Welcome back to the Woven Well Podcast!
If you’ve delivered a baby before, you know there are a few things you can count on in those first few weeks - sweet baby smells, lots of sleepless nights, and at least one friend or family member asking you, “When will you have the next one?”
Why this gets so consistently asked of sleep deprived, newborn parents, I do not know - but, it is a good reminder of the reality that, believe it or not, your fertility will return - and it could be sooner than you’d think.
Today’s episode is for all the ladies who are either in that postpartum time, or who are pregnant and anticipating it, and are wondering - Am I fertile or not? How can I know for sure? When does that typically return? How does breastfeeding or bottle feeding affect it? Can you still use a method like Creighton during this time?
I work with a lot of postpartum mamas and one thing they’re clear about is that they need to know if they’re fertile or not. And I get it! You’re holding a newborn - you are not ready to conceive another one this month.
But this time can also feel uncertain as far as fertility. Can you be fertile while breastfeeding, for instance? If not, why is your OB asking you about birth control at your 6 week post partum appt? How come some women go a year or more without a period and others have a period before their baby is 3 months old? And how did so-and-so get pregnant again without ever seeing a period??
Here is the good news:
Regardless of how your baby gets their nutrition, your body will give you the signs that you need to know when your fertility is returning.
If you’re listening to these signs and tracking them accordingly, you don’t have to worry about a surprise conception, because you’ll know when you’re fertile and can make an informed decision about how to use that time!
Knowing how to do this only requires tracking one thing - cervical mucus - and you can do that with 99.5% effectiveness through use of the Creighton system.
Listen, your OB will ask you about how you plan to manage your fertility at your 6 week postpartum appointment, and he/she will likely give you options like hormonal contraception or some type or an IUD, but we want to make sure you know that you can very successfully manage your fertility without the use of any hormones, chemicals, or devices. Your body will tell you when your fertility is returning, if you know how to read its signs. Plus, with so many hormonal changes already happening in your body, some women may not want to use an option like hormonal contraception or a hormonal IUD that can cause more uncertainty or side effects.
Still, we know postpartum is a stage in your reproductive life that can feel a little mysterious. Let’s take away a little of that uncertainty by explaining what’s going on hormonally in those first months after delivery, at a very basic level:
Initially after delivery, you experience a dramatic shift in reproductive hormones as all of the estrogen and progesterone that have been elevated during pregnancy suddenly decrease. This happens while other hormones - prolactin and oxytocin - begin rapidly increasing to help with stimulation of contractions and milk supply.
By a few months after delivery, your estrogen and progesterone levels have stabilized, but not before you notice some possible side effects from the shift, like hair loss or depression/anxiety. Both are usually related to these shifting hormones, and - in fact - there are natural treatments available for postpartum depression outside of SSRIs and other mood stabilizing drugs. Be sure to ask your local napro physician about those options!
So at this point, while estrogen and progesterone have calmed down quite a bit, prolactin and oxytocin are still elevated if you’re breastfeeding at all.
Prolactin comes from the pituitary gland and production is stimulated when a baby nurses at the breast. The more nursing that occurs, the higher and more stable this number tends to be.
This is why breastfeeding can have a direct impact on the odds of your cycle returning. The more prolactin that is released from nursing that the breast, the more likely your reproductive hormones will be suppressed and ovulation or menstruation will be prevented.
This is why you hear about women utilizing something called ecological breastfeeding to produce lactation amenorrhea. This is a very specific approach to breastfeeding that encourages this high prolactin state and reduces the chances of your fertility returning while practicing it.
But ecological breastfeeding is a very specific practice and philosophy. It requires specific things like sleeping with your baby in order to nurse during naps and not following any sort of a feeding schedule.
This is often why we get mixed messages about the impact breastfeeding can have on delaying your ovulation.
Does breastfeeding have an impact on when your fertility will return? Yes! That prolactin makes a difference!
But not all breastfeeding practices and schedules create the same results. Things like using pacifiers, pumping, supplementing with formula or food, creating a feeding schedule, or not using the breast as a way of calming all reduce the amount of time the child nurses, and therefore affects the amount of prolactin.
The physiological response of a baby nursing at the breast is different than pumping. Both provide wonderful nourishment for your baby, but the body reacts differently to the two processes. Even if your baby drinks pumped breastmilk exclusively, your return to fertility will likely be sooner than nursing directly.
Even when following exact ecological breastfeeding principles, there’s still no guarantee you’ll go at least a year without a cycle.
Why? Well, we’re all unique. Our bodies are unique. There’s going to be some natural variation to how our bodies respond to the postpartum season, breastfeeding or pumping, hormonal changes, etc.
In fact, at least 35% of women will ovulate before their first period postpartum. Remember, it’s ovulation that causes a period in most cycles. This can be a little different in that first period postpartum, but not for at least 35% of women. THIS is why you had a cousin, sister, friend who got pregnant again before ever having another period. She ovulated first. Of my clients, I’ve only had a few have a period without ovulating first!
Here’s the thing - all of these “if, ands, thens, buts” are okay. We all know that the goal during this special time is to feed and care for your baby. For some, that’s going to be through breastfeeding, maybe even ecological breastfeeding specifically. For others, it will be through pumping breastmilk for bottle feedings, or supplementing breastmilk and formula, or using formula exclusively. Your goal is to nourish your child in whatever way is best for you and baby. Don’t let your fertility be a stressor about those choices.
Instead, I recommend learning how to read your body’s signs of fertility so that you can know exactly when your fertility returns - regardless of which of those options works best for you and your baby. Your body will tell you!
Plus, postpartum is a wonderful time to learn a form of natural family planning, because you do have significantly more time of infertility to learn and feel comfortable. You’ll feel experienced, prepared, and confident when those first signs of fertility show up.
We teach the Creighton method, which is a thorough, tailor made system that not only helps you appreciate and manage your fertility, but also helps you identify underlying health and hormonal issues. Some forms of natural family planning struggle during the postpartum stage, but not Creighton - which is just another reason why we use it. This is a system you can use in any reproductive stage - cycling, breastfeeding, postpartum, premenopausal. You name it. We teach you all the ins and outs of your cervical mucus - so that you only have to track this one biomarker to understand your fertility.
We go way more in depth about this topic on episode 2 of our basic series - how your body works, but your cervical mucus responds to the rise in reproductive hormones, like estrogen, to let you know that your body is hitting that sufficient level of hormones needed in order to ovulate. You’ll start seeing signs of that change and, along with the direction of your FCP, you will know when to anticipate ovulation and your first period.
Using the Creighton method, you can absolutely know with confidence whether you are fertile or infertile on any given day. And you can use that information to make informed decisions together as a couple about how you want to use those days - to avoid or achieve a pregnancy with 99.5% effectiveness.
You can manage your fertility naturally, even postpartum. You do not have to use hormonal contraception or a device like a condom or IUD. You can do this! yes, even with a newborn! And we would love nothing more than to help you feel educated and prepared during this time.
An easy way to decide if this is right for you, or to get started, is to attend one of our monthly Introductory Sessions. These are online, group presentations of all the basics of how your body works, how to identify cervical mucus, what’s involved in the creighton system, and how to get started. It’s about an hour long and led by myself. There’s no commitment to attending, and I’d love for you to join us, whether you’re already in that postpartum stage, or pregnant and anticipating it - either time is a great time to join! You can register at wovenfertility.com/join-us.
I hope this episode has been informative and encouraging!
Thanks so much for listening and for being here as we continue to explore together what it means to be woven well.