During pregnancy, women are free of their menstrual periods for more than nine months. But it returns after delivery. Whether you have a C-section or vaginal delivery does not have an effect on the restart of your period.
However, the first menstrual period after pregnancy differs from woman to woman as it depends on the individual’s body. This MomJunction post helps you understand the return of periods after cesarean delivery, and when to worry about the possible outcomes.
Will C-Section Delay Your First Period?
Having a C-section will not cause any delay in your first period. The return of the menstrual cycle is mostly influenced by certain factors such as breastfeeding, hormones, and health conditions before and after pregnancy.
When Do You Have Your First Period After C-Section?
The return of your period depends on your breastfeeding pattern, and how soon your hormones return to normal because the levels of estrogen and progesterone hormones drop post-pregnancy.
- If you are exclusively breastfeeding, you will not get back your period until you wean your baby.
- If you are not breastfeeding, you will get your period back in five to six weeks after delivery (1).
Why Is Your First Period Delayed When Breastfeeding?
Your first period is delayed while breastfeeding because of the hormones produced by the body. Prolactin, which is needed for breast milk production, suppresses the reproductive hormones (2). Therefore, you may not ovulate or produce an egg for fertilization. As a result, you do not menstruate.
What Factors Affect Menstruation After C-Section?
The hormonal changes that take place in the body after delivery will have a significant effect on the first few periods. It depends on the:
- Health issues you had before pregnancy
- Changing hormonal levels
- Irregular menstruation before your pregnancy
A few other factors that affect your first period are:
- Weight loss or gain
- Thyroid disorder
- Irregular physical activity
Remember that C-section does not affect the start of your first period, but it does change the way you bleed.
How Is Your Period Different After Pregnancy?
The period after C-section or vaginal delivery may not be the same as the one you used to get before pregnancy. The body is once again adjusting to the menstrual cycle, and therefore it differs in many aspects from the pre-pregnancy period (1).
- Heavy flow: The bleeding could be heavy in the first period after C-section. One of the reasons is the surgical incision on the uterine wall.
- Bright red: The first-period blood that is formed after the clearing of uterine tissue is fresh, and can be in bright red.
- Increase in pain: Some may have stronger cramps that lead to painful periods. For some, the period can be less painful because the uterus is already stretched during pregnancy. The pain depends on the hormonal changes too.
- Lasts longer: The first period usually continues for seven days like a normal period. But most of them may have heavy bleeding for four to five days followed by lighter bleeding for a longer time.
- Irregular periods: Factors such as pregnancy weight gain or loss, stress and thyroid problems might make the menstrual cycle irregular.
- Heavy with blood clots: Dark color or bright red clots release especially when the first period is heavy.
You are likely to have heavy bleeding in cases such as thyroid problems or adenomyosis (thickening of the uterine wall), and lighter bleeding if you had conditions such as endometriosis (the tissue grows outside the uterus), Asherman syndrome (existence of scar tissue in the uterus) and Sheehan syndrome (the damage of pituitary gland).
It may take some time for your menstrual cycle to get regular. Sometimes, you may not get back your regular periods for months. Also, you might have the first period, and then a break in the cycle before it resumes (3).
Can Postpartum Periods Be Less Painful Than Before?
A study has found that the period pain was lesser after childbirth than that before childbirth due to the bodily changes brought in by the first pregnancy (4).
Will The First Period Affect The Breast Milk?
You might see some changes in your breast milk supply or your baby’s reaction to milk when your period returns. Hormonal changes could result in:
- A decrease in milk supply
- Changes in the frequency of nursing
- Composition and taste of the milk
These changes are sparse and do not affect your breastfeeding ability.
When To Meet The Doctor?
If your periods do not become normal even after a few months, and you notice some unusual changes, you should check with your doctor. You may also consult the doctor in the below instances:
- Soaking more than one pad in one or two hours
- Heavy bleeding with pain
- Sudden fever and severe headache
- Blood clots that are bigger and unusual
- Foul smelling period
- Pain during urination
- Difficulty in breathing
First Period After C-Section And Tubal Ligation
Tubal ligation (tying of the fallopian tubes to prevent future pregnancies) after the C-section does not affect your first period. The period might be heavy but that is nothing to worry about. If you are sure of having a tubal ligation after the current pregnancy, then you may consider having that done at the time of C-section itself to avoid additional incisions and anesthesia.
The first period after cesarean section may be either heavier and painful or lighter and easier. For some, it may occur shortly after delivery while for others, it might take months. It may also be irregular for some months. But if you experience anything unusual, check with your doctor.
Do you have an experience to share? Let us know about it in the comments section below.
2. Marc E. Freeman et al.; Prolactin: structure, function, and regulation of secretion; American Physiological Society Physiological Reviews
3. Breastfeeding and periods; Healthdirect (2017)
4. Mahboobe Firouzi, et al.; Comparing the pattern of primary dysmenorrhea before and after childbirth; Journal of Midwifery and Reproductive Health (2019)