Your sexual and reproductive health after having a baby

When will my period start again after having a baby?

It will be different for everyone, but most women will start having periods again about 5-6 weeks after birth. 

You may be able to get pregnant as little as 3 weeks after the birth of your baby, even if you are breastfeeding and your periods haven't started again yet.  

How does breastfeeding affect my periods and fertility?

If you are breastfeeding exclusively, your periods may not start again until you stop breastfeeding or until you stop night-time breastfeeding. This is because the hormone that causes your body to make breastmilk can stop your body making the hormone that controls your periods. 

If you combine breastfeeding with formula feeding, your first period could start again after about 5-6 weeks after having your baby.

When your baby starts breastfeeding less often (around 3 feeds a day), you may start ‘spotting’. Spotting is a light and irregular period that usually appears as spots of blood. 

Can I use breastfeeding as a form of contraception?

Because breastfeeding can suppress ovulation, some women use it as a form of natural contraception. This is known as the Lactational Amenorrhoea Method (LAM). It's important to start using another form of contraception if:

• your baby is more than 6 months old
• you give them anything else apart from breast milk, such as a dummy, formula or solid foods
• your periods start again (even light spotting counts)
• you stop night feeding
• you start to breastfeed less often
• there are longer intervals between feeds, both during the day and at night.

It is important to note that experts don’t know how expressing breastmilk affects LAM, but it may make it less effective. 

NHS has more information about natural family planning.

If I bottle feed instead of breastfeeding will that help my cycle ‘go back to normal’ quicker?

This is possible, but there are many things that will influence your menstrual cycle. This includes things like stress or having a medical condition such as polycystic ovary syndrome. 

The World Health Organization recommends that all babies are exclusively breastfed for 6 months, and then for 2 years or as long as mother and baby want to, alongside solid food.  

There are lots of benefits to breastfeeding. However, there are many reasons why women decide not to breastfeed or to stop breastfeeding after a time. 

Finding the best way to feed your baby can sometimes be difficult or stressful. Don’t be afraid to ask for help if you need it, because it’s important that you’re happy about how you’re feeding your baby.

Your health visitor is there to help you find the best option for you and your baby.

Can I use tampons after giving birth?

Even if you think your period has started again, don’t use a tampon (or menstrual cup) until you’ve had your 6-week postnatal check. This is because you still have a wound where the placenta joined with the wall of your womb. Using internal sanitary products before the wound has healed could increase your chance of infection. It’s best to use maternity pads instead.

What will my first period after birth be like?

You first period may be different from how your period was before. You may have:

• irregular periods (especially while you're breastfeeding)
• cramping (this may be better or worse)
• heavier periods
• small blood clots in your periods.

If you have had blood clots in your period that have lasted a week, or have much heavier blood loss than you have had before, you should speak to your midwife, health visitor or GP. 

There are other things that can affect when your periods start again including: 

Stress

Having a baby can be a great experience but it can also be stressful and overwhelming. You will probably be trying to cope with sleepless nights, learning to feed your baby and coping with hormone changes as your body recovers from pregnancy. 

It can be a tough time for every parent. But if you’re struggling with negative feelings, it’s important to talk to someone. Up to 1 in 5 women develop mental health problems during pregnancy or in the first year after childbirth, including low mood, depression anxiety. Partners can be affected too.

Tell your health visitor or GP how you feel. It can be hard for some people to talk about this but try to remember that your healthcare professionals won’t judge you. They will focus on helping you find the right treatment and support so you can take care of yourself and your baby. 

Sudden weight loss

Sudden weight loss can be caused by things like stress, eating disorders, depression or an overactive thyroid gland. If you have any concerns about your health, talk to your midwife, health visitor or GP. You do not need to wait until your 6-week check or other scheduled appointments to get help.

Being overweight

Most people who give birth will be bigger for some time after giving birth. This won’t bother some, but others may have negative feelings about their post-baby bodies. It’s important not to try and lose too much weight too quickly after giving birth by limiting your diet or exercising too much. This will likely cause more stress and make it harder for you to care for your baby. Doing too much exercise can also cause irregular or stopped periods. Try to take things slowly instead. 

Talk to your health visitor or GP if you have any concerns about your menstrual cycle or what you periods are like.

Having a healthy intimate relationships after having a baby

Having sex may the last thing on your mind after having a baby. But it can be an important part of a relationship. Many people find it hard to talk about sex, but you can talk to your health visitor about any concerns you have about this. Find out more about sex after pregnancy.

Your fertility after having a baby

You may be able to get pregnant as little as 3 weeks after the birth of your baby, even if your periods haven't started again yet. 

Some women feel that they won’t need contraception so soon after having a baby, especially if they have found it difficult to get pregnant before. But your body goes through lots of changes during pregnancy and for some women they can have increased fertility.  Even if you had your baby by IVF, it is important to think about which contraception you’d like to use. 

What kind of contraception should I use after pregnancy? 

What kind of contraception you should use after pregnancy will depend on several factors, including if you:

• are hoping to have another baby and when
• are breastfeeding
• know that you do not want any more children 
• are comfortable remembering to take something at the same time every day
• have any medical conditions.

You can talk about your options at any time with your health visitor, GP or a doctor or nurse at a contraception or sexual health clinic. 

You can also visit Contraception Choices or sexual health charity Brook. Both websites have information designed to help people decide which method of contraception may suit them best. 

Remember that condoms are the only contraception that prevent sexually transmitted infections. 

