Can you get pregnant during postpartum bleeding

Q: Can you get pregnant if your still bleeding after giving birth?

Its possible to get pregnant before your first postpartum period, which can occur as early as four weeks after giving birth or as late as 24 weeks after baby arrives (or later), depending on whether youre breastfeeding exclusively or not.

Q: Can you get pregnant when you have Lochia?

While its unlikely, you can get pregnant in as little as three weeks after giving birth (postpartum), even if youre breastfeeding and your periods havent returned yet .

NEW YORK (Reuters Health) -- Just had a baby, and not ready for another one quite yet?

Table of Contents Show

So, what are your chances of conceiving?
Fertility Awareness Method postpartum
An interview with Ashley Chea
Can you get pregnant if your still bleeding after giving birth?
Can you get pregnant when you have Lochia?
Do you ovulate after postpartum bleeding?
What happens if you get pregnant shortly after giving birth?

To be safe, you should consider using contraception as soon as 3 weeks after birth, according to a new review published in Obstetrics & Gynecology.

Women who are breastfeeding are very unlikely to conceive, and most women who aren’t breastfeeding won’t start ovulating again until 6 weeks after giving birth. Still, it’s possible in less time, say the authors.

“For women with a new baby, contraception may not be at the top of their list of concerns,” Dr. Emily Jackson, one of the study’s authors, from the World Health Organization (WHO), told Reuters Health in an email.

“It is really important that people who provide care to postpartum women bring up the subject of contraceptives, alert women to the fact that they may become fertile soon after having a baby, and make sure that women have their chosen method before they become fertile again,” said Jackson, also a family doctor in Los Angeles.

Using some kinds of contraceptive pills right after pregnancy is dangerous because both the estrogen in pills and post-pregnancy hormones increase a woman’s risk of blood clots. That risk drops off over time.

The aim of the current study was to help determine at what point after a woman gives birth the benefits of using contraceptive pills again begin to outweigh the risks.

Jackson and her colleague Dr. Anna Glasier reviewed four studies that have examined when non-breastfeeding women begin to ovulate again after giving birth, and whether women had a good chance of getting pregnant during those first ovulations.

In all of the studies combined, ovulation started, on average, between 45 and 94 days after a woman gave birth. However, in two studies women started ovulating as early as 25 and 27 days after giving birth.

The studies also found that most of those first ovulations probably wouldn’t result in pregnancy.

Based on these results, and on data regarding the likelihood of blood clots, the WHO determined that the benefits of starting contraceptive pills containing both estrogen and progestin probably outweigh any risks starting at 3 weeks after birth.

After 6 weeks, WHO researchers said that there should be no restrictions on new mothers taking contraceptive pills.

Contraceptive pills that contain progestin only are thought to be safe right away after a woman gives birth, and so these could be an option for women, said Dr. Kavita Nanda, a researcher at Family Health International who was not involved in the current study.

The study’s recommendations only apply to women who are not regularly breastfeeding.

In addition, doctors don’t recommend that mothers who are breastfeeding take contraceptive pills with estrogen, because of a controversial potential risk that those could slow infants’ growth.

Jackson also said it’s important that doctors speak to all women, including women who are breastfeeding, about their options for contraception.

“Breastfeeding can be a lot of work, and women may have a break in breastfeeding that they don’t plan for or stop breastfeeding earlier than they thought they would, potentially putting them at higher risk for pregnancy unexpectedly,” Jackson said.

“It would be great if we could make sure that all women were prepared in advance to address their return to fertility postpartum.”

SOURCE: bit.ly/hqlHLT Obstetrics & Gynecology, March 2011.

for-phone-onlyfor-tablet-portrait-upfor-tablet-landscape-upfor-desktop-upfor-wide-desktop-up

Many women are often surprised to learn that after having a baby, you can become pregnant again without actually menstruating first. This is because about 60% of women will ovulate before their first period postpartum. However, only about half of these women will have a long enough luteal phase to sustain a pregnancy after this first ovulation. The other 40% will have some sort of bleeding to indicate their first postpartum ovulation is approaching. Due to the wide variations of returning fertility, it can be very difficult to detect when ovulation occurs for the first time after giving birth.

So, what are your chances of conceiving?

Lactational amenorrhea is the suppression of a menstrual cycle due to the breastfeeding hormone, prolactin. While there are exceptions, exclusively breastfeeding on-demand both day & night, without using of bottles, pumping, or pacifiers usually suppresses fertility until baby starts solids. When these criteria are met, your chances of conceiving before first foods are introduced is about 2%, which is lower than the risk of a fertile woman conceiving using either hormonal birth control pill (8%) or male condoms (15%).

