While your doctor and every other person you know (as well as strangers on the street) will likely give you tons of advice about the delivery and caring for your newborn, very little attention is usually paid to the reality of postpartum healing. In fact, research shows that an overwhelming number of new mothers do not feel adequately prepared for the postpartum experience.
Overview
This lack of communication about the toll of pregnancy on the body and the process of postpartum recovery leaves a lot of moms surprised by now intensive and lengthy the healing process can be. Plus, many new moms are confused about and unprepared for what happens during each phase of recuperation, which can last months. Often, with so much excitement about the baby, many women simply don’t think to ask about this transitional period. But putting a little focus on learning about post-pregnancy healing can help you prepare, reduce stress, and boost confidence and comfort during this phase, which many call the “fourth trimester.” To help you get a handle on what to expect after the delivery, here’s a postpartum recovery guide, including the changes your body goes through, coping strategies, how long each phase lasts, and how to tell if what you experience is normal.
1 Week Postpartum
The first week postpartum is the most intensive in terms of adjustment and recovery. You have just given birth, are taking care of a newborn, and may have experienced vaginal or perineum tearing (and stitches) or other delivery complications. Your vagina and entire pelvic region will be uncomfortable, swollen, and possibly, abraded. Your breasts, nipples, and areola are likely sore. If you had a c-section, you are also recovering from major surgery. All of your organs need to shift back into place, your hormone levels are changing rapidly, and your body is preparing (and learning) to breastfeed.
Parenthood
You’ll likely spend the first one to two nights in the hospital before going home. Ask for advice and support as you need it. It can feel scary to head home with the responsibility of a newborn. Know that everyone feels a bit overwhelmed and uncertain as they enter parenthood. Plus, even though you may have already done lots of preparation and read all the baby books, it’s normal to still have lots of questions and for things not to always go as planned. While babies have simple needs, caring for one can be more challenging and confusing than expected. Getting on a sleeping, feeding, and diaper changing schedule with your baby is harder than it sounds. Be flexible and patient with yourself (and your baby), trust your instincts, and try not to worry too much.
Breast Changes
A few days postpartum, your breasts will begin to fill with milk. This will happen whether you plan to breastfeed or not—initial milk production is based on the decline of the hormone progesterone after your placenta is delivered. For some women, milk “coming in” just produces some extra fullness. Other women experience engorgement, which can become very uncomfortable. In this case, it’s important to release some of the extra milk in your breasts through massage, breastfeeding, or pumping. Many women also find relief by placing cabbage leaves inside their bra, a trick that helps reduce engorgement.
Nursing
Few people will tell you beforehand that breastfeeding can be difficult—leaving many new moms in tears. But if you ask around, you’ll discover that initial nursing woes are very common, although often shortlived. So, don’t be discouraged if breastfeeding isn’t second nature for you at first. For some women, it’s downright frustrating and/or painful. Luckily, slight adjustments (in nursing position and latch), a good nursing pillow, and a tube of nipple ointment can make a world of difference. Nurses, doctors, and lactation consultants can work wonders to help you get the hang of nursing. Other breastfeeding moms can be a great resource as well. Be sure to listen to your body and to eat, drink water, sleep, and shower on a regular schedule. Nourishing yourself will help you (and your milk supply) as much as your baby.
Postpartum Bleeding
In the first week or so, you can expect to experience some heavy postpartum bleeding, including the passage of large blood clots. This is the case whether you delivered vaginally or by c-section. Your vaginal discharge (called lochia) isn’t just blood; it also consists of the mucous membrane that lined your uterus during pregnancy. Expect to wear pads for a few weeks. Do not use tampons during this period as they can cause infection.
Uterine Cramping
Afterbirth pains can be very painful (and often get worse with subsequent births). But they actually have a very good purpose—to shrink your uterus back down to its normal, pre-pregnancy size. After giving birth, your uterus weighs about 2.5 pounds; by 6 weeks postpartum, it will have shrunk to only 2 ounces. Pretty amazing, huh? You will likely find that your afterbirth pains are more intense during breastfeeding. That’s because the release of oxytocin during breastfeeding strengthens uterine contractions.
Vaginal and Perineum Healing
Whether or not you experienced vaginal or perineum tearing or an incision (from an episiotomy), this area is going to feel engorged, stretched out, banged up, and not quite right for a while. You may also feel sore, stinging sensations if you have any broken skin, as well as general achiness. You can soothe your vaginal area by taking warm baths, using ice packs and witch hazel, sitting on a donut pillow, and squeezing warm water over your vaginal and perineum areas after (or while) urinating. Hospitals often give new moms a squirt bottle—take it home with you—to gently clean the vaginal area with warm water after using the bathroom. Speak to your healthcare provider if your vaginal pain is worsening or if you develop a fever, as these could be signs of infection.
