Navigating Postpartum & Charting Your Cycle

Induction into the new mama club is one humbling surprise after another. After I had my first baby, I still looked pregnant. Thanks for the heads up, Mom. No one told me I'd need to wear a supersized maxi pad for the next three weeks for something called the lochia--google it. I also had no idea that breastfeeding is a lot more complicated than it sounds. 

Granted, this was a looong time ago, my firstborn is now a teenager. There has been a vast increase in the accessibility to childbirth education and breastfeeding support. Growing up, I didn’t have a lot of, if any, exposure to pregnant and breastfeeding women. Everything I encountered with my first pregnancy and childbirth was a deer-in-the-headlights experience. This was before blogs, forums, and Facebook. Yeah, I’m old. I still remember the first day home with my newborn. My mother-in-law, a retired labor and delivery nurse, swept in to my rescue. I was sitting in my brand new Babies-R-Us rocker trying to figure out how to get my newborn to latch. As she instructed me in proper technique my husband walked in and his response sums it up: Well this is awkward, I never thought I’d walk in a room to find my wife topless with my mother holding on to her breast.

The awkwardness of the moment vanished in a flash as my baby latched on and started suckling. The relief I felt to have the support of another woman. “You are doing great”, she assured me. “It will get easier with time.” She was right, it did get easier, and with subsequent pregnancies, I knew what to expect.

I often wonder if my induction into the new mama club would have been easier if I'd been better educated about the whole process.

I read books and studied the physiological aspect of pregnancy, labor, delivery, and how to care for a newborn. But I was in the dark on what to expect when it came to navigating the postpartum terrain within my own healing body.

What is Postpartum?

The first 6 months following the delivery of a baby is the postpartum period (not to be confused with your menstrual period).  This is an exciting and exhausting time for growing families. The special attention required when caring for and feeding a newborn often encourages couples to step away from or decrease their typical social and work commitments to allow for rest, recuperation, and bonding with their new child. During the postpartum time, the mother’s body is healing from delivery, and if breastfeeding, using energy to produce breast milk for her growing baby. Caring for a newborn child is a sacred and delicate phase in the journey of parenthood. 

Naturally, most couples want to postpone another pregnancy. The standard medical practice is to pressure women into hormonal contraception before leaving the hospital. Many women are not comfortable taking synthetic hormones while breastfeeding but may feel their options are limited when it comes to postpartum family planning.

Charting your cycle during postpartum is an effective way for couples to navigate the return to fertility.

There are several factors to take into consideration, such as breastfeeding practices and frequency of feedings. With the proper support, women can successfully and confidently chart their cycle following the birth of their baby.

Charting your cycle postpartum does not come without its challenges. The first priority is to establish a consistent charting routine. Whether you are returning to charting after a 9 month hiatus or beginning this practice for the first time, it is important to recognize the obstacles to reliable charting during postpartum that may dampen confidence in charting your cycle. Your priority, of course, is caring for your new child, getting adequate sleep (if possible during the infant stage), and taking care of any other immediate needs. Adding the task of charting your cycle can feel heavy. To overcome any potential overwhelm, it’s recommended that you learn to chart or revisit your observational routine in the final month of pregnancy. Work to establish a routine before the baby is born. There is an added benefit to charting when 9 months pregnant: you will be keenly aware of any subtle changes that may occur in the days or hours leading to labor, giving you advanced time to mentally prepare for labor. 

The main focus of charting before a baby is born is not to interpret your charting data, but rather to establish a solid observational routine.

In Chart Your Cycle, we take the 5 Micro Habit approach to charting, but focusing on Micro Habits 1 to 3 to establish consistency and routine is all that is needed during this time. In addition to building consistency with your observations, it’s important to get your spouse on board with charting during the postpartum period. Working together to navigate the return to fertility during this unique time will boost confidence and efficacy, especially if your intention is to chart for natural birth control. Help your husband download your charting app on his phone so he can help record observations. Your chart is only as good as the data you provide.