Certain practices have shown to extend lactational amenorrhea, including:

frequent nursing
lying down when breastfeeding
providing baby access to comfort nursing
co-sleeping at night
napping with baby
skin-to-skin
babywearing
keeping baby close

Fertility Awareness Method postpartum

Before having kids myself, I practiced the Fertility Awareness Method (FAM). It proved so reliable for me that it was the only method of ‘birth control’ (pregnancy avoidance) my husband and I used. With FAM I was able to closely monitor my fertility signs to both avoid pregnancy and then successfully conceive after we decided to begin trying.

The 3 main fertility signs to monitor are cervical mucus, basal body temperature, and cervical position. However, these can prove much more challenging to observe prior to your cycle returning after having a baby. Before your first period postpartum your hormones still "cycle" and fluctuate as they gear up for ovulation. Eventually they finally surge and drop enough for ovulation, then menstruation to occur. These fluctuations can cause seemingly fertile cervical mucus for several months without actually being fertile yet. Temperature reading are done first thing when you wake up in the morning. Although they're no longer accurate if you experience sleep disturbances, which is usually the reality for most mothers with young children. As for cervical positioning, it can feel different after having a baby and may be difficult to monitor until your cycle returns and you can familiarize yourself with your ‘new normal’.

An interview with Ashley Chea

Ashley Chea and I first met at an Ergobaby event in 2017. We each had our daughters with us and they were both 6 months old, born just days apart from each other. When I saw her at the same Ergo event this year, she shared that she was pregnant again with her third baby and that she conceived before the return of her first period postpartum. She was breastfeeding her 9 month old at the time, without the use bottles or pacifiers. She also slept with her baby and regularly wore her in a carrier as well.

How did you realize you were pregnant and how far along were you when you found out?

I didn't realize until I was about 4 months pregnant. I thought I was dying because I kept having migraines and feeling really sick. I went to the doctor to get an MRI and he said I was pregnant, not dying of a brain tumor like I thought. (I kept having headaches and getting dizzy, which is why I asked for the MRI.)

How old was your youngest when you became pregnant? Were you breastfeeding at that point?

My youngest was 1 year old when I found out I was pregnant, 13 months to be exact. I was still breastfeeding her and had no cycle, so it was a complete surprise.

Before your pregnancy was confirmed, did you have a suspicion?

Complete surprise for me because we weren't using contraceptives but we weren't trying to make a baby. I assumed that I was safe from getting pregnant because I was breastfeeding and had no cycle. That clearly isn't accurate.

Does this pregnancy feel quite different than your previous pregnancies?

It has been completely different from my other two pregnancies. I was sick morning and night until about 5 months. I started having severe pelvic pains early on and haven't been able to work out/exercise much at all. This has been my laziest pregnancy. I normally work out 5 times a week while pregnant up until the day I give birth. This time I have had to take it really slow and can barely go on walks without severe pelvic pain and pressure. It has been a very humbling experience for sure.

Prior to your own experience did you know that it was possible to become pregnant before your first period returned postpartum?

I knew that it was a small possibility but researched and it seemed rare. Especially if you aren't attempting to get pregnant (meaning avoiding that part of intercourse). The pull out method is obviously not a guarantee but I really thought it would work. We used the same method and our first two are seven years apart. So I was extremely surprised when I found out I was pregnant with my third.

{Note from Carley: Full transparency, this is the method my husband and I use too. I'm currently 20 months postpartum without the return of my cycle and I peed on a pregnancy test immediately after reading Ashley's story. As in, packed the kids into their car seats and drove directly to the store. (It was negative.)}

Can you get pregnant if your still bleeding after giving birth?

It's possible to get pregnant before your first postpartum period, which can occur as early as four weeks after giving birth or as late as 24 weeks after baby arrives (or later), depending on whether you're breastfeeding exclusively or not.

Can you get pregnant when you have Lochia?

While it's unlikely, you can get pregnant in as little as three weeks after giving birth (postpartum), even if you're breastfeeding and your periods haven't returned yet .

Do you ovulate after postpartum bleeding?

Most women did not begin ovulating until at least 6 weeks after childbirth, but a few ovulated sooner. Usually, women who are not breastfeeding ovulate sooner after giving birth than women who do breastfeed. However, a woman's first ovulation cycle might occur before she gets her first postpartum period.

What happens if you get pregnant shortly after giving birth?

But getting pregnant too soon after giving birth can be risky for both you and your baby. Becoming pregnant again within a year of giving birth increases the chance that your new baby will be born too soon. Babies that are born too soon can have health problems.