Nicole Wendler has a doctorate in biology from the field of oncology and immunology. As a medical editor, author and proofreader, she works for various publishers, for whom she presents complicated and extensive medical facts in a simple, concise and logical way.
Until the first period after birth it usually takes a while. This is due to hormonal changes. Depending on whether a woman is breastfeeding or not, the onset of the first menstruation is delayed for different lengths of time. Read here when you can expect your first period after childbirth, which hormones play a role and when you are fertile again.
The hormones change
If the hormonal balance was set for pregnancy in the past nine months, the physical regression is the hormonal focus after the birth. This process begins immediately with the postpartum period. With the birth of the placenta, all blood and urine levels of the hormones it produces decrease. These include the steroid hormones estrogen and progesterone. As these hormones decrease, menstruation starts to change and return to normal. The production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), on the other hand, picks up again, and follicle maturation in the ovary starts again.
The fact that the first period after birth is still some time in coming is due to another hormone, prolactin. It is produced in the brain (more precisely: in the anterior pituitary gland) as soon as estrogen drops off. Prolactin ensures that the mother’s breasts produce milk soon after birth – milk is usually let down on the third to fifth day after childbirth. As the baby sucks at the breast, the production of prolactin is further stimulated. Prolactin prevents ovulation in most nursing mothers. As a result, the so-called lactation or lactamenorrhea occurs, i.e. the absence of menstruation during the breastfeeding period.
In women who are not breastfeeding, prolactin levels normalize within two to three weeks. Then it usually comes soon to the first period after birth.
When is the first period after birth?
The onset of the first period after birth depends on how intensively the woman breastfeeds. The more lactic prolactin is produced, the more effectively egg maturation and ovulation are inhibited, and the later menstruation resumes. Women are therefore less fertile, especially in the first six weeks after giving birth. Only after weaning does a normal cycle settle in again.
But even if fertility is reduced in the first six weeks after birth and breastfeeding suppresses the maturation of the eggs, it must always be emphasized: Breastfeeding is not a safe method of contraception! The first ovulation usually occurs unnoticed before the onset of the first period after birth. So you can get pregnant again even before the onset of the first menstrual period!
Non-breastfeeding women can expect their cycle to resume as early as six to twelve weeks after giving birth. The first period after pregnancy and birth could therefore occur after about eight weeks. Besides prolactin, the stage of involution also plays a role here.
Weekly flow or period?
The menstrual flow sometimes lasts up to six weeks. Therefore, lochia and menstruation may immediately follow each other. Since the postpartum flow becomes light and rather white towards the end, the onset of the period with a new beginning bleeding can usually be easily distinguished from the postpartum flow. If you are still unsure, ask your gynecologist.