Emily Oster

2 min Read Emily Oster

Emily Oster

What’s the Deal With Postpartum Bleeding?

Q&A on recovery

Emily Oster

2 min Read

Can I get my period four weeks after birth even if I’m breastfeeding?

—Ellie

Short answer: no. Or at least you would be very far outside the norm. But it would be well inside the norm to still be bleeding at this stage.

For a longer answer, it’s useful to start with bleeding post-birth. After birth — regardless of whether you’ve had a vaginal or a cesarean delivery — you will have postpartum bleeding, called lochia. This bleeding will be heavy at first. In the first few days postpartum, you may pass fairly large clots. (Generally, anything larger than your fist is something to bring up with a postpartum nurse or your doctor.)  

Over the next days and weeks, the bleeding will become progressively less, moving toward something more like a heavy menstrual period and then like a lighter menstrual period. During this time, you want to watch for bleeding getting much heavier again, which could be a sign of a concern. The total length of postpartum bleeding varies across women. In one review of many studies, the average length of active bleeding was 24 to 36 days, but the minimum was 2 and the maximum 90. 

lady having pain in the abdomen
Cottonbro Studio / Pexels

This is to say: it’s quite possible that you would still be bleeding — similar to a period — at four weeks out.

It is much less likely that you would be having a period. To see that, we can look at studies that measure the typical length of time for a return to ovulation postpartum. For women who are not breastfeeding, a review of the data suggests the average time to ovulation is 45 to 90 days postpartum. The minimum in these studies was about 30 days — that’s for ovulation, so menstruation would be roughly two weeks later. 

For breastfeeding women, return to ovulation is often considerably later, with only about 10% resuming ovulation within even four months. 

Studies cannot capture all experiences — there are always outliers. However, for a breastfeeding mom like you, it would be very far outside the distribution of the data for you to have a period four weeks after giving birth. Given this, if you’re experiencing more bleeding than you have been up to this point, that’s worth a call to your doctor. Since it’s probably not a period, it could indicate another issue.

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multivariatemama
5 months ago

Similar to Rebecca I also exclusively breastfed (for the first 6 months), I stopped lochia bleeding after about 5 weeks post birth. But then began (heavy) bleeding again around 8 weeks for a few days, and then again at 10 weeks. I checked in with my doctors who asked me to come in for an ultrasound to check for retained material.

Everything looked good…in the end I was just one of the very “lucky” outliers who got my period back essentially right away postpartum. I got my period frequently at first (approximately once every 3 weeks), then eventually after a few months it tapered off to my normal (approximately once every 30 days). Definitely good idea to check in with the doctor, but if in the end it is your period I hope this helps!

Rebecca
Rebecca
5 months ago

I exclusively breadt fed both my children, and both times the lochia stopped within 3-4 weeks and regular periods began at 4-6 weeks (4 weeks with my first, between 5 & 6 with my second). So the “short answer” may be no but that would have been incorrect in my case.

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