In our latest article we address a frequently asked question that concerns new mothers – when and how is it possible to become pregnant again after childbirth? If you’ve embarked on the adventure of parenthood and are now considering adding another little miracle to your family, this article is just for you!
We’ll look at when menstruation and ovulation resume after childbirth, how breastfeeding affects this process, the risks associated with getting pregnant early, and when is the next best time to get pregnant. At Surecheck, we’re invested in in educating people on reproductive health and sexual literacy, so in this article, we explore all perspectives so that you can get the information you need and approach starting a family with confidence and calmness.
When do menstruation and ovulation resume after childbirth?
Menstruation and ovulation after childbirth can come back at different times depending on the individual characteristics of each woman and whether or not she is breastfeeding. Understanding these processes is important for planning your next pregnancy and for a woman’s overall health.
● Non-breastfeeding mothers
Women who don’t breastfeed, typically get their ovulation and menstruation back faster than those who do. According to the American College of Obstetricians and Gynecologists, ovulation in non-breastfeeding women usually resumes about six weeks after delivery. This means that they can expect their first menstrual period a few weeks after that, most commonly around 8 – 12 weeks after delivery.
Why does the process work this way?
- Hormonal changes: During pregnancy, hormone levels, such as estrogen and progesterone, are high, which prevents ovulation and menstruation. After birth, the levels of these hormones drop sharply, allowing the body to restore its normal hormonal cycle. The drop of oestrogen and progesterone levels in the body is the main reason why your cycle will go back to normal.
- Lack of prolactin: In non-breastfeeding women, prolactin levels, the hormone responsible for breast milk production, are lower. To stimulate ovulation, the body requires high levels of a hormone called GnRH. When your prolactin levels are high (during breastfeeding), your GnRH levels are low. Therefore, when your prolactin levels fall, your body can more quickly restore ovulation.
- Physiological processes: A woman’s body goes through a number of physiological changes after childbirth to return to its normal state. The uterus shrinks and returns to its normal size, and hormone levels stabilise, leading to the resumption of the menstrual cycle. The recovery process also involves the normalisation of the functions of the hypothalamus and pituitary gland, which regulate the hormonal balance in the body.
It’s possible to get pregnant before the return of your period
Some women start ovulating earlier, even before they get their period back. This is why it’s important to use contraceptives if you don’t wish to immediately get pregnant again after giving birth.
● Breastfeeding women
In women who are breastfeeding, getting your period and ovulating again can be a significantly longer process. This is because of the hormonal changes that come from breastfeeding. Breastfeeding leads to an increased level of the hormone prolactin, which suppresses ovulation. Although it can delay the resumption of ovulation, this effect is individual and depends on the frequency and intensity of breastfeeding.
Hormonal changes
- Role of prolactin: As we mentioned earlier, prolactin is a hormone that is produced in large quantities during breastfeeding and is responsible for the production of breast milk. A high level of prolactin suppresses the release of the gonadotropin-releasing hormone (GnRH) from the hypothalamus, which reduces the secretion of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland. These hormones are key to stimulating ovulation and getting back your menstrual cycle.
- Frequency and intensity of breastfeeding: the more often and intensively a woman breastfeeds, the higher the prolactin level remains, which delays the resumption of ovulation. With more active breastfeeding (no additional feeding of the baby except breastmilk), ovulation may recover more slowly. Breastfeeding every 2 – 3 hours during the day and at least once at night can keep prolactin levels in the body high enough to prevent ovulation.
Recovery process
To summarise: after childbirth, a woman’s body begins a recovery process that involves the regulation of hormones and the restoration of normal ovarian function. During the first few weeks after birth, hormone levels, such as estrogen and progesterone, decrease, while prolactin levels remain high in lactating women. Gradually, as the frequency of breastfeeding decreases or when breastfeeding is discontinued, prolactin levels drop, allowing the hypothalamus and pituitary gland to stimulate ovulation by releasing certain hormones.
It’s best for women to consult a physician for individual recommendations and to be informed about the processes involved in menstrual recovery and ovulation after childbirth. Being aware of this process can help women plan their next pregnancy and make appropriate decisions about their reproductive health.
Are there any risks with early pregnancy after childbirth?
Early pregnancy after childbirth can pose various risks to both mother and newborn. Various health organizations, including the American College of Obstetricians and Gynecologists and the Centers for Disease Control and Prevention (CDC), recommend waiting at least 18 months before the next pregnancy. This time allows the body to fully recover and reduces the risk of complications.
Risks for the mother
- Anaemia: Frequent pregnancies can deplete the body’s stores of iron and other important nutrients, increasing the risk of anaemia. Anemia can lead to fatigue, weakness, and other health problems.
- Uterine rupture: In women who have had a caesarean section, becoming pregnant less than 18 months after giving birth increases the risk of uterine rupture during labour. This is especially risky for women who plan a vaginal birth after a c-section.
- Increased risk of placental abruption: the short interval between pregnancies can increase the risk of the placenta separating from the inner wall of the uterus before birth, which can be dangerous for both mother and baby. It can decrease or block the baby’s supply of oxygen and nutrients and cause heavy bleeding in the mother.
Risks to the newborn
- Premature birth: getting pregnant within six months of giving birth significantly increases the risk of preterm birth. Premature babies are more prone to health problems such as breathing difficulties, infections and long-term neurological damage. Statistics show that pregnancies less than 18 months apart are associated with a higher risk of premature birth.
- Low birth weight: Babies born within a short interval of a previous birth are more likely to have a low birth weight. This can lead to a variety of health problems and the need for intensive care after birth. Short intervals between pregnancies also increase the risk of placental abruption. Studies show that these risks are significantly lower when the interval between pregnancies is at least 18 months.
- Increased risk of congenital anomalies: Short intervals between pregnancies may be associated with a higher risk of congenital anomalies and other health problems for the baby.
Why is it important to wait?
Waiting 18 to 24 months before the next pregnancy allows the mother’s body to rebuild nutrient stores, deal with inflammation and infection, and prepare for the next pregnancy. Pregnancy and breastfeeding can significantly deplete the body’s stores of nutrients, including iron, calcium, and folic acid. Waiting to repeat pregnancy reduces the risk of complications for both mother and newborn.
Although some women may feel ready for a new pregnancy well in advance, it is important to consult their doctor. They can best assess the mother’s individual condition and provide advice on the most appropriate time for the next pregnancy, taking into account all factors and risks.
Special cases
- Women over 35: For women over 35, the waiting time may be shorter due to reduced fertility with age. In these cases, doctors may recommend waiting only 12 months before the next pregnancy to minimize the risk of age-related complications.
- After miscarriage: For women who have had a miscarriage, there is no established need for a long waiting period before the next pregnancy. According to research, many women are able to successfully become pregnant soon after miscarriage without an increased risk of repeat miscarriage or other complications. However, the emotional state of the mother and her recovery after the first pregnancy is also important and should be taken into consideration before trying again.
In summary, it’s best to wait 18 to 24 months before becoming pregnant again to reduce the risks of complications. We recommend that you consult with your doctor who can best assess your individual case, and wish you the best of luck on this happy adventure called parenthood!