C-Section Recovery
Though common, don’t forget that c-sections are major abdominal surgery. It’s important to get as much rest as possible (obviously a big challenge when caring for a newborn) after your c-section and follow your doctor’s orders in terms of wound care, including staying off your feet, keeping the incision clean, and not putting pressure on your incision. After your epidural wears off, you will begin to experience incision pain. Pain medication can help, and ideally, stick to a regular medication schedule to keep discomfort in check. The incision site will not be as acutely painful after the first few days but will remain tender for a while.
First Bowel Movement
Many women fear passing their first stool after giving birth. But it’s worse to hold things in—you risk worsening any hemorrhoids (a normal side effect of bearing down in delivery), and making that first bowel movement even more uncomfortable. The truth is that nothing is going to “fall out” when you pass your first stool; you will do just fine. Constipation is often an issue, as pain mediations and the toll of the birth on your body often lead to harder stool. If you are feeling backed up, you may consider taking a stool softener for some extra help.
Weight Loss
It’s totally normal to still look pregnant after you’ve had a baby. Remember that your uterus is still in the process of contracting back to its regular size. Additionally, your skin is stretched out, and you’re still retaining some extra fluids. After your baby is born, you’ll likely have lost about 10 to 15 pounds, which includes the weight of your baby, the amniotic fluid, and your placenta. But as women tend to gain double or triple that during a healthy pregnancy, you’ll still be heavier than you were before getting pregnant. This is totally normal and nothing to worry about. You will continue to lose excess fluids over the next few weeks, but shedding the extra body weight will be a slower process, as postpartum weight loss happens most healthfully if it’s gradual and based on healthy eating habits and exercise. Extended breastfeeding can help with weight loss, too.
Mood Changes
The body experiences rapid hormonal shifts right after you give birth, which can make you feel extra weepy, moody, elated, and/or irritable. You are also adjusting to motherhood, feeding a baby, running on very little sleep, and likely feeling overwhelmed. Make sure to open up about how you are feeling with those you love and trust, stay hydrated, and well-nourished, and rest whenever possible. Be compassionate and patient with yourself, your healing process, and your (sometimes) erratic or overwhelming moods. Know that postpartum depression is common and be on the lookout for its symptoms, including excessive worrying about the baby, a lack of interest in the baby, feeling overly sad, restless, guilty, or worthless, and/or having trouble sleeping, focusing, remembering, or eating. Check-in with your doctor if you feel you excessively blue or have any concerns about your emotional well-being.
2 Weeks Postpartum
At this point, you may be starting to feel better, but you are definitely still in recovery. Take things slowly, and remember to call your healthcare provider with any questions or concerns you may have about your post-pregnancy body.
Postpartum Bleeding
You are probably still experiencing vaginal bleeding, but it shouldn’t be very heavy at this point. It’s normal for bleeding to last (and taper out) during this second week. You may notice that some of the vaginal discharge is pinkish-brown or yellowish in color; this is also normal. You may experience vaginal bleeding and discharge (consistently or on and off) for up to 4 to 6 weeks postpartum.
Vaginal and Perineum Healing
By now, you are less likely to experience acute pain or stinging, though you may still feel some residual soreness. If you had a vaginal tear or episiotomy, you may be experiencing itching as your skin heals.
C-Section Recovery
Although you may still be feeling tenderness at your incision and under doctor’s orders to take things easy, you are past the most painful and uncomfortable stage of recovery and should be feeling a bit better. As your incision site continues to heal, make sure to properly clean it. Your incision site may feel itchy or numb.
Night Sweats
About a third of all women experience night sweats or hot flashes in the first month postpartum. This is due to hormonal shifts as well as your body’s need to shed excess pregnancy fluids. Hot flashes and night sweats can be very uncomfortable, but they are normal, and usually pass within a few days or weeks. Sleeping on top of a towel, which you can remove when it becomes damp, can help lessen the need for changing the sheets during the night.
3 to 6 Weeks Postpartum
You may be starting to feel a bit more and more like yourself at this point, which is awesome. You’re likely exhausted from caring from your newborn but are starting to get on a schedule. Remember that you are still recovering and most likely haven’t gotten the “OK” from your healthcare provider for more strenuous activities yet. Also, know that as your body heals, it will recover into a new “normal.”
Postpartum Bleeding
Postpartum bleeding should be very light now and will end during this phase. If it comes back or if you are bleeding heavily, you should contact your healthcare provider. Making sure to rest and not exert yourself too heavily will keep the bleeding to a minimum and help you heal faster.
General Body Recovery
By now, your vaginal area shouldn’t be very sore, although you likely won’t feel recovered enough for sex quite yet. Your c-section scar may be somewhat tender or even numb, but your pain should be on the milder side. Some lingering lack of feeling along the c-section scar is normal as the incision cut through nerves that take time to recover (and may never fully reconnect). You still might look somewhat pregnant, but your uterus is gradually shrinking back to its normal size.
