What happens in the first postpartum period

The postpartum period starts from the moment the baby is born and lasts about six to eight weeks. The postpartum period is divided into two main stages: the early postpartum period, which lasts the first two to four hours after the birth of the child, and the late postpartum period following it. The fourth trimester (as the first three months of a child’s life is sometimes called) and the postpartum period from which it begins is a very important time in the life of a mother and baby. Mom will have to adapt to a new way of life, her body will have to take on new challenges. At the same time, a mother can experience a whole range of emotions – from euphoria to sadness. From this article you will find out how the postpartum period goes, what to expect. We will talk about postpartum depression, how long after childbirth you can have sex and when your period returns after childbirth.

Postpartum period

What is the postpartum period

The postpartum period is the stage that lasts about six to eight weeks after delivery. The postpartum period does not imply that during this period the mother will fully recover after childbirth – some of the consequences of pregnancy and childbirth persist much longer. The postpartum period is a time of getting used to and adapting to the new role of the mother, to new concerns. Adapting your couple to parenting. Physical adaptation while your body recovers from pregnancy and childbirth. And finally, emotional adaptation, experience and acceptance of all the changes that have occurred. Knowing what you can face in the postpartum time, the features of this period, can prepare you for it. Feel free to ask questions about the postpartum period and share your concerns with your doctor so that you can get qualified help if necessary.

Physical changes

In the first weeks and months after giving birth, the body undergoes many changes as it recovers and adjusts new functions. Below are the physiological manifestations that a mother may encounter in the early and late postpartum period.

The first few days after giving birth

And now your baby was finally born, and this is happiness. You feed him, take care of him and at the same time begin to recover from pregnancy and childbirth.

Here’s what you may encounter in the first days after childbirth :

  • Vaginal discharge. Blood and tissue lining the uterus during pregnancy usually comes out in the first few days and weeks after birth (sometimes longer). This discharge is called lochia . The first discharge is usually bright red, gradually lightening, becoming brown or yellow. You may notice that the discharge increases during breastfeeding. This is due to the contraction of the uterus during feeding.
  • Cramping. For ten days after giving birth, you may feel a pulling pain in the lower abdomen. The uterus contracts to return to its original size. Pain relievers can be taken if these pains are very uncomfortable, but if you are breastfeeding, consult your doctor.
  • Pain in the perineum. If the birth was vaginal, the area between the vagina and the anus is stretched so that the baby can be born. If there is a rupture or an incision (episiotomy) during labor, you will be stitched. During the healing period, this area may hurt and swell. Depending on the severity of the tear or pain, your doctor may recommend remedies to relieve the discomfort. It usually helps to apply a cold compress or sit in warm water, and use a comfortable cushion for sitting. Your doctor may recommend an anesthetic spray or cream.
  • Pain when urinating. During a vaginal birth , the baby’s head puts a lot of pressure on the bladder and urethra. In the postpartum period, you may experience pain when urinating, or you may have an urge to go small and go nowhere. This unpleasant condition worries women usually in the first 3-5 days after childbirth. Try pouring warm water over your vaginal area while urinating to help relieve pain. If the pain intensifies and bothers for a long time, it is imperative to consult a doctor – such a condition may be a sign of an inflammatory process that has begun.
  • Swollen legs . Try keeping your feet raised on a pillow or footrest (multiple packs of diapers can be used as a support).
  • Constipation. You may be postponing going to the toilet a lot mainly because of the pain. At the same time, the causes of constipation can be the muscles of the abdominal and perineum relaxed after childbirth, as well as changes in the hormonal background. If you experience constipation, try to move more, eat fiber-rich foods (fruits, vegetables), and take a laxative as recommended by your doctor. And don’t forget to drink plenty of water.
  • Engorgement of the mammary glands. Within a few days after childbirth, the breasts may become heavier and “full”, and sensitivity may increase. Once you start breastfeeding , the discomfort will go away . If you feed your baby with formula, the breast will stop swelling seven to ten days after giving birth. If you are not going to breastfeed, pain relievers can help alleviate the discomfort in the first days after childbirth (be sure to get permission from your doctor). Wear a comfortable bra and loose clothing, and try applying cool compresses to your breasts. Apply the baby to the breast more often – timely emptying of the mammary glands will help get rid of painful sensations.