You can start implementing all 5 Micro Habits and charting your observations when the lochia decreases, which is typically 3 weeks postpartum. The lochia is a bloody discharge that occurs after a vaginal delivery. Yes, you read that correctly, you will bleed for about 3 weeks after a vaginal delivery, stock up on super-sized maxi pads. And while we are on the topic of postpartum facts that no one talks about, unless you are a unicorn, you will still look pregnant after the delivery. Keep those maternity clothes handy.

What is Anovulation?

Anovulation is the absence of ovulation. If you are not ovulating, you cannot get pregnant. Understanding anovulation in the context of the postpartum time and navigating the return to fertility can be done with the right strategy and support.

Ovulation and menstruation do not return immediately following pregnancy.

In non-nursing postpartum women, ovulation resumes between 2 and 3 months after delivery, but is delayed with breastfeeding. Breastfeeding releases the hormones prolactin and oxytocin, which suppress ovulation, and the return to fertility can be delayed for the first six months or longer. There is a high incidence in return to fertility before the end of the first year for the modern nursing mother.

The 3 Categories of Postpartum Charting

How you navigate your first postpartum cycle, commonly referred to as Cycle 0, depends on if you are totally breastfeeding, partially breastfeeding, or bottle-feeding with formula. It can take up to three full cycles postpartum before your menstrual cycle regulates. For some women, their cycle may regulate by 6 or 9 months postpartum and for other women, it may be well over a year before they experience the return to regular cycles. If you are charting to avoid pregnancy, it is important to have the support of a fertility awareness instructor or resources that define specific postpartum charting protocols.

Total breastfeeding

Research suggests that during the first 6 months of unsupplemented breastfeeding, if the mother remains amenorrheic, then breastfeeding on demand is usually sufficient to postpone the recovery of fertility [1, 2]. This is often referred to as the lactational amenorrhea method or LAM. In order to use LAM to postpone pregnancy, three criteria must be met:

1. The absence of menstruation
2. Fully or nearly fully breastfeeding. No more than 4 to 6 hours between breastfeeds 
3. Less than 6 months postpartum.

All three criteria must be met to practice LAM. Once the sixth month has passed it’s recommended to work with a fertility awareness coach who is trained in postpartum fertility charting to ensure you have the proper support and protocols to identify potential fertile windows as you prepare for the return to menstruation and normal fertility.

Partial breastfeeding

Partial breastfeeding simply means that the baby is not receiving 100% nutrition from mom. This could be in the form of supplemental formula feedings or the introduction to solid foods. Mothers who are partially breastfeeding can anticipate an earlier return to fertility than if totally breastfeeding. Understanding what biomarkers to track and how to interpret your unique charting pattern is the foundation to confidently understanding days of potential fertility.

Not breastfeeding

The return to fertility occurs much earlier if a mother is not breastfeeding. This is because prolactin is not being produced in response to the baby sucking at the breast. Prolactin suppresses ovulation and therefore suppresses the return to fertility. If a mother is not breastfeeding then the first three weeks following delivery are considered infertile. It is essential to chart cervical mucus and it may be helpful to include urinary hormone testing to navigate Cycle 0 and the return to normal fertility.

The Takeaway

The length of postpartum amenorrhea is influenced by breastfeeding practices. There is a wide range in the reports as to the likelihood of ovulation occurring before the first menstruation. It is estimated that 12-78% of first postpartum menstrual bleeds are preceded by ovulation [1]. In general, ovulation precedes the first menstruation more frequently in mothers who do not nurse [1]. With careful monitoring of specific biomarkers and cycle tracking, it is possible to navigate the return to fertility. If ovulation occurs prior to your first menses the signs of ovulation will be detected in your charting pattern.

Cycle 0 looks different for each and every woman. At Chart Your Cycle we help women confidently navigate Cycle 0 with frequent 1-1 chart check-ins, postpartum charting protocols, and customized charting practices to fit your unique needs and intention. Getting the proper support during this special time allows you to grow in self-awareness and to be empowered to navigate postpartum with support and confidence.

Written by: Melissa Buchan, CYC Founder and Fertility Coach

References:

1. Chao S. The effect of lactation on ovulation and fertility. Clin Perinatol. 1987 Mar;14(1):39-50. PMID: 3549114.