When Is It Safe to Use Tampons or Menstrual Cups After Birth?

If you are like many postpartum people, you are not prepared for the awful postpartum menstrual pads and stretchy underwear you have to wear after giving birth. It can feel like a punch to your already very sore belly, a further indignity after all the other trauma your poor child-birthing body has been through. For many of us, the last time we wore pads this thick was when we still had braces and teenage acne. So, it is unsurprising that many postpartum people can’t wait to return to tampons or menstrual cups. Keep reading to learn how to use tampons or menstrual cups safely postpartum.

You will have postpartum bleeding if you have a vaginal delivery or cesarean birth. Even if you read all about postpartum bleeding, lochia, and what to expect, you may still not be prepared to wear menstrual diapers held in place with ugly mesh undies. Postpartum bleeding can be unpredictable, heavy at first, and maybe even with clots. It usually tapers off, only to return if you do too much too soon (as all new mothers inevitably will).

Wearing pads for the first few days after your delivery is critical because it helps you (and your healthcare team if you are still in the hospital) get a more accurate sense of how much you are bleeding and if there is any cause for concern. Postpartum hemorrhage is most common in the days right after your delivery but can happen weeks later (called delayed postpartum hemorrhage). The American Academy of Family Physicians estimates that about five out of every 100 women giving birth will have a postpartum hemorrhage.

Even though you might be more interested in your newborn’s poop than the color of your postpartum bleeding, you may want to take a closer look at your discarded pads. Tracking the consistency, color, and amount of bleeding will help clue you into your amazing body’s healing process. Lochia is the name doctors and midwives give postpartum bleeding because it is much more than blood. Lochia also contains the remnants of pregnancy-related:

  • Red and white blood cells
  • Uterine lining
  • Amniotic fluid
  • Tissue from the placenta
  • Mucus

The first stage of postpartum bleeding is lochia rubra, which usually lasts about a week. It is called rubra because your flow is generally redder in this stage. Lochia rubra then transitions to lochia serosa, lasting between two and six weeks. After that, you will notice your flow lightens up (finally) in both amount and color, becoming more pink or brown. And then you are in the home stretch, or lochia alba, as it is called, when you start seeing whitish, yellowish discharge and no more blood. Finally!

If your bleeding picks up at any time during this process, such that you need to change those thick pads more often than once an hour, you should call your healthcare provider. Other signs and symptoms that you should check in with your healthcare provider about are:

  • Increasing pelvic pain or worsening cramping
  • A fever higher than 100.4 F
  • Odd-smelling vaginal discharge or blood
  • Pain, burning, or difficulty urinating
  • Increased tears, swelling, bruising, or separation of incisions in your perineum (area between the genitals and anus)

Most healthcare providers recommend waiting at least six to eight weeks after a vaginal or cesarean delivery before using tampons or a menstrual cup. It is a good idea to always check with your healthcare provider before putting anything in your postpartum vagina. Why? You are at greater risk for infection postpartum for several reasons:

  • Your body takes time to heal. Whether you’ve had a vaginal birth or a C-section, it can take 6-8 weeks for your uterus to return to its pre-pregnancy shape and heal the wound where your placenta was once attached.
  • After a vaginal birth, your cervix is still open. A menstrual cup, tampon, penis, or sex toy could all deliver bacteria to your vaginal canal and cervix. These bacteria can travel up into your uterus, creating an infection.
  • Even with a C-section, there’s still a risk of infection. In addition, inserting a menstrual cup or tampon too soon after major surgery on your belly and pelvic area could be painful or potentially hurt healing tissues or wounds.

So, while a menstrual cup or a box of tampons may not be packed in your hospital bag with other postpartum products to help you recover, you don’t have to wait too long to say goodbye to those thick pads – hopefully just six to eight weeks with your healthcare provider’s blessing.

For many people, it is their first or second period after delivery when they return to using menstrual cups or tampons. But when do most people get their periods after having a baby? Unfortunately, there’s no standard time frame to know when your period will come back. Instead, your menstrual cycle’s return depends on various factors. For example, starting birth control after delivery, like having an IUD inserted postpartum, can impact the return of your menstrual cycle. Another factor is, if and how much you’re breastfeeding:

  • Exclusive breastfeeding during the first six months (no supplementing with formula or food) – no periods.
  • Breastfeeding with supplemental food — When you add supplemental food to breastfeeding, your body no longer suppresses ovulation. Periods can return, but timing varies from person to person.
  • Not breastfeeding at all – If you’re not breastfeeding, your period may return around six weeks after childbirth. However, everyone is different, especially if you start hormonal birth control shortly after delivery.

Don’t forget even though you’re not menstruating, you can still get pregnant. If you want to avoid another pregnancy in the near future, speak to your healthcare provider to learn which birth control method is right for you. Condoms, IUDs, or progesterone-only pills won’t impact your breastmilk supply but protect against unplanned pregnancy.

If you are a faithful menstrual cup user, you might want to keep in mind that your pre-pregnancy menstrual cup might not fit as well post-baby. Again, many people can go right back to their original menstrual cup, but others may need a slightly bigger cup. While childbirth does not permanently stretch out your pelvic floor, it can take time for your pelvic floor muscle tone to return to pre-pregnancy levels of strength.

Some postpartum women find that their cups leak more after childbirth or don’t maintain as good suction with the vaginal walls. Additionally, your vaginal nerve endings may be more sensitive post-delivery. You may have less lubrication postpartum, especially if you are breastfeeding. A softer, more flexible menstrual cup and some water-based lubricant can help insertion feel more comfortable. That same lubricant can help tampon insertion seem less daunting too.

As with many parts of parenthood, there is no way to predict postpartum bleeding. What worked for you pre-baby in terms of menstrual products may not work postpartum. While you will have to turn back time and go back to wearing pads for a few weeks or months, know that you will be able to return to tampons or menstrual cups for your periods after childbirth someday soon. Your baby should be the only one wearing diapers, not you!

Amy Harris
Amy Harris is a certified nurse-midwife with a Master's Degree in Maternal and Child Health from Harvard Chan School of Public Health. Her passions are health literacy and women's reproductive health. A recent two-year sabbatical with her family in Spain was the impetus for becoming a freelance women's health writer. An exercise nut, she is happiest outdoors and on adventures abroad.

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