Postpartum Bleeding Concerns: Irregular Menstruation After C-Section

Postpartum menstruation is persistent?

Hello, I am eight weeks postpartum (after a cesarean section).
During my sixth week check-up, I experienced my first menstrual period (from June 9 to June 13, which was normally seven days before pregnancy).
On the day of my six-week postpartum check-up, I had some bleeding, but the doctor did not perform a Pap smear.
After that, I had a week without bleeding, and today, June 22, I suddenly have bleeding again.
After giving birth, I did not have much lochia; it lasted about one to two days.
I have been breastfeeding daily, but the amount is not significant, approximately 100-150 ml per day.
In the first four weeks postpartum, I had intermittent light bleeding, but it was very minimal and stopped after two to three days.
I would like to know if it is normal for my menstrual cycle to be irregular like this.
Should I stop breastfeeding while I have my period? Thank you.

13, 30~39 year old female. Ask Date: 2021/06/23

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
It is recommended to visit the obstetrician for a vaginal examination and a transvaginal ultrasound.

2.
Breastfeeding can stimulate uterine contractions, helping to control bleeding.

Reply Date: 2021/06/23

More Info

Postpartum bleeding and irregular menstruation after a cesarean section (C-section) can be concerning for many new mothers. It is important to understand the normal physiological changes that occur in the body after childbirth, as well as when to seek medical advice.

Firstly, it is not uncommon for women to experience irregular menstrual cycles in the months following childbirth, especially after a C-section. The body undergoes significant hormonal changes during pregnancy and after delivery, which can affect the menstrual cycle. The first menstrual period after childbirth can vary widely among women, both in timing and flow. Some women may experience their first period as early as four to six weeks postpartum, while others may not see their period return for several months, particularly if they are breastfeeding.

In your case, you mentioned that you experienced your first menstrual period around six weeks postpartum, which is within the normal range. The subsequent irregular bleeding you experienced on June 22 could be attributed to several factors, including hormonal fluctuations, the body adjusting to the postpartum state, or even the effects of breastfeeding. Breastfeeding can suppress ovulation, leading to irregular periods or even amenorrhea (the absence of menstruation) in some women. However, it is also possible to have a period while breastfeeding, as you have experienced.

Regarding the amount of bleeding, it is essential to differentiate between menstrual bleeding and postpartum bleeding (lochia). Lochia is the vaginal discharge that occurs after childbirth, consisting of blood, mucus, and uterine tissue. It typically lasts for several weeks and gradually changes in color and consistency. If you had minimal lochia and then experienced a sudden increase in bleeding, it is crucial to monitor the situation. If the bleeding is heavy (soaking through a pad in an hour), accompanied by severe pain, or lasts longer than a few days, it would be advisable to consult your healthcare provider.

As for breastfeeding during your menstrual period, it is generally safe to continue breastfeeding. Menstruation does not affect the quality of breast milk, and many mothers continue to breastfeed without any issues. However, some women may notice a temporary decrease in milk supply or changes in the taste of breast milk due to hormonal fluctuations during their period. If you notice any significant changes in your breastfeeding experience, it may be worth discussing with a lactation consultant or your healthcare provider.

In summary, experiencing irregular menstruation and some bleeding after a C-section is relatively common and can be attributed to the body's adjustment post-delivery. However, it is essential to monitor the amount and nature of the bleeding and consult with your healthcare provider if you have any concerns. Continuing to breastfeed during your menstrual period is generally safe, and you should not feel the need to stop unless advised otherwise by a healthcare professional. Always trust your instincts as a mother, and do not hesitate to seek medical advice if something feels off. Your health and well-being, as well as that of your baby, are paramount.

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