January 18, 2022

Preparing for Postpartum Periods with Dr. Jamie Rempe

Pregnancy is a beautiful journey, but the changes your body endures don’t stop after giving birth. It can take anywhere from three weeks if you didn’t experience vaginal tearing (perineal laceration) to six weeks or more if you experience complications such as tearing or episiotomy. Being patient and understanding the next steps in the process will make it easier to cope.

One of the most common questions The University of Kansas Health System St. Francis Campus Women's Center’s Jamie Rempe, DO, receives is about a mother’s first menstrual cycle after delivering a baby.

“The first menstrual cycle after a baby can be very different for each person,” Dr. Rempe said. “This also depends on several factors with the biggest being whether the patient is breastfeeding or not. Often women that are breastfeeding will not have a period for many months while they are breastfeeding until they start to space out feeds and the ovaries start to ovulate again. This is normal in those situations. However, some women will have some bleeding while breastfeeding and this may be very light, intermittent bleeding or they could go back to regular cycles if breastfeeding is not suppressing ovulation.”

Your first period postpartum may feel different than your cycle did prior to bearing a child. Even people with very consistent cycles may experience changes when their period returns.

“It is not uncommon for the first period after a baby to be heavier than a typical menstrual cycle,” Dr. Rempe said. “The first period after a baby may also have more cramping than before pregnancy. Passage of some clots may also be normal with the first few cycles after delivery. “

Hormone regulation will ultimately determine when your periods return. That’s why people who choose to bottle feed their newborn, as opposed to breastfeeding, may experience a normal period as early as 3-4 weeks after delivery.

“Periods may return for some as early as three weeks after delivery, but I would say typically the first menstrual cycle is somewhere between four and six weeks out for patients that choose to not breastfeed but it could also be longer,” she said. “If a patient has a history of irregular cycles and long periods between cycles before pregnancy, this could be the same after delivery as well. If there are no menstrual cycles within 8-12 weeks of delivery and you’re not breastfeeding, I’d suggest reaching out to your provider for recommendations. If you’ve been sexually active without contraception, then a pregnancy test should be done. There are also some other medical conditions to consider that can affect cycles such as thyroid disorders.”

While your period may look and feel different postpartum, certain symptoms should be shared with your doctor.

“We would typically recommend a patient call their doctor or seek care if the bleeding associated with their cycle is saturating a pad or tampon faster than every 30 minutes for more than 2 hours and not slowing down or if the patient is having signs or symptoms of anemia from acute blood loss such as shortness of breath, dizziness with standing or heart palpitations,” Dr. Rempe said. “While this bleeding may be normal, we need to rule out other causes of heavy bleeding such as infection or retained tissue from the pregnancy, as well as bleeding disorders.”

Dr. Rempe, along with our team of physicians and midwives at The University of Kansas Health System St. Francis Campus Women’s Center, offers a full range of gynecological and obstetric services for keeping you healthy through every stage of life. Our experienced team is committed to providing personalized, quality care that you deserve. To learn more or to schedule an appointment, call 785-295-5330 or visit kutopeka.com/services/womens-health.

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