The first few months after giving birth

Pregnancy and childbirth is a big “adventure” for the female body, and it will take time to recover. In the process, you may discover new symptoms and changes in the body. And this is not surprising, because you carried and gave birth to a child! Here’s what you may encounter in the first months after giving birth:

  • Fatigue. It is normal to feel very tired in the first months after giving birth. You have experienced a lot, both emotionally and physically. Every day you are faced with a new experience. Frequent feedings, lack of sleep – there are enough reasons for fatigue. To reduce fatigue and reduce stress, try to sleep when the child is sleeping, ask for help from loved ones, and do not be zealous with guests. Eat healthy foods rich in protein and iron, and keep things to a minimum. For example, it will be right and useful for the baby’s mother if someone takes over the washing and cooking (or, if possible, you can order food). A new mom needs peace of mind and the ability to focus on herself and her baby.
  • Heavy sweating. During the postpartum period, you may sweat a lot, especially at night. This will go away, but for now, you may be more comfortable sleeping on a soft towel to absorb sweat. If you are concerned about the intensity with which you sweat, talk to your doctor.
  • Your belly looks different. Looking pregnant after giving birth is a common thing. The stretched abdominal muscles gradually return to their previous state. Sometimes the abdominal muscles separate, this is called diastasis. After a while, they will gradually return to normal.
  • Stretch marks . Stretch marks may appear on the body during pregnancy. It is unlikely that they will disappear completely, but over time they will fade and become less noticeable.
  • Your hair may start to fall out. In most women, some time after giving birth (usually 3-4 months), hair begins to fall out. This is a natural, temporary process and is not a cause for concern. Gradually, the level of your hormones will return to normal and your hair will return to the same level as before. We have written a separate article on hair loss after childbirth .
  • Weight loss. In the postpartum period, you can quickly lose up to 10 kg without additional effort. Weight gained during pregnancy is not just about fat storage. This includes the weight of the placenta, the baby itself, amniotic fluid, extra blood and fluids produced in the body to carry the baby. Therefore, immediately after giving birth, you will “fall off” slightly. And then try to play sports (not very intensely) and eat right. Then in a couple of months you will most likely be able to return to your original weight. We wrote a separate article on how to lose weight after childbirth., in which you will find useful tips. Refrain from dieting – your body now needs adequate nutrition to recover. Be more patient and gentle to yourself. If you are breastfeeding, it is especially important for you to avoid sudden weight loss, as this will negatively affect the amount of breast milk . Your doctor will be able to advise you on how many kilograms you can lose without harm to your health and how to do it gradually.
  • Urinary incontinence. If your panties periodically get wet, this is also normal. Many mothers complain about urine leakage after childbirth. Vaginal labor and a large baby are risk factors for incontinence. In many cases, this symptom goes away on its own within three months. Do Kegel exercises to help tone your muscles . If the situation does not improve, be sure to see a doctor.
  • Fecal and intestinal gas incontinence. Often mothers are faced with such a delicate problem after childbirth. This may be due to muscle and nerve damage in the rectal area. If you experience these symptoms, try to overcome the embarrassment and be sure to see a doctor. Your doctor may prescribe physical therapy and medications.
  • Haemorrhoids. If you have had varicose veins of the vulva or hemorrhoids during pregnancy, they may worsen after childbirth. They can also appear for the first time after childbirth due to the heavy workload during childbirth. Your doctor may recommend appropriate treatments, such as using special suppositories with pain relieving ingredients or applying cold compresses. Try to avoid constipation, eat a diet high in fiber, and maintain optimal physical activity throughout the day. Over time, the painful, swollen veins should shrink or disappear completely.

My body is changing – how to deal with it

During pregnancy, the body goes through many transformations, changes continue into the postpartum period. Try to be gentle and condescending towards yourself. It took time to carry the baby, and it will take time to recover too. A healthy diet, moderate physical activity, and personal time are very important elements for a mother’s successful recovery. Recovery and return to the previous physical form will take quite a long time, and this is completely natural. Be condescending to yourself, do not rush yourself, you have enough worries and responsibility!

Living with a newborn: the habituation period

With the birth of a baby, your lifestyle can change dramatically and dramatically. The new reality can delight and inspire you, but you can also yearn for the old life. You will most likely experience both. Accepting that your life will now be redesigned is an important step in adapting to parenting. Life with a baby is not only joyful moments, but also stress, fatigue. Therefore, it is very important to take care of your body and state of mind. Ask for help and, if possible, share the concerns with your partner. For example, a friend might happily bring you a cooked lunch, or a partner might get up at night and bottle feed your baby so you can sleep and rest. Share your feelings with friends and family members, tell how you feel. A conversation with a close understanding person can already “unload” you. If there are times when you feel that you are about to fall on the baby, put the baby in his crib and leave the room. Inhale, exhale, distract yourself for a couple of minutes. Never shake your baby because of irritation, etc. Consider what will help you not feel exhausted and reduce stress during the postpartum period. Perhaps this is the help of a partner or family. Check with antenatal clinics or social networks for mothers to see if there are any support groups in your area. which will help you not feel exhausted and reduce stress during the postpartum period. Perhaps this is the help of a partner or family. Check with antenatal clinics or social networks for mothers to see if there are any support groups in your area. which will help you not feel exhausted and reduce stress during the postpartum period. Perhaps this is the help of a partner or family. Check with antenatal clinics or social networks for mothers to see if there are any support groups in your area.

