Fertility after Childbirth
After childbirth and before the first postpartum ovulation, some women might not be thinking about their fertility so soon and that another child could be a possibility again. But just like during pregnancy, life with a baby changes at a rapid pace. Hormones can fluctuate highly during this time, sleep can be disrupted, not to mention the return of fertility - so it's best to learn and prepare early on the topic of "fertility after childbirth"!
Did you know that a woman who does not breastfeed her baby, or does not breastfeed exclusively, can ovulate again as early as 21 days after delivery1? If you are exclusively breastfeeding, the break usually lasts several months, but exclusive breastfeeding (in the medical sense) means that your baby never sucks on a pacifier or a bottle and that there are never more than six hours between two breastfeeding meals2. The first sips of juice or the first night of sleeping through the night could mean that the first ovulation could be just around the corner.
Breastfeeding and fertility
The Lactation Amenorrhea Method, or LAM for short, is considered natural family planning - as long as all the rules are followed. However, this is not always easy, because for LAM you must:
- Feed the baby at least six times a day, and at least every six hours
- Do without pacifiers, soothers, etc.
- Give the breast exclusively, i.e. never pump
- Not allow the baby to have bottles with water, milk, or juice.
- Not offer the baby complimentary food2.
The more often the baby is breastfed, the more reliably the hormones triggered by sucking, including the breastfeeding hormone prolactin, suppress ovulation. A study of 624 Australian women showed that it works if women are well trained and follow the rules perfectly3.
Breastfeeding every six hours is particularly difficult to implement in the fourth, fifth and sixth months of a child's life. At this age, some babies sleep seven or eight hours at a time, which means that the alarm clock has to be set every night, and the baby has to be put back to sleep after six hours at the latest.
Daysy in the postpartum period - what you should know
We recommend that you resume using Daysy at any time after the first six weeks postpartum. Before that time, the flow and hormonal changes will not allow a qualified assessment of fertility. Until you have entered a first menstruation on Daysy, Daysy will show you yellow (possibly fertile). However, your temperature curve during this time can still provide valuable information. Once you have entered your first menstruation, Daysy will show your fertile (red) and infertile (green) days, even if you are still breastfeeding. You can also analyze your cervical mucus to help monitor for other signs of fertility. However, experts only recommend this to women who have already had experience with this method before pregnancy and therefore know their own body very well.
What to do if your period starts again much later than you expected? In fact, anything between five weeks and a year is considered normal, because in addition to breastfeeding and fertility hormones, stress hormones, diet, and your general lifestyle also have an impact on your post-baby cycle. Sometimes it takes the same woman only two months after one pregnancy, and nine months after the next, until she has periods again. These may be quite different in duration and intensity than before delivery and may also come more irregularly, but this typically regulates. As long as you’re feeling well, your body just may need more time to find its natural rhythms again.
If you ever have concerns, it’s always a good idea to reach out to your midwife and/or gynecologist.
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1) Makins A, Cameron S. Post pregnancy contraception. Best Pract Res Clin Obstet Gynaecol. 2020 Jul;66:41-54. doi: 10.1016/j.bpobgyn.2020.01.004. Epub 2020 Mar 2. PMID: 32217053.
2) https://trainyabrain-blog.com/2013/01/lam-die-natuerlichste-verhuetung-in-der-stillzeit/
3) Gross BA, Burger H; WHO Task Force on methods for the natural regulation of fertility. Breastfeeding patterns and return to fertility in Australian women. Aust N Z J Obstet Gynaecol. 2002 May;42(2):148-54. doi: 10.1111/j.0004-8666.2002.00148.x. PMID: 12069140.