated with the restoration of hormonal balance. The duration of the cycle can fluctuate by about 10 days: sometimes 25, sometimes 35 days. And if the mother still continues to breastfeed, then the intervals between menstruation can be lengthened, and the restoration of the regularity of menstruation can be delayed.
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Obstetrics / Ed. Savelieva G.M. — 2000
Principles of management of puerperas in the early postpartum period / Kuzmin V.N. // Issues of gynecology, obstetrics and perinatology — 2010 — T. 9 No. 6