Pregnancy is a special situation in a woman's body in which all her ovarian activity stops. This means that the ovaries remain at rest and, therefore, there is no ovulation or menstruation.
After giving birth, the menstrual cycles do not start up again immediately, but the woman has to undergo a return to fertility.
Furthermore, breastfeeding is another special condition that delays the activation of ovaries and ovulation. With ovulation comes the restoration of fertility. In this case, the time it will take a woman to recover her fertility after childbirth will also depend on whether she chooses to breastfeed or formula feed.
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What is the puerperium?
The time from the day after delivery until the woman's first menstrual period is known as the puerperium or quarantine and is divided into different phases:
- Immediate Puerperium
- includes the day after delivery.
- Mid-term postpartum
- is from the second to the tenth day after delivery.
- Remote Puerperium
- extends from the tenth day to about 40-45 days postpartum.
- Late Puerperium
- can be extended up to 6 months, as it will depend on the type of breastfeeding.
Firstly, the woman goes through the well-known 6 weeks recovery period, characterized by lochia. This the vaginal discharge caused by the wound left by the placenta in the uterus.
Once this time is over, the length of the postpartum period depends on many things, such as if the mother is breastfeeding or bottlefeeding. The length of time the woman breastfeeds her baby is also plays a role.
Breastfeeding
Women who choose to breastfeed their babies will have high prolactin levels. This means it will be longer before they ovulate after birth and the periods return.
Prolactin, produced by the pituitary gland (hypophysis), is the hormone that stimulates breast milk production.
As well as stimulating milk prodiction, prolactin is responsible for blocking FSH and LH hormones. These two hormones stimulate the ovaries and trigger ovulation.
In an interview with as Dr. Nadia Caroppo she tells us that is why, in most cases, postpartum infertility is maintained for the duration of full breastfeeding.
The duration of the postpartum period in breastfeeding women is difficult to determine, as it can range from 12 weeks after delivery to 2 years.
Some factors that influence the return of fertility are the following:
- Exclusive breastfeeding or mixed feeding (in combination with bottle feeding)
- The number of daily feeds
- If there are night feeds
- Sucking intensity
In general, It takes about 6-8 months after birth for a lactating women to ovulate again and have menstrual cycles.
Bottle feeding
Conversely, women who choose not to breastfeed their baby return to their typical hormonal control. Hences they will ovulate again earlier, between 4 and 8 weeks.
It is very important to keep in mind that a woman could become pregnant again during this period of time, since ovulation can occur before menstruation.
Therefore, it is advisable to use protection in sexual relations during the puerperium, whether the woman breastfeeds or not. The lack of fertility in the breastfeeding period is not total and women do fall pregnant unexpectedly.
Ovulation symptoms after birth
During the puerperium it is common to present a basic pattern of infertility characterized by vulvar dryness and/or unchanged vaginal discharge. This is due to the low estrogen level in the woman's body.
As estrogen increases in the days leading up to ovulation, it will be possible to notice how the cervix produces a more mucous discharge. It is common for the basic pattern of infertility to be interrupted by intermittent days of lubricating mucous discharge for several weeks.
In addition, the woman may also notice how the cervix acquires a softer consistency and a higher position.
These signs can allow the woman to anticipate ovulation and, therefore, it is important to observe them correctly during the postpartum period.
FAQs from users
Can I get pregnant after childbirth if I am not menstruating?
It is true that breastfeeding is considered the best supression of ovulation due to the increase in prolactin level. However, as lactation is reduced, the prolactin level returns to its normal state. This is not immediate and, therefore, if pregnancy is not desired, contraceptive protection is recommended.
In addition, we should not forget that, although it is rare, there may be female periods in which there is ovulation but no menstruation.
Therefore, even without menstruation, there is a possibility of pregnancy after childbirth, although it is low.
Is it normal for postpartum periods to be irregular?
Yes, after childbirth, hormone levels gradually adjust and return to normal, i.e., to the pre-pregnancy state.
Therefore, since the menstrual cycle is regulated by hormones, it is common to have irregular periods after childbirth.
What is the lactational amenorrhea method (LAM) form of contraception?
LAM is a contraceptive method that takes advantage of the absence of ovulation and menstruation during lactation to prevent a new pregnancy.
However, to ensure that this method is effective, the following requirements must be met:
- The newborn is not more than 84 days old
- The baby is exclusively breastfeeding. Not even water should be taken from a bottle.
- The baby is attached to the breast for at least 100 minutes every day.
- The babys feeds at least five times a day.
- There is no more than 6 hours between feeds, be it day or night.
Can I do an ovulation test while breastfeeding?
Yes, but most likely it will be negative, since the ovulation test detects the LH hormone and this is inhibited as a result of prolactin production.
If you need more information about this, you can continue reading here: Ovulation tests.
Is a new pregnancy possible four months after a cesarean section?
When the birth is not natural, but is produced by cesarean section, specialists recommend waiting a period of time for the mother to recover completely before attempting a new pregnancy. This period of time is usually about 6 months, since getting pregnant again sooner after a cesarean section may entail a higher risk of complications.
However, this does not mean that pregnancy is not possible 4 months after cesarean section. There are women who have become pregnant during quarantine and have not had any gestational complications.
Recommended reading
If you want to continue reading about the puerperium and what the first menstruation is like after giving birth, we recommend reading the following article: Menstrual periods after childbirth.
Alternatively, if you would like information about the breast and bottlefeeding, take a look at this article: Feeding your baby.
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References
Campino C, Ampuero S, Díaz S, Serón-Ferré M. Prolactin bioactivity and the duration of lactational amenorrhrea. J Clin Endocrinol Metab. 1994; 79:970-975 (View)
Howie PW, Mcneilly AS. Breast-feeding and postpartum ovulation. IPPF Med Bull. 1982;16(2):1-3.
Perez A, Vela P, Masnick GS, Potter RG. First ovulation after childbirth: The effect of breast-feeding. American Journal of Obstetrics and Gynecology 1972; 114(8):1041–1047 (View)
P W Howie, A S McNeilly, M J Houston, A Cook, H Boyle. Fertility after childbirth: infant feeding patterns, basal PRL levels and post-partum ovulation. Clin Endocrinol (Oxf). 1982 Oct;17(4):315-22. doi: 10.1111/j.1365-2265.1982.tb01596.x (View)
FAQs from users: 'Can I get pregnant after childbirth if I am not menstruating?', 'Is it normal for postpartum periods to be irregular?', 'What is the lactational amenorrhea method (LAM) form of contraception?', 'Can I do an ovulation test while breastfeeding?' and 'Is a new pregnancy possible four months after a cesarean section?'.
Authors and contributors
More information about Michelle Lorraine Embleton
I breastfed for 2 years and uased the LAM method for the first 6 months sucessfully. We did use condoms after that though as my daughter started to space her feeds.
Hi,
My girlfriend says she doesn´t want to breastfeed even though I am really keen for her to do so. Is is true it delays her getting her period?
Hi RogerLee
If the mother is exclusively breastfeeding, and the baby is feeding regularly (more than 6 times daily) it is likely that her prolactin levels will be high and therefore supressing ovulation. Without ovulation the period should not occur.
Perhaps you could suggest this article to your girlfriend, and also the following one may be of interest: Menstrual period after childbirth.
I hope this answers your question and all the best for you future baby.