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The First Period Postpartum Is Intense—Here’s What You Need to Know 

Postbirth bleeding, the return of your regular cycle, and how to manage it all in the haze of new parenthood.  

Pregnancy is almost long enough for you to forget what having a period feels like. But rest assured, the first period postpartum will swoop in to remind you—potentially with a vengeance. 

Over the course of nine long months, pregnancy will introduce plenty of new anxieties (though, don't worry, there's probably a pregnancy app for that). One plus for many pregnant people, however, is the nearly yearlong hiatus from having to worry about birth control side effects or stocking up on pricey period products. In all the excitement leading up to labor and delivery, it's understandable why you might not be thinking about postpartum bleeding, but knowing what to expect from the first period postpartum—including what's normal and what's cause for concern—can help make those first weeks of new parenthood much smoother. 

Here's everything you need to know about what to expect immediately after delivery and when your regular cycle will likely return. 

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Postpartum bleeding vs. the first postpartum period

Whether you give birth vaginally or via C-section, prepare for a significant amount of bleeding in the days and weeks after delivery. Known as lochia, this postbirth vaginal discharge is not the same as the return of your regular cycle. “This bleeding contains not only blood but pieces of your uterine lining, white blood cells, and mucus to start shedding and restoring your uterine lining,” says Jessica Shepherd, MD, a board-certified ob-gyn and chief medical officer at Verywell Health. “Women may also notice blood clots but shouldn’t be alarmed. These are more likely in the beginning and will stop as well after a few days.”

There's no way to sugarcoat it: Lochia lasts a long time. Four to six weeks of bleeding and discharge after birth is common. For the first few days, you can expect bright or dark red blood and some small clots. This will likely look like an extremely heavy period, where you can expect to soak a thick pad every two to three hours, according to the Cleveland Clinic. Expect period-like cramping. 

Over time the discharge will look less like blood and more like mucus, says Dr. Shepherd: “The color should change as your body starts to heal.” In the second stage of lochia, which lasts anywhere from 4 to 12 days, your flow will be pinkish brown in color and any clots should disappear. If the heavy bleeding doesn't begin to subside after several days, check in with your physician. “It is important to discuss any heavy or prolonged bleeding with your doctor,” she says. 

Finally, you'll enter the third stage of postpartum bleeding, which actually doesn't contain much blood at all. Lochia alba lasts anywhere from 12 days to six weeks and is characterized by yellowish white discharge. 

Can I use a tampon after giving birth?

“Women should avoid using tampons until at least their six-week check-in after labor,” says Dr. Shepherd. Pads or postpartum diapers are your best bet for dealing with lochia. 

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When will my regular period return after giving birth?

You can expect your normal period to return within six to eight weeks postpartum, says Dr. Shepherd. (So essentially just after lochia ends.) If you're breastfeeding, your menstrual cycle may not return for a year or more, depending on how long you breastfeed. “This is because the hormone that causes you to make milk keeps you from ovulating and having your period,” she explains.  

That doesn't mean you can't get pregnant while breastfeeding. While research shows there is a drastically reduced chance of pregnancy for parents who breastfeed, it comes with a lot of caveats. Namely, you have to be exclusively breastfeeding. Women who pump and bottle feed, supplement with formula, or breastfeed while babies transition to solid food all have a higher likelihood of getting pregnant. 

How long does the first postpartum period last?

It’s common for your period to look different after giving birth. When your regular period does return, it may be longer or shorter, lighter or heavier than it was prepregnancy. “Your body is adjusting and hormones are changing, so this is completely normal,” says Dr. Shepherd. The irregularity won't last forever—typically periods return to normal about a year after giving birth she says. “If your period doesn’t return to normal after about a year, and you’re not breastfeeding, speak with your doctor about the changes,” she says. 

When is postpartum bleeding cause for concern?

Passing so much blood that you're soaking through a maxi pad every two hours and passing blood clots the size of golf balls will likely seem alarming if it's never happened to you before. But before you spiral with postpartum anxiety, know that this is normal after giving birth. 

Postpartum bleeding becomes a cause for concern when “clots are larger than a prune, discharge is greenish or smells [foul], you have significant pain or cramping, or the bleeding seems to have increased or isn’t fading," says Dr. Shepherd. “Bleeding can slightly increase a few weeks after delivery but should not be substantially heavy and then it should decrease again.” 

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Any one of these symptoms is worth a call to your doctor to rule out any complications. “You should also pay attention to how your overall health is,” Dr. Shepherd says. “Any fever, chills, nausea, or dizziness could be cause for concern and should be brought to your doctor’s attention as soon as possible.” 

Excessive bleeding—more than a pad an hour—can be a sign of postpartum hemorrhage, which is rare but extremely serious. This is most likely to occur in the first 24 hours after birth, according to the Cleveland Clinic, but can happen anytime in the 12 weeks following delivery. If you're experiencing excessive bleeding, and feel faint, dizzy, or nauseous, call your doctor or 911 immediately. 

Macaela MacKenzie is a writer and editor specializing in wellness. She writes about self-care, mental health, fertility, and women's equality with a focus on breaking down stigmas in women's health.