Exercise during the postpartum period

Most likely, you will regularly feel tired and there will be very little time for yourself. But try not to forget that exercise helps replenish energy and get back in shape. Aim to exercise for about 150 minutes a week at moderate intensity. If you’ve had a vaginal birth, you can usually start exercising as soon as you feel ready for the stress. If you had a caesarean section, you will need to wait four to six weeks. Before starting your workout, be sure to get a doctor’s approval. Note that it may take some time before you can return to the same intensity exercise that you were able to do before pregnancy. Brisk walks, swimming and special workouts for newly born babies are good choices for physical activity.

Do not set yourself the task of reaching a certain mark on the scales or getting into “pre-pregnant” jeans. Think of sports as a way to take care of your health and get the energy you need to take care of your baby. In the postpartum period, it is especially important to strengthen the muscles of the back and abdomen, since they are the ones that suffer the most during pregnancy. If your doctor has given you the green light to exercise, you can try these exercises:

Repeat each exercise 20 times using the instructions below and the illustrations. Important: During all exercises, use your abdominal muscles and breathe without delay. Try not to arch your back, and in those positions where you need to lie on your back, try doing the exercise so that your back remains fully pressed to the floor.

  • A. On all fours. Get on all fours so that your arms and legs are at right angles. Take a deep breath, and as you exhale, tighten your abdominal muscles. This is how you work them out. You will need to use your abs in all of these exercises.
  • B. Sliding feet. Lying on your back, bend your knees slightly, press your feet to the floor and tighten your abs. Take a deep breath and straighten one leg, sliding your foot on the floor. Exhale and return the leg to the starting position. Repeat with the other leg.
  • C. Bicycle.Take the same position as in the previous exercise. Bending your knee, lift it so that the knee is above the hip. Then straighten your other leg. Make a movement as if you were riding a bicycle: straighten your bent leg and bend the one that was extended.
  • D. Touching the floor with the heels. Lying on your back, lift both legs at a 90 ° angle so your calves are parallel to the floor. Lower one leg to the floor so that the heel touches the floor and the knee remains bent. Repeat with the other leg.
  • E. Stretching the legs. Lying on your back, lift both legs at a 90 ° angle so your calves are parallel to the floor. Extend one leg straight so that your foot is 30-60 cm above the floor. Return your leg to its original position and repeat the exercise with the other leg.

Return to work

Each woman has her own factors that affect how long after giving birth she plans to return to work: financial situation, conditions for maternity leave and various family circumstances. Even if you planned when you would go to work during pregnancy, the situation may change after giving birth. If you can take your time, give yourself enough time to make a decision that is comfortable for you. If both mom and dad return to work, you need to decide who will stay with the baby. You can ask for help from someone from the family, hire a nanny or send your baby to kindergarten. Give yourself time to find the solution that’s right for you.

Depressed postpartum

It is normal to experience sadness during the postpartum period. 80% admit they are depressed after childbirth. If you are sad and depressed, this does not mean that you are a bad mom or that you do not appreciate what is given to you. It just means that your body is adapting. Try to remind yourself of this when you are uncomfortable. Heart-to-heart conversations with loved ones, relaxation (as much as possible) and personal time when you are doing something for yourself help dispel the melancholy.

Usually, these bouts of sadness go away in a couple of days. But if they linger or the sensations become more intense, see a specialist, as this may indicate postpartum depression.

Sex in the postpartum period

Sooner or later, you may wonder: how long after giving birth can you have sex again? You may also be worried about your decreased attraction to your partner. Some doctors recommend waiting six weeks after giving birth before resuming sex. If you feel ready for intimacy earlier, consult your doctor. You and your partner may find that your sexual appetite has changed. Fatigue may be the reason, you may worry that sex will be painful. Sex drive is weakened in many women who have recently given birth. Take your time and be sincere with your partner. Try to find a time when you can retire and no one and nothing will disturb you. Decide which method of contraception you will use. Even if you are planning to have another child, according to the recommendations of specialists, it is best to wait 12 months after the last birth for the body to fully recover between pregnancies. Talk to your doctor about which method of contraception is best for you.

When menstruation returns after childbirth

After giving birth, you will have vaginal discharge – lochia . Don’t confuse them with your period.

If you are breastfeeding, your period may return a few months after giving birth (on average, six months). But most moms don’t come back until they wean the baby . If you are formula feeding your baby , your period may return six to eight weeks after giving birth. At first, they may differ from what you are used to in terms of duration, soreness (may be less painful). Gradually, the cycle is normalized. Keep in mind that your ovaries can release eggs even if your period hasn’t started yet. This means that you can get pregnant without your period. If you are not planning a second pregnancy, talk with your doctor about which contraceptive is right for you.

