While I was researching information around a woman’s first menstrual cycle after birth, I was shocked at how much I didn’t know. But, then I thought of the stigma that surrounds the words “menstruation” and “period” or even just a picture or the sight of a pad or tampon, and it made sense; though at least 50% of the world’s population have, do, or will menstruate, the commonality of this natural bodily process doesn’t make it less taboo. Oftentimes, nicknames such as “Aunt Flo” and “On the Rag” are used as code for menstruation, creating a perpetually hushed bubble around the scientific reality of this cycle. Open discussion of menstruation in societal interactions and communication aren’t welcome in general, so much so that many menstruating individuals are often left unprepared for their “first” period -- not only those approaching puberty, but also mothers who have just given birth and are awaiting their cycles to return.
It comes at no surprise that the taboo nature of menstruation comes from the predominantly patriarchal societies that the world consists of today. I was reading through one of my old textbooks from college and came across Gloria Steinem’s 1978 satirical essay titled “If Men Could Menstruate”. I remember reading it years ago, and reading it again made me realize how the stigma surrounding menstruation is rooted in the structure and culture of our society. In it, she shares:
“What would happen, for instance, if suddenly, magically, men could menstruate and Women could not? The answer is clear--menstruation would become an enviable, boast-worthy, masculine event.”
But, it’s the women who are stuck with the menstrual cycle - and so, along with the stigma, us women have learned to recognize it as the reminder of our naturally cycling hormones and our fertility. It continues into and beyond motherhood, bringing along the unknowns and celebrations right with it. You most likely received your very first period between the ages of ten and fifteen, and from that day forward you experienced the pleasure of Mother Nature paying you a visit every month. At first it started off as a nuisance, but eventually, the monthly occurrence became a part of your regular schedule, though sometimes arriving irregularly. Now, after forty weeks of no periods (just an occasional bleeding every now and then), you may be wondering what might change in the process that once was routine, now that you’ve undergone the birthing process.
Unlike the typical shedding of the uterine lining every month, your uterus retains that lining while pregnant, which is why you don’t have periods. During pregnancy, you may have some occasional bleeding, just like you would have some spotting after a normal period. However, call your doctor if there is too much blood, as that could be a sign of ectopic pregnancy, miscarriage, or a complication during pregnancy. Your regularly scheduled period will return with correlation to the healing processes of your body, but in case you’re feeling anxious, we will discuss some of the most frequently asked questions.
Breastfeeding is one of the biggest contributing factors that determines when you’ll have your period again. Generally, mothers who solely breastfeed will experience their periods later than mothers who either solely formula feed or feed their children with a combination of the two. Due to this, periods may resume months or even years later depending on how long a woman chooses to breastfeed. This temporary postnatal infertility is medically known as lactational amenorrhea, as consistent nursing tends to inhibit the release of the monthly menstrual hormones that aid in the preparation for a next child. This being said, your period could return as soon as six weeks or up to a year post-birth, depending on how much or little you breastfeed.
Other than the fact that breastfeeding and the hormones involved mainly affect the timing of return for your period, you should also be aware that your period may not come back the same way you remember it. For some women, their periods become more easy to manage, and less painful; for others, unfortunately, their time of the month gets worse than prior to becoming pregnant. There are many factors that contribute to the changing of your cycle. It may become worse because your uterine cavity is larger than before. On the other hand, your period may improve due to the stretched uterus or dilated cervix. In both cases, it is recommended to use a sanitary pad or period underwear rather than a tampon up until your six week check up, to provide time for your body to heal.
With each scenario, your body is readjusting and recovering after having a baby. There is no one-all experience for the first cycle after birth--it will be unique to you and your uterus. It may be similar to your previous periods, and it may be completely different. Cramping might be worse, or possibly better than before. You may experience a heavier flow, irregular cycle lengths, flow that starts and stops, and blood clots. These differences will fluctuate over time, and eventually decrease. It’s when these differences are accompanied by severe headaches, fevers, very large blood clots, discharge that smells unusual, bleeding through more than one pad an hour, trouble breathing, and bleeding for more than seven days that you should look out for and call your doctor if you experience them.
Another piece of important information: while you may not be getting your period until at least 6 weeks post-birth, you will be seeing some discharge early on that is often mistaken for a menstrual cycle, called lochia. Though bright red and appearing very similar to our monthlies, lochia is not a period--rather, it is the sign that your body is still recovering, shedding the layers of uterine lining that built up during the 40 weeks of pregnancy. One way to tell if the discharge you’re releasing is lochia or a menstrual cycle is to assess the color. While menstrual blood tends to darken during a cycle, discharge in the 24-36 day cycle of lochia will lighten and eventually become clear. Though different in nature, the characteristics of lochia are quite similar to a period, and as such you may also experience symptoms such as cramps during this time. Alongside this, keep an eye out for concerning symptoms, such as odorous discharge and using a pad per hour--though these are precautions for periods, they apply to lochia, too. Don’t worry when lochia arrives--this is a completely normal and natural process that your body does to help you recover from those long weeks of pregnancy.
All in all, your first period post-pregnancy will likely be different than what you’d expect. Don’t fret as varying menstrual cycles are common as your body heals. Rather, recognize the signs of concerning symptoms, and use this time to educate your loved ones about the menstrual cycle post-birth--as they likely will be unaware. Comprehensive, holistic sex education that includes hefty information on menstruation, including the time surrounding pregnancy, is vital for women across the world. Without this knowledge, menstruating individuals may resort to using unsanitary period products, be prone to infections, may be caught off guard, and all in all, be uninformed of their natural bodily functions that happen rather frequently. The cycle continues, from ten to fifteen years old and onwards, from America, to South Korea and everywhere in between and beyond. Let’s take care of those who bring life into our world. Let’s take care of our women.