First Postpartum Period: What to expect and how to prepare

The nine-month-long pregnancy is a good escape from periods, though there might be a zillion other problems. But once you have given birth, it’s time to embrace the same old life and the same old body. The hormonal upsurge starts settling, the skin and hair get back to normal or may get worse, and you get your first postpartum period. Read along to know more about them, what to expect, and how to spot the red flags (literally).

What is the first postpartum period and when can you expect it?

A postpartum period is the return of menstruation after giving birth. It can be a different experience for each woman and can vary depending on whether they have had a vaginal delivery or a cesarean section if they are exclusively breastfeeding or not, hormonal changes, and individual variations.

After a vaginal delivery, it is common for women to experience some vaginal bleeding known as lochia. This bleeding can last for several weeks and is the body’s way of shedding the uterine lining and healing after delivery. After the lochia stops, the regular menstrual cycle may return in a few weeks to a few months, depending on the individual.

In the case of cesarean delivery, the recovery time may be longer, and the woman may experience heavier bleeding compared to vaginal delivery. This is because the uterus has been surgically opened, and it takes longer for the incision site to heal. Once the bleeding stops, the menstrual cycle may return in a few weeks to a few months.

If you are not breastfeeding then you are most likely to resume menstruation by 12 weeks after giving birth. However, if you are exclusively breastfeeding i.e. you are feeding your baby frequently (every 4-6 hours), and not giving her formula or any other drink, then you may delay your period to 20 weeks or longer.

Why breastfeeding delays the first postpartum period?

This happens due to a hormone called Prolactin which is needed to produce breast milk. During breastfeeding, the serum levels of this hormone are high and suppress the reproductive hormones which are needed for ovulation and menstruation.

This delay in menstruation is called lactational amenorrhea. Interstingly, the lactational amenorrhea method (LAM) can act as a type of birth control that relies on hormones your body makes while breastfeeding. If you strictly meet the guidelines (your infant is strictly on breastmilk and you are regularly feeding her every 4-6 hours), LAM can be 98% effective in preventing pregnancy within the first 6 months after you give birth.

How can the first postpartum period affect breast milk?

You might observe some changes in your milk production or your baby’s response to breast milk when your period eventually returns. Your breast milk may be impacted by the hormonal changes that give your body a period.

For instance, you might see a change in how frequently your baby wants to nurse or a drop in your milk production. The composition and flavor of your breast milk may change as a result of hormonal changes for both you and your baby. But, these modifications are often extremely slight and shouldn’t interfere with your ability to breastfeed your child.

How your first postpartum period may be different from your pre-pregnancy periods

There can be a lot of variations among individuals, some moms may have heavy flow with clots after postpartum while some have light and easy periods. Some may experience more cramping than before and for some, they might not be so regular at first.

According to doctors, these variations are completely normal and it may take up to a year for the periods to get back to normal. However, if they are still irregular after a year of delivery and you aren’t breastfeeding then you should consult your doctor.

What is the difference between lochia and postpartum period?

Once you deliver (either vaginally or surgically), you may experience a heavy blood flow with clots as the uterus is shedding its lining and cleaning itself. Some blood may also come from the wear and tear of the birth itself. But do not confuse this with your first period, it is not. It is called lochia. After 3-10 days of bright red-colored flow, this discharge changes its color to brown and then to a clear yellowish-white watery fluid. This may continue for several weeks to a month or longer. C-section deliveries often experience shorter and lighter lochia flow.

The postpartum period is bright red in color and appears after 6-10 weeks or longer after delivery.

Your birth control options after having a baby

You should keep in mind that you may get pregnant after having a baby, while still breastfeeding, or before you get your postpartum period. So using a method of contraception is a good idea after delivery if you are not planning another baby very soon.

Time after birth	Contraceptive	Remarks
Anytime after birth	(If not at any medical risk) Contraceptive implant (more than 99% effective) Contraceptive injection (more than 99% effective) Progestogen-only pill (99% effective if taken correctly) Male condoms (98% effective if used correctly) Female condoms (95% effective if used correctly)	you can choose to have an IUD (intrauterine device) (more than 99% effective), or an IUS (intrauterine system) (more than 99% effective) inserted within 48 hours of the birth. If an IUD or IUS is not inserted within 48 hours, you’ll usually be advised to wait until 4 weeks after the birth.
3 weeks after birth	If not breastfeeding then: Combined pill (more than 99% effective if taken correctly) Vaginal ring (more than 99% effective if used correctly) Contraceptive patch (more than 99% effective if used correctly) If breastfeeding: Use any of the methods mentioned at any time after birth	But if you’re breastfeeding, have certain health conditions, or have a risk of blood clots, you’ll usually be advised to delay using the combined pill, ring, or patch until at least 6 weeks after the birth.
4 weeks after birth	If you did not have an IUD or IUS inserted within 48 hours of the birth, you can have one inserted later. But you’ll usually be advised to wait at least 4 weeks after the birth.	–
6 weeks after birth	Combined pill Vaginal ring Contraceptive patch Diaphragm cap (92% effective)	If you used a diaphragm or cap before becoming pregnant, see a GP or a doctor or nurse at a contraception clinic after the birth, to make sure it still fits correctly. This is because childbirth and other factors, such as gaining or losing weight, can mean you need a different size.

When to seek medical attention during your postpartum period

Postpartum bleeding is heaviest in the first 10 days when you notice clots as well. Also, the bleeding might increase once you increase your moving about and daily activities. However, if the heavy bleeding persists even after that then it may be a cause of concern as it can cause a drop in your blood pressure. If you notice any of the below signs and symptoms then contact your healthcare provider immediately:

• Soaking through more than one pad every hour
• Bleeding that’s accompanied by sudden and severe pain
• Sudden fever
• Bleeding continuously for more than seven days
• Blood clots that are bigger than a softball
• Foul-smelling discharge
• Severe headache
• Trouble breathing
• Pain while urinating

Self-care tips for a healthy and comfortable first postpartum period

There are several self-care tips that can help to make this experience more comfortable and healthy.

1. Use comfortable menstrual products: It’s important to use comfortable and reliable menstrual products during the first postpartum menstruation. This can include pads, tampons, menstrual cups, or period panties. It’s important to choose a product that is comfortable and easy to use and to change it regularly to maintain good hygiene. Many doctors advise not to put anything in the vagina for 6 weeks after birth, so tampons may not be suitable if the periods come before this time.
2. Stay hydrated: Drinking plenty of water and other fluids can help to keep the body hydrated and support overall health. This can also help to alleviate menstrual cramps and other discomforts.
3. Get enough rest: Getting enough rest and sleep is important during the first postpartum menstruation. This can help to reduce fatigue, stress, and other symptoms associated with the menstrual cycle.
4. Exercise: Gentle exercises, such as walking or yoga, can be beneficial during the first postpartum menstruation. This can help to reduce stress and improve mood, as well as alleviate menstrual cramps and other discomforts.
5. Eat a healthy diet: Eating a balanced and healthy diet can help to support overall health during the first postpartum menstruation. This can include foods rich in iron, such as leafy greens and red meat, which can help to replenish the body’s iron stores after childbirth.
6. Practice good hygiene: Maintaining good hygiene during the first postpartum menstruation is important for overall health and comfort. This includes changing menstrual products regularly, washing hands frequently, and showering or bathing daily.
7. Seek medical advice if needed: If menstrual symptoms are severe or persistent, it’s important to seek medical advice from a healthcare provider. This can help to identify any underlying health issues and ensure proper treatment and care.