Mood Changes and Postpartum Depression
“The baby blues” are experienced by many moms in the first two weeks postpartum, and these feelings can extend for multiple weeks. It’s common to feel weepy, cry over the littlest things, and go from feeling elated one minute to sad the next. Your hormone levels are going through a huge adjustment, as is your body and lifestyle (as in becoming a mom), so it’s very normal to feel overwhelmed or stressed, or even, to miss your old life. Sometimes, the emotional fallout from all these changes can become more entrenched and turn into postpartum depression. If you are struggling emotionally, seek help by talking to your doctor, family, and friends.
6 Weeks to 6 Months Postpartum
At about 6 weeks, you will likely have your postpartum check-up with your healthcare provider. They will verify that any vaginal tears or c-section scars are healing properly and ensure that your uterus has shrunk down to its pre-pregnancy size. Your doctor will also do an overall health assessment. If all is well, you will be given the green-light for exercise and sex (though it’s very normal to want to take things slow in both of these areas). Your check-up is a great time to discuss any other concerns you have with your doctor.
Postpartum Hair Loss
During the first few months postpartum, you will likely notice some strange things happening in the hair department, namely that your hair has thinned or has even started to fall out. It might seem strange, but it’s totally normal. Here’s why: The hormones of pregnancy caused your hair to be thicker and fuller. Once those hormones leveled out, your body naturally sheds the excess hair.
Bladder Control
Post-delivery, many women experience urinary incontinence to some degree—from occasional leaking (often with sneezing, yelling, laughing, or straining) to having “to go” much more frequently. This is due to the normal stretching and weakening of the pelvic floor muscles during pregnancy and delivery. Additionally, having an episiotomy or tearing during delivery (especially 3rd- and 4th-degree perineum tears) can contribute to both urinary and fecal incontinence. Kegel exercises can help strengthen these muscles and help you regain control. If bladder control issues persist (or for help on exactly how to do a Kegel), consult your physician. They may refer you to a pelvic floor physiotherapist. This professional can also help treat diastasis recti (the completely normal stretching of the linea alba tendon that holds the abdominal muscles together). Moderate to severe diastasis recti can weaken your core strength and create a hollow (or pooch) around the belly button area. Fecal incontinence (difficulty controlling bowel movements or gas) can also be a postpartum challenge. If you experience leaking stool or struggle to make it to the bathroom in time, seek help from your doctor.
Return of Your Period
If you aren’t breastfeeding, you should get your first post-delivery period within the first 6 to 12 weeks postpartum. Most breastfeeding women will find that their postpartum period is delayed, sometimes for months longer. Every woman is different, but if you are exclusively breastfeeding (no supplements and feeding on demand), it is unlikely that you will get your period back before your baby starts eating solids or breastfeeding decreases. Before you resume sex, even if you aren’t getting your period, discuss birth control options with your healthcare provider. Remember that breastfeeding alone usually doesn’t protect you from an unexpected pregnancy and that you can get pregnant without ever getting your period.
Return to Sexual Activity
Although most women are cleared for sexual activity by 6 weeks postpartum, not everyone feels ready at that point. This is perfectly normal, after all, you are probably exhausted, possibly covered in spit-up, and may just generally not feel “in the mood” quite yet. Give it time, and concentrate on other ways of connecting with your partner until you are ready for sex. If vaginal discomfort is persistent at this point, bring up your concerns with your healthcare provider.
Return to Exercise
If you were an avid exerciser before having kids, you may be itching to get back into your old routine. But even once you are cleared for exercise, remember to take things slow. Think of your return to exercise as you would when coming back after an injury. If you are starting exercise for the first time, considering something like gentle yoga, swimming, or walking, slowly building up to more high-intensity workouts. Pushing yourself too hard in the first few months can lead to injuries.
A Word From Verywell
There isn’t a clear consensus among experts on when your postpartum recovery is truly complete. Many put a full year or more as a benchmark, but this will vary woman to woman. Also, while many women feel ready for (and successfully conceive) another child before a year postpartum, some doctors recommend waiting at least 18 months before trying for another baby to give your body optimal time to recover. However, remember that these timelines are estimates and include a wide range of normal. You are the best expert on your body’s healing process—give your body however long it needs. The specific time your body takes to recover will depend on many factors, including the ease of your pregnancy and delivery, your general mental and physical health, any health complications you have (pregnancy-related or not), the health (and sleeping patterns) of your newborn, your access to community and familial support, and your general lifestyle. Your postpartum journey is unique, and it’s best not to compare yourself to others. Keep in mind, too, that you likely aren’t going to ever feel exactly like your pre-pregnancy self again—and that’s OK. Changes in your body’s shape, from more curves to stretch marks, are hallmarks of motherhood, and ultimately, are something to celebrate along with your new baby.
