by Brigid Taylor
Most people know that women don’t menstruate during pregnancy (I mean TV loves to do the whole “late period” thing to hint that a character is pregnant so we should really all know this by now). But what about after pregnancy? When a pregnancy ends with the birth of a baby, what happens next for mom’s body? Our culture is obsessed with the idea that women should “get their bodies back” as soon as possible following pregnancy and birth. This is stupid and misogynistic for SO many reasons (when did the body stop being mine?), but let’s focus on the fact that a new mother’s body is not designed to just zap back to “normal” once the baby has vacated the uterus. And truthfully, it can never be exactly the same because our bodies change all the time in small and large ways whether we are pregnant or not. In the case of a woman who has recently given birth the changes are more obvious, especially if she is breastfeeding. Here is where the menstrual cycle comes in.
All women who have given birth experience postpartum bleeding known as lochia for anywhere from a few weeks to over a month. Although it may seem period-like, lochia is not a menstrual period. For women who do not breastfeed the first true menstrual period generally comes around 6 to 8 weeks after giving birth. If a woman is breastfeeding the amount of time until the return of her cycle can vary greatly, but there is usually a period of menstrual suppression.
Why? Well because Mother Nature is awesome. With this period of menstrual suppression comes a period of natural infertility. Mother Nature understands (unlike the leaders of countries without maternity leave), that a new mother needs time to physically and emotionally recover from pregnancy and birth, and that she needs time to adjust to caring for her new baby. The baby also needs mom’s full attention for quite a while in order to thrive. Another pregnancy soon after giving birth can make things difficult for both mom and baby. So Mother Nature made a period of natural infertility a part of the pregnancy-birth-breastfeeding cycle. Cool, huh?
Now it’s not just any breastfeeding that suppresses fertility. I’m talking about exclusive breastfeeding and this means three things: baby is under 6 months old, mom’s periods have not returned*, and baby is breastfeeding on demand during the day and night and only receiving breast milk. When these guidelines are followed the Exclusive Breastfeeding method of birth control, also known as the Lactation Amenorrhea Method (LAM) is 98%-99.5% successful at preventing pregnancy. Head over to the fabulous online breastfeeding resource KellyMom to learn more about LAM.
For some women menstruation resumes well before their baby is six months old, while others go months or even years without menstruating. There are a lot of factors that go into when a woman’s cycle returns, including if she is practicing ecological breastfeeding, which involves keeping baby as close as possible as often as possible without schedules. For women who practice ecological breastfeeding, menstruation returns an average of 14.6 months postpartum. In an article on breastfeeding and fertility for New Beginnings, the magazine of La Leche League International, the author Christine Foster notes, “The exact duration of amenorrhea depends on each woman’s nursing pattern and on her own physiology…some women go two years or more without a period while they are breastfeeding, and some breastfeed without any supplementation and still have their menses return at a few months postpartum.” (for more information on ecological breastfeeding please see the linked articles from KellyMom and La Leche League International).
My period came back when my son was 9 ½ months old. The next month however I didn’t have a period. Since then a few of my cycles have been unusually long and sometimes the number of bleeding days is unusually short. International Board Certified Lactation Consultant (IBCLC) Becky Flora comments on the normalcy of experiences like mine: “Once menstruation returns it may continue to be irregular during lactation. It’s not uncommon to have a shorter or longer than normal period while breastfeeding. It’s also not abnormal to skip a period or see the first period return and then find that months pass before the next one.”
Studies show that a new mother’s fertility actually returns in stages rather than all at once. Some women even have one or more periods without ovulation before full fertility resumes, while others ovulate before experiencing their first postpartum period. In fact, the longer the period of amenorrhea, the more likely it is that ovulation will precede menstruation. It is then possible (although very uncommon) to become pregnant again without ever experiencing a menstrual period between pregnancies. This can be a frightening thought if you are a new mother who really doesn’t want to get pregnant again anytime soon. Knowledge of fertility awareness can come in handy here, as IBCLC Philippa Pearson-Glaze notes, “If you are aware of what to look for, your body will show signs of impending ovulation such as sensitive breasts or nipples and changes in cervical fluid and waking temperature. . .”
If any or most of the information here is new to you it’s not surprising. Menstruation and lactation have a lot in common in our society in that they are both highly misunderstood and frequently vilified. Menstrual blood isn’t gross and neither is breast milk. Every single person reading this would not be here if it were not for both menstrual blood and breast milk (even if you did not breastfeed most of your ancestors did). These two processes are part of a well orchestrated biological plan to keep humanity going. But you would never know it if from the way menstruating women are belittled as hysterical and disgusting, and breastfeeding women are judged as selfish and exhibitionist. I mean, come on people! If we want humanity to continue we’re going to have to start respecting and supporting the half of the population whose bodies bring forth new life. One way to do this is to learn more about the amazing things that the female body can do.
*According to Philippa Pearson-Glaze, IBCLC, “A menstrual bleed is defined as two consecutive days of bleeding after [the] baby is eight weeks old.”