What to expect from your period after giving birth?

Everyone knows a pregnancy means you stop getting your period for a while.

As always there is likely to be some variation, after all Each body and menstrual cycle are different! But regardless of when your first period postpartum comes, it’s a good idea to know what to expect.

Is the bleeding after labour a period?

After giving birth, it’s completely normal to experience bleeding, but this isn’t a period. This bleeding is called lochia, and it happens as the womb sheds the remaining blood, tissue, and mucus from pregnancy. Lochia usually starts off bright red and heavy, similar to a very heavy period, then gradually becomes lighter in colour and flow over the following weeks, changing from red to pink, then brown, and eventually creamy or yellow-white before stopping. Most people bleed for around four to six weeks after delivery, although the flow can vary from day to day and may increase temporarily with activity or breastfeeding.

Your first true period after birth will return later, depending on factors like breastfeeding, hormones, and your individual cycle. If the bleeding suddenly becomes very heavy, contains large clots, has a foul smell, or you feel unwell, or if you are still bleeding after six weeks, it’s important to speak to a healthcare professional.

What causes postpartum period cramps (afterpains)?

In the weeks after giving birth, you might feel cramps that are similar to period pains, but they aren’t your period. These cramps, known as afterpains, happen because your uterus was stretched during pregnancy and now needs to shrink back down to its usual size. Anyone can get afterpains, but they’re often stronger if you’re breastfeeding, as breastfeeding releases the hormone oxytocin, which makes the uterus contract. They can also be more noticeable if you’ve had more than one baby. Afterpains usually settle within a few days, although they may feel sharper during feeds. If the pain becomes severe, you feel unwell, or your bleeding suddenly becomes very heavy, it’s important to seek medical advice.

So, when can I expect to get my first period after giving birth?

Breastfeeding can also have an effect on when your period returns. The hormone prolactin, which helps you make milk, can suppress ovulation. This means that if you’re breastfeeding exclusively—day and night, with no long gaps—your period may not return for several months, and in some cases not until you reduce feeds or stop breastfeeding. If you are combination feeding or your baby sleeps long stretches at night, your period may return sooner. Once your periods do come back, they may be irregular at first, and your flow or cramps might be different from before pregnancy. Even without a period, ovulation can still occur, so contraception is recommended if you want to avoid pregnancy

If you do have periods during feeding you may notice that their milk supply dips slightly in the days around their period, and babies may pick up on a small change in taste due to hormonal shifts. You might also find that your nipples feel more sensitive or breastfeeding feels a little less comfortable at this time. These changes are usually mild, short-lived, and don’t affect breastfeeding in the long term.

When your first postpartum period does come, there’s a good chance your flow could be a little different to what you’re used to – it could be heavier, lighter, longer or shorter than your pre-baby periods. The blood might even be a different colour or texture. You might notice different premenstrual symptoms or miss a period. Don’t worry, these changes are generally temporary and settle within a few cycles, but if your period becomes very heavy, painful or prolonged please see your doctor.

What period products can I use after giving birth?

Doctors recommend waiting until the 6 week check or the lochia has stopped before using tampons. During the early weeks, the cervix is still healing and slightly open, and inserting anything into the vagina can increase the risk of infection or cause discomfort. This means tampons should never be used for lochia or for any bleeding that happens before your body has healed.

Once you start using tampons again, you may find they feel different from before. Some people prefer a smaller absorbency at first if they have vaginal dryness, which is very common after birth and in particular if you are breastfeeding , some lubricant on the tampon applicator may be helpful. It may also help to adjust your insertion angle, as the shape of the vagina can shift slightly after childbirth.

Many people choose to use pads for their first postpartum period, as the flow may be heavier or unpredictable. Pads can also help you keep track of the amount and appearance of bleeding. If you do use tampons again, pantyliners can be helpful while you gauge your new cycle and flow to protect against any leaks as you adjust to your changing flow.

What about contraception? Do I need to use contraception?

After giving birth, it’s normal for couples to have questions about when it’s safe to resume sexual activity. There is no hard and fast rule but you may want to wait until bleeding (lochia) has stopped and any perineal or surgical wounds have healed. Most women are ready to have sex again around 6 weeks postpartum, which coincides with the routine postnatal check. Physical healing is one factor, but emotional readiness, fatigue, and breastfeeding changes can also affect comfort and desire. Lubrication may be reduced, especially while breastfeeding, so using a water-based lubricant can help make sex more comfortable. It’s important to remember that you can ovulate before your first postpartum period, so it is possible to become pregnant even if you haven’t started bleeding again. Fertility can return as early as 3 weeks after birth, particularly if you are not exclusively breastfeeding. For this reason, considering contraception early after childbirth is recommended if you want to avoid another pregnancy. Waiting until the first period is not a reliable method of protection.

Several contraceptive options are safe to start immediately postpartum. These include the progestogen-only pill, implant, injection, condoms, and in some cases, an IUD or IUS if inserted within the first 48 hours after birth. If an IUD/IUS is not inserted immediately, it is generally safe to insert it from about 4 weeks postpartum. These methods are suitable for women who are breastfeeding and do not affect milk supply, making them the preferred choice for early postpartum contraception.

Methods that contain oestrogen, such as the combined pill, contraceptive ring, or patch, are usually delayed after birth because of an increased risk of blood clots and, if breastfeeding, the potential to reduce milk supply. For women not breastfeeding and without clot risk, combined methods can sometimes start from around 3 weeks postpartum, or about 6 weeks after birth if you are breastfeeding.

Some women rely on exclusive breastfeeding as contraception, known as the lactational amenorrhoea method (LAM). When used correctly, the baby is under 6 months old, exclusively breastfed day and night with no long gaps (feeding less than 4hrs during the day and less than 6hrly at night) or formula/solid feeding, and the periods haven’t returned, LAM is over 98% effective. However, once any of these conditions change, or after six months, its isn’t as effective, so additional contraception may be needed.

When should I worry about a postpartum period?

After giving birth, it’s normal for your period to take some time to return, especially if you are breastfeeding. For women who are not breastfeeding, periods usually come back within six to eight weeks. If you are breastfeeding, it is common for periods to be absent for several months, and this is usually not a cause for concern. The first few periods after having a baby can also be heavier or cause more cramping than before pregnancy.

Even if your periods haven’t returned, you can still ovulate and become pregnant. This is why it is important to consider contraception before your first postpartum period, particularly if you are sexually active and do not want to conceive. Fertility can return as early as three weeks after birth, so relying on the return of menstruation alone is not a reliable form of contraception.

You should contact your doctor if your period has not returned within a few months after stopping breastfeeding, or if you experience any unusual symptoms. Very heavy bleeding, bleeding that lasts longer than seven days, or clots that are larger than usual for you are all reasons to seek medical advice. Other signs to see a doctor include foul-smelling discharge or fever accompanied by abdominal pain, which could indicate an infection.

Some people may notice shorter or lighter periods than they had before pregnancy, and this is usually normal. However, persistent changes in your flow, very irregular cycles, or missed periods could also be caused by various conditions from hormonal imbalances or thyroid problems, and these should be assessed by your doctor.

The bottom line: postpartum recovery is a huge physical transition, so be patient with yourself. Your body and your hormones are adjusting to a new normal. Chances are, it’ll all settle down and find a new normal but if it doesn’t please seek help.

This is generalised advice and isn't personalised nor to replace the advice of your doctor and other health care professionals.