Expert: Catherine Beier MS CBE - 5/7/2008

Question
I am almost 7 mos postpartum and stopped breastfeeding at 5 1/2 mos.  I got my first postpartum period last month and it lasted a full 7 days of VERY HEAVY bleeding.  The day I started, my husband and I left for our first vacation without the kids.  Needless to say, we were intimate while we were away, but used the rhythm method, because even though I knew better, I thought my chances of getting pregnant again were pretty low.  Now, I am a week late for my period.  I took a HPT this morning and it was negative.  I do not get much sleep with 2 kids at home and I have made recent (within the last 2 weeks) drastic changes to my diet in effort to lose the last of the baby weight.  I have made an appointment with my OB for tomorrow to take another test, and must admit I am completely freaked out at the prospect of being pregnant again so soon.  I guess I am looking for a little reassurance.  The RN at my OB's office said that postpartum menstrual periods are normally not this erratic.  I normally run on a 28 day cycle, but I know that the hormone surges that come along with pregnancy and the postpartum period mean that all bets are off.  What the heck is happening here?

Answer
Corie,

I wholeheartedly disagree with the RN at your OB's office.  Postpartum cycles can be extremely erratic, even past a year after giving birth and especially when you breastfeed for any length of time.  Add the stress of childbirth, poor diet, and lack of sleep to the mix, and you've got the perfect recipe for crazy cycles.


Since you've already gotten one negative HPT and you didn't indicate that you had unprotected intercourse during your fertile time (this is usually about 14 days before your next cycle is to begin, which doesn't seem to be the time you went on vacation, since you'd just started your cycle), then it seems unlikely that you're pregnant again.


My best guess is that you're experiencing a shift in cycles due to the stress, lack of sleep, and diet changes you've already described.


It is also quite possible that your first cycle after giving birth will be longer than normal as you may or may not ovulate during that cycle.

So, go take another test.  If it's negative, then you might have a screen on your hormone levels to let you know where things are at.  That's one of the most common reasons for delayed cycles and might just be something that evens out in its own time.


Best,
Catherine