Postpartum cycle: the midwife explains what happens

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Marie-Ange Demory
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Post partum cycle

With the birth, that somewhat relaxing experience of not having a period for a full nine months. Most women are relieved not to have to think about it for a long time and thus create doubts and confusion as to when the postpartum cycle and what actually happens to female physiology after childbirth.





Difference between postpartum and period lochings

The first fundamental question to understand is to recognize the difference that exists between lochiations and menstruation. After giving birth, each of us has physiological blood loss, more or less intense depending on the type of birth, personal characteristics and countless other factors. These blood losses are the lochiazioni, they are essentially a "cleaning”Completes that the uterine wall carries out before returning to the typical cyclicality. Basically these losses are still a event related to childbirth, the uterine vessels to which the placenta was attached have closed but the internal mucosa of the uterus must flake and return to its pre-pregnancy appearance in order to restart with the normal cycle.



Indicatively, but here too the variability from woman to woman is large, they last about 20-30 days but they have the fundamental characteristic of changing quantity and color. In fact, immediately after childbirth they are abundant and bright red, then become darker and scarcer, until they become yellow lossesee very scarce and then disappear completely. They are therefore not menstruation and we cannot consider them as a cycle.

Head of ward symptoms

The first real menstruation after childbirth is what we call "head of department". When it appears it depends on many factors but, before seeing what they may be, it is important to recognize this menstruation because it essentially marks the return to woman's fertility. Until we see this first period after childbirth it is quite difficult, indeed almost impossible, for a woman to have a new pregnancy.



The symptoms of the foreman are the same as in the monthly menstruation of the pre-pregnancy period. They can start with little ones spotting (small droplets of blood), present with tension or light cramps in the lower abdomen, some women also report breast tension. In short, everything like a normal menstruation. However, there are some cases in which the head of the ward is completely asymptomatic and therefore the woman finds herself having to manage her menstruation suddenly.

Read also: How to cope with 40 days after giving birth

When menstruation returns after childbirth

The factor temporal cycle return is the most complicated factor to calculate. This is because it basically depends on the time in which the alternation of the various ones hormones that regulate our cycle return to being at the level before pregnancy. That is, until the cycle of spikes and drops in hormones FSH, LH, estrogen and progesterone our menstruation will not come. Another factor plays an important role in the return of menstruation, breastfeeding. You have heard ofbreastfeeding amenorrhea. It is precisely the absence of a cycle due to breastfeeding, because the prolactin it inhibits the resumption of the hormonal cyclicality that we have just mentioned and therefore prevents ovulation. Ultimately it is not possible to estimate the precise moment in which menstruation will return, and above all it cannot be the same for all women.

Fertility after childbirth

So if I don't have my period, I can't have it another pregnancy? This is one of the most common questions moms ask me. In theory this is indeed the case, but we must always remember that menstruation occurs after the egg has not been fertilized. So we don't really know exactly when ovarian activity resumes after childbirth and then use this idea as a contraceptive can be very wrong.

Once again, the parenthesis exists breastfeeding regarding fertility. As we have understood, those who are breastfeeding will most likely have a cycle that appears later, but even in this case, several parameters must be evaluated so that it can be considered safe to use breastfeeding as a contraceptive method:

  1. the baby must be less than 6 months old
  2. breastfeeding must be exclusive (i.e. breast milk only meals on request)
  3. there must not have been the foreman yet.

If all the conditions are met it is very likely that the woman is not yet fertile. With the onset of the first menstruation, the woman must instead consider herself fertile again and therefore consider using contraceptive methods if she does not want a new immediate pregnancy.

Will your period be painful after giving birth?

Very often they also ask me how painful the period will be after giving birth. Unfortunately, I don't have a single answer to give here. In the sense that some women report a change, in one sense or another of the cycle. In fact, some tell me that the first cycles above all, are much more painful than they remembered, others instead that perhaps suffered much more report an improvement. It is therefore also in this case a purely question subjective. There is no scientific rationale, an approved study that says yes it certainly hurts more or less.

It is certainly true that there has been a change from a physical point of view, there has been a pregnancy and even a birth but from a hormonal point of view nothing has changed since before pregnancy. Presumably the relationship with the painfulness of the period after childbirth it is more of a personal nature and linked to how positively the resumption of cyclicality is experienced, but even in this case there are no large studies that prove this theory. We therefore remain very concrete and say that the perception of pain in the cycle after childbirth is very personal.

When the period is regularized after childbirth

The regularization of the cycle after childbirth is instead a slightly simpler factor to investigate because it exclusively concerns a hormonal aspect. When the hormones return to behave as in the pre-pregnancy phase, we will have menstrual regularity. This means that the first few cycles will most likely be different both in terms of duration and quantity. By definition we can consider themenstrual irregularity like physiolgica after the birth and for six months following the appearance of the foreman (I cannot say 6 months from the birth because, as we know, the foreman can also take place after 8-9 months from the birth and beyond). If there are menstrual irregularities even beyond six months from the first menstruation it could be useful to check hormone levels, but without alarming because our body may simply need more time to return to the condition before pregnancy.

Menstruation after childbirth and breastfeeding

We talked about breastfeeding at various points in this chat and now let's tackle the topic that, also in this case, is proposed to me by new mothers: what changes in breastfeeding if I am menstruating? The answer seems obvious but it is not at all like that. Traditionally it was said that the milk produced during the period of menstruation had to be thrown away because bad.

This is not the case at all, milk is produced in another way that has no relation to the menstrual cycle, does not decrease, does not change taste. What can happen at the most is that your period becomes a little longer painful during breastfeeding (I mean during feedings) because the uterus reacts tooxytocin released from breastfeeding and therefore has small contractions.

So if you are advised not to breastfeed when you are menstruating you can safely answer that there is no scientific basis for these claims and therefore that you will continue to breastfeed.

As you have noticed, there are not many reliable data concerning the menstruation after childbirth. Our body works physiologically thanks to a delicate hormonal balance, however different from person to person. For this reason we are different and also special. So mothers, the topic of menstruation should not alarm you particularly, you will certainly know how to manage it also thanks to the checks that you will do after birth with the obstetrician or with the reference gynecologist who will guide you if you have doubts or fears.

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