Visit your doctor after childbirth

Your doctor will ask you to see him two to six weeks after giving birth. You will see your pediatrician on a monthly basis in the first three months of your baby’s life. After a caesarean section, your doctor may schedule an examination two weeks after birth to check how the stitches are healing. At the first examination after childbirth, the doctor may ask you to weigh yourself, most likely, they will measure the pressure, examine the chest and abdomen, and conduct a vaginal examination. If you have had diabetes during pregnancy, your doctor may also order a blood test. Before going to the doctor, prepare a list of all your questions so you won’t forget anything. At the first examination, the doctor will tell you whether further observation is required, whether it is necessary to pass any tests or undergo examinations. Check with your doctor if you need vaccinations. For example, a flu shot orDTP (tetanus, whooping cough and diphtheria vaccine) .

Diseases in the postpartum period

Below we will talk about the diseases that sometimes occur in women after childbirth. If you notice symptoms of these diseases or other ailments in yourself, be sure to see a doctor.

  • Postpartum depression. It happens that mothers of babies experience a very strong feeling of depression, which does not go away after a few weeks. If so, it could be a sign of postpartum depression. It can manifest itself in a feeling of despair, increased anxiety, crying for no reason. Also, it can be difficult for a mother with postpartum depression to concentrate, wake up on time, or, conversely, fall asleep, even when the baby is already sound asleep. Postpartum depression usually appears in the first three weeks after childbirth, but symptoms can occur up to a year after the baby is born. If you are experiencing symptoms of depression, do not delay contact a specialist. The condition can be alleviated with psychotherapy or medication, or both.
  • Postpartum endometritis. Endometritis is an inflammation of the inner surface of the uterus (endometrium) that arose in the early postpartum period as a result of an infection. Postpartum endometritis is rare, but the risk is higher after a caesarean section. To prevent the development of infection after a cesarean section, the mother is usually given antibiotics. Be attentive to yourself and if a few days after giving birth you have a fever, you feel nauseous and there is pain in the abdomen, consult a doctor right away. The doctor will be able to diagnose and prescribe treatment (in case of infection, this will be a course of antibiotics).
  • Postpartum hemorrhage. Bleeding occurs the day after delivery or within 12 weeks. In the first 24 hours, it occurs due to weak contractions of the uterus. Other possible reasons are the delay of parts of the placenta in the uterus, pathology of hemostasis, trauma to the soft tissues of the birth canal. Bleeding in the first 24 hours after childbirth occurs in 4-6% of cases. Your doctor will be able to provide you with the help you need, such as medication or massage of the uterus to stimulate contractions. If there is a lot of blood loss, your doctor may order a transfusion. If at any time after giving birth you start bleeding, see your doctor.
  • Postpartum thyroiditis. Thyroiditis after childbirth occurs against the background of autoimmune inflammation of the thyroid gland. Simply put – until the moment of birth, immunity is suppressed, this is necessary to maintain your pregnancy. And after the birth of a child, immunity returns to its original state, it begins to work in full force. With autoimmune thyroiditis, its increased activity is observed, the thyroid gland becomes a victim of it. Thyroid function usually stabilizes over time, but in some cases this can lead to a chronic condition called Hashimoto’s disease. Symptoms of thyroid disease, such as fatigue and weight fluctuations, are easily confused with the normal “symptoms” of the postpartum period or the fatigue of the mother of the newborn. But if you feel worried and symptoms persist over time, tell your doctor.
  • Gestational diabetes mellitus. If you experience gestational diabetes during pregnancy, you will need to see your doctor after giving birth. You will most likely need to have a glucose tolerance test 4–8 weeks after giving birth. To reduce the health risks associated with gestational diabetes, your doctor may recommend weight management and proper diet.

When to call a doctor

If you experience any of the following symptoms during the postpartum period, contact your doctor immediately:

  • temperature above 38 °
  • nausea or vomiting
  • pain while urinating
  • heavy bleeding (for example, if you change two pads with maximum absorbency in an hour)
  • severe abdominal pain
  • swelling in the legs
  • chest pain
  • painful lumps in the chest
  • pain or signs of infection (redness, discharge) at the site where the stitches were placed
  • a strong-smelling vaginal discharge
  • feelings of despair and longing (especially if the mood does not change after ten days)


You don’t have to deal with problems alone. The postpartum period is not a time for heroism. Ask for help from your partner, family members, and friends. If you do not want to see friends or relatives, you do not have the strength to do so, refuse meetings, limit home visits. If you keep in touch with your midwife or doula, they can be of great help after giving birth by answering questions and giving advice. If you’ve taken a childbirth class, talking to your classmates can be a relief as well, as they’re probably going through a similar experience at the same time as you. You can also check with your local health center or antenatal clinic if there are local support groups for new mothers.

Dr. Ashwani Kumar is highly skilled and experienced in treating major and minor general medicine diseases.