**2.3 Ovarian function**

Ovulation starts as early as 27 days after childbirth. It can start after about 70 to 75 days in non lactating women. But for breastfeeding women, the mean time to ovulation can be about 6 months.

Menstruation usually resumes by 12 weeks postpartum in 70% of non lactating women. The mean time to the first menses after childbirth is 7 to 9 weeks.

In a woman exclusively breastfeeding, the likelihood of ovulation within the first 6 months postpartum is 1% to 5%.

The persistent elevation of serum prolactin in lactating women is the basis for ovulation suppression in lactating women. Prolactin levels get back to the normal range by 3 weeks after delivery in nonlactating women but remains elevated till the 6th week in lactating women.