Not all methods of contraception will be suitable for you

Not all methods of contraception are safe for all women. For example, you should not use some methods if you have certain medical conditions, such as high blood pressure (hypertension). 

There are some medical conditions where some types of contraception are not recommend because of the risk of a blood clot (venous thromboembolism). These include:

• pre-eclampsia
• immobility
• caesarean section
• postpartum haemorrhage
• blood transfusion.

Your doctor or midwife should advise you if there are any types of contraception that you can’t use. However, if you are worried or have any questions, ask your health visitor or GP.

What if I don’t want to or can’t use hormonal contraceptives?

Some contraceptives work by using hormones that are similar to the hormones women produce naturally. These hormones are oestrogen and progestogen. Contraceptives that contain these hormones aren't suitable for some women.

Not all contraceptive methods use hormones. Some work in other ways, including:

• intrauterine device (IUD)
• male condoms or female condoms
• diaphragm or cap.

Contraceptives that contain oestrogen are not suitable for women who:

• are over 35 and who smoke
• are very overweight 
• take certain medicines 
• have certain medical conditions, such as problems with blood circulation or migraines with aura. 

Can I start any type of contraception straight away? 

Once you have given birth, there are some contraceptives you can start straight away and others that you need to wait to use. 

Immediately after birth

As long as you have no medical risks, you can have:

• a contraceptive implant 
• a contraceptive injection 
• the progestogen-only pill 
• male or female condoms 
• an IUD (intrauterine device) or an IUS (intrauterine system). 

An IUD OR IUS should be fitted within 48 hours of the birth. If you chose not to, you’ll usually be advised to wait until 4 weeks after the birth.

3 weeks after birth

If you're not breastfeeding and you have no medical risk factors for a blood clot in a vein, you can start to use the:

• combined pill 
• vaginal ring 
• contraceptive patch. 

If you're breastfeeding, have certain health conditions or a risk of blood clots, you'll usually be advised to delay using the combined pill, ring or patch until at least 6 weeks after the birth.

4 weeks after birth

If you did not have an IUD or IUS inserted within 48 hours of the birth, you can have one inserted now.

6 weeks after birth

If you're breastfeeding or you've developed certain medical conditions during pregnancy or delivery, you'll need to wait until at least 6 weeks before you can use the:

• combined pill
• vaginal ring
• contraceptive patch.

You can usually start using a diaphragm or cap around 6 weeks after giving birth. 

If you used a diaphragm or cap before becoming pregnant, see a GP or a doctor or nurse at a contraception clinic after the birth to make sure it still fits correctly. This is because childbirth and other factors, such as gaining or losing weight, means you might need a different size.

Will contraception affect my breastmilk?

If you’re using a hormonal method of contraception, a small amount of hormone will pass into your breastmilk. There is no evidence that this will harm your baby, but you are advised to wait until the baby is 6 weeks old before starting the combined pill, the contraceptive vaginal ring or the contraceptive patch. This is because these methods contain the hormone estrogen which may prevent your milk production from starting. 

Using the IUD doesn’t affect your milk, and copper from it doesn’t get into the milk. 

Can I use emergency contraception after having a baby?

If it’s been 21 days or more since the birth, you can use emergency contraception. It’s not possible to get pregnant earlier than 21 days (3 weeks) after the birth.  

The emergency pill (morning after pill)

You can use the emergency pill from 21 days after giving birth. There are two types: levonelle and ellaOne. 

Levonelle is safe to take while breastfeeding. Although small amounts of the hormones in the pill may pass into your breastmilk, it's not thought to be harmful to your baby.

The safety of ellaOne during breastfeeding isn't yet known but the manufacturer recommends that you don't breastfeed for 1 week after taking it. Try to express and throw away your breastmilk during that week so you don’t interrupt your flow.

The intrauterine device (IUD or coil)

You can use the emergency IUD from 28 days.  The intrauterine device (IUD) is a small, T-shaped plastic and copper device that's put into your womb (uterus) by a doctor or nurse. It releases copper to stop the egg implanting in your womb or being fertilised.

The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy.

What if I don’t want any more children?

Sterilisation is an option if you are sure that you don’t want any more children. 

Female sterilisation involves surgery to block or seal the fallopian tubes are to prevent the eggs reaching the sperm and becoming fertilised. Male sterilisation (known as vasectomy) involves surgery to cut or seal the tubes that carry a man’s sperm.

Both female and male sterilisation is more than 99% effective at preventing pregnancy permanently and is available on the NHS. Once you're sterilised it's very difficult to reverse it, so it’s really important to consider your options before making your decision. Sterilisation reversal is not usually available on the NHS.

NHS has more information on female sterilisation and male sterilisation.

What if I want to get pregnant again?

You can stop taking or have any kind of contraception taken out at any time you want and your normal fertility (ability to get pregnant) will go back to normal. 

However, if you use the contraceptive injection, your fertility may not return for several months after your last injection has worn off. It can sometimes take up to a year for your periods and fertility to get back to normal.  

Generally, you are advised to waiting at least 2 years after giving birth before getting pregnant again. This can help you have a healthier pregnancy and birth, and can also reduce the risk of complications such as an early birth or a very small baby. 

If you had a caesarean section (c-section), it’s recommended that you wait a year before getting pregnant again. This is because recovering from a caesarean section usually takes longer than recovering from a vaginal birth, even if the birth was straightforward. 

Of course, pregnancy isn’t always planned. Or you may want to get pregnant sooner for your own reasons. If you do get pregnant earlier, don’t worry, just make your booking appointment with a midwife as soon as you can. Find out more about pregnancy and giving birth after a c-section.