It has been almost a year since they were gone—so long that you may have almost forgotten them. But as all good things come to an end, they’re back: your period. The return of menstruation refers to the first periods after childbirth. When do they reappear? What about the return of menstruation and breastfeeding? And what about contraception after childbirth? We answer all your questions!

What is the lochia and when does it occur?

You carried life for nine months—an extraordinary feat for your body! In the weeks after delivery, your body gradually returns to its pre-pregnancy state: these are the postpartum weeks , also called the post-partum .
During this time, your hormonal system also begins functioning again,
which naturally allows your first periods after
childbirth to return. This is what is called the return of menstruation .

Many new mothers are surprised by these first periods, because it’s difficult to predict exactly when they will return—and they can reappear at any time. Still, there are a few factors to consider, which generally fall into three scenarios.

1. The return of menstruation and breastfeeding

After childbirth, your body begins producing the hormone prolactin, which stimulates lactation. One effect of prolactin is to inhibit, or even delay, ovulation depending on the method and rhythm of breastfeeding. That’s why you may not have your period. The absence of menstruation during breastfeeding is also called lactational amenorrhea or postpartum amenorrhea. The timing of your return to menstruation therefore depends on how much prolactin your body releases. The more you breastfeed, the more hormones your body releases, and the more ovulation is inhibited. Of course, this is not an exact science, as prolactin levels vary from woman to woman. Some mothers see their periods return even before they stop breastfeeding, while others don’t have them for several weeks. But beware: even exclusive breastfeeding does not guarantee the absence of ovulation, which can still occur even without the return of menstruation.

2. The return of menstruation without breastfeeding

In principle, if you have chosen not to breastfeed, your period returns more quickly. Milk production stops, as does prolactin secretion, which allows your hormone levels to return to normal and ovulation to resume. You can therefore expect your period to return within six to eight weeks after childbirth , although for some moms, it can take longer.

3. The recovery after a cesarean section

Following a cesarean section, the return of menstruation usually occurs earlier than after a vaginal birth. The reason? After a cesarean, the placenta and other residues are removed directly during the operation, so the body does not have to expel them on its own. As a result, the uterus heals more quickly, and menstruation may return sooner.

What differentiates lochia from the first menstrual periods after childbirth?

Just after childbirth, you get little rest—because when it comes to bleeding, Mother Nature doesn’t give you a break! Your body expels uterine and placental residues from pregnancy. Although this flow is very red at first, it has nothing to do with your period. Lochia can last between two and six weeks, so your period may possibly occur right after. You may also wonder how to tell lochia apart from the return of your period. While lochia becomes whitish toward the end, your period is red—light or dark—similar to your pre-pregnancy menstruation. So you should have no trouble telling them apart!

How does the menstrual cycle change after pregnancy?

After pregnancy, it generally takes some time for your hormonal balance to fully restore itself, and this can affect your menstrual cycle. The first periods after childbirth are usually heavier, sometimes more painful, and longer than usual. If the pain feels too intense, you can take an analgesic containing ibuprofen or paracetamol, even if you are breastfeeding. Your subsequent cycles may also be affected: they may be shorter, and your flow may be lighter. It can take up to six months to regain hormonal balance and a regular cycle. With the arrival of your little adventurer, your sleep schedule has probably changed, which can also influence the (ir)regularity of your periods. Don’t worry if your periods aren’t as punctual as usual, but consult your gynecologist if you experience abnormal bleeding or if your periods are particularly painful.

What should you pay attention to regarding hygiene?

In terms of hygiene, you should pay attention to a few details during the lochia period; everything is explained in our article « Lochia: a closer look at postpartum bleeding ». ». If your period starts right after, continue to pay special attention to your intimate hygiene and the products you use . Indeed, it is possible that your uterus has not yet fully healed. If your period occurs later than usual and your routine check-up with your gynecologist reveals nothing abnormal, you can use tampons or a menstrual cup again. You may also need a larger size than the one you used before pregnancy. Inserting a tampon or cup into your vagina may also feel unusual, even uncomfortable, because after childbirth, the anatomy of your vagina has changed . However, this should only concern you if insertion is painful. In that case, consult your gynecologist.

Should contraception be used after childbirth?

After childbirth, if you are not planning a new pregnancy, you’ll need to choose a contraceptive method that suits your new situation as a mother.

Even if it may seem that way, breastfeeding is not a reliable method of contraception. What’s more, you can theoretically get pregnant again shortly after childbirth . Because the first periods and ovulation are unpredictable, the risk of pregnancy remains. You can ovulate without realizing it and be fertile well before your period returns. A change in your breastfeeding pattern can be enough to trigger ovulation. If you do not plan to become pregnant again, you should therefore use contraception as soon as you resume sexual activity.

If you are not breastfeeding, you can use a regular contraceptive method, such as the combined pill, the mini-pill, the intrauterine device, or the condom. If you are breastfeeding, options are more limited. Hormonal contraceptives containing estrogens can reduce milk production, so they are not suitable. You can use a non-hormonal method like the condom or the IUD, or opt for a mini-pill or progestin-only pill starting from the 15th day after delivery. After you stop breastfeeding, you can switch back to an estrogen-progestin pill.

Maybe you used your pregnancy to think about contraception? This is also discussed during your follow-up appointment with your gynecologist, and together you can choose the method that suits you best.

Sometimes it takes time for your cycle to stabilize and become as regular as it was before pregnancy. Give your body time to regain its balance. After all, it did an incredible job during pregnancy and childbirth—and it’s still doing it.