Stages of Postpartum Bleeding: When Does the Menstrual Cycle Return After Birth?

After childbirth, women experience normal bleeding lasting 6-8 weeks, whether the delivery was natural or by Cesarean section. This bleeding is known as postpartum bleeding, but it is not a menstrual period. During this time, the body is getting rid of the blood and tissues left from the uterus lining after pregnancy, which is different from menstrual bleeding.

In this article, we will discuss the stages of postpartum bleeding, the changes that occur during it, and when and how the menstrual cycle returns after childbirth. We will also explore the impact of breastfeeding on its regularity, and the difference between normal and abnormal bleeding after delivery, along with when to consult a doctor to ensure the mother's safety.

Stages of Postpartum Bleeding: What Are the Normal Changes?


Postpartum bleeding goes through several stages, with changes in its color and quantity as the body recovers. The bleeding process differs from one woman to another, but a general pattern can be observed during the first few weeks after birth. Here's what you can expect in each stage:

● From birth until 10 days after

Directly after delivery, the bleeding is heavy and bright or dark red. It gradually decreases, and by around the seventh to tenth day, you may notice a change in the color of the lochia (vaginal discharge after childbirth) from bright red to dark brownish-red. Small clots might appear, requiring frequent changes of postpartum pads.

● After 4 weeks

By the fourth week, the bleeding should lessen. During this stage, it might become light pink. You may also start using fewer postpartum pads and switch to regular sanitary pads.

● After 6 weeks

For most mothers, the bleeding has significantly slowed by the sixth week, turning into yellow or white discharge rather than blood. However, some may continue to experience light bleeding or spotting for up to ten weeks post-birth.

Return of the Menstrual Cycle After Birth: When to Expect It?

The return of the menstrual cycle after childbirth depends on breastfeeding. A mother who exclusively breastfeeds may not see her period return until they stop breastfeeding or reduce its frequency, especially if the night feedings are reduced. Mothers who use formula feeding entirely or a combination of breastfeeding and formula may notice their period returning within four to five weeks after delivery. However, even if the menstrual cycle is absent, especially for those using formula or mixed feeding, it doesn't mean ovulation isn't occurring, meaning there's still a chance of becoming pregnant without a visible period.

Breastfeeding's Impact on Menstrual Cycle Delay

Breastfeeding delays the return of the menstrual cycle in nursing mothers because of the hormone prolactin. This hormone is crucial for stimulating milk production in the breasts and inhibits the release of sex hormones like estrogen and progesterone. With high levels of prolactin due to breastfeeding, it affects the hormonal system responsible for regulating the menstrual cycle, preventing ovulation, and thereby the menstrual cycle itself.

First Menstrual Period after Childbirth: Characteristics

As the body continues to release lochia post-birth and the postpartum bleeding slows, the discharge may still be white or yellow or tinged with some blood. If lochia stops for several days and bleeding resumes, it's likely the menstrual period. The first period may differ from the pre-pregnancy cycle, potentially being heavier or experiencing changes in cramp intensity. To verify, look for:

● Bright red blood
● Increased blood discharge with movement
● Slightly unpleasant smell

Irregular Menstrual Cycle Post-Birth: Is It Normal?

It is normal for the menstrual cycle to be irregular after childbirth. There are no guarantees about the post-birth menstrual cycle. Your period might start between two to seven days of bleeding and typically repeats every 28 days. The post-birth menstrual cycle might vary, affecting the cycle's length or duration. Breastfeeding can also impact this; your cycle may still be irregular even after it returns due to ongoing nursing.

It's expected that over time, the cycle will return to its previous state. However, if the period stops for several months or if you have any questions or concerns about your health after childbirth, it's best to consult your doctor.

Distinguishing Between Normal and Abnormal Postpartum Bleeding

Research suggests about three to five percent of mothers experience postpartum hemorrhage. This happens when you lose more than half a liter of blood within the first 24 hours after delivery. Additionally, note that bleeding can occur anytime during the first six weeks after birth.

For postpartum bleeding or abnormal levels of hemorrhage, indicating significant bleeding, look for these key signs:

● Severe bleeding that doesn't slow down or stop, requiring changing sanitary pads more than once per hour for consecutive hours.
● Large blood clots.
● Blurred vision.
● Feeling chills.
● Noticing clammy skin, indicating wet or damp skin without a clear reason.
● Rapid heartbeat.
● Dizziness, confusion, or fainting.
● Nausea.

If you notice any of these signs, consulting your doctor is essential to determine if they are normal or require medical intervention. Unaddressed, postpartum bleeding can be life-threatening. It is crucial to contact your doctor and act promptly.

Nifas Advice

Dear mother, don't worry if postpartum bleeding lasts longer than expected; it's a natural part of the recovery process. Always monitor the color and intensity of the bleeding. If you experience severe bleeding that doesn't slow, large blood clots, or feel dizzy and extremely tired, don't hesitate to consult your doctor immediately. Your health is most important, and taking care of yourself ensures you are well enough to care for your little one with love.

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