What to expect as you recover from having a baby

October 10, 2019 | by Lisa Chorzempa-Schainis, MD
Categories: Healthy Driven Moms

You’ve gone through months of pregnancy, then labor and, at last, the birth of your baby. Your body has done the most important job of all, so it can take time to recover — physically and emotionally.

The first six weeks following birth are known as the postpartum period (or the “fourth trimester”). It’s a critical time for you and your baby, as new moms are at risk of serious health complications in the days and weeks after giving birth. Postpartum check-ups with your doctor are essential to make sure you’re recovering well.

The American College of Obstetricians and Gynecologists recommends seeing your doctor for a checkup within three weeks of giving birth and a complete checkup no later than 12 weeks after, along with ongoing care as needed.

At your checkups, your doctor will monitor your recovery and help you manage any pain, health conditions or pregnancy complications. You will likely be screened frequently for postpartum depression through a questionnaire. This is when you should talk about how you’re feeling and ask questions. Even if you’re feeling fine, don’t miss your postpartum checkups.

Your body will go through a number of changes after giving birth, all while you are trying to care for your newborn and adjust to motherhood. What can you expect during the postpartum period? Your recovery partly depends on what type of delivery you had.

Vaginal delivery is generally easier on a woman’s body, and recovery is usually shorter and less painful. Recovery from a vaginal delivery may be 2-4 weeks. Some drawbacks of vaginal delivery are tears (which usually heal easily) and weakened pelvic muscles. The entire perineal area will likely be swollen and sore (especially if you had an episiotomy), so ice packs or frozen pads can help, as well as sitting on a pillow and soaking in a warm bath. Your doctor may also suggest over-the-counter pain medicines such as ibuprofen or acetaminophen to help reduce the pain.

Cesarean section (c-section) takes at least 4-6 weeks to recover from, and recovery is often more difficult. Like all surgeries, c-section poses risks of infection, blood loss and other complications. Your incision may be painful and movement can be difficult. Your doctor may advise you to avoid any strenuous lifting or exercise for a period of time.

While every woman’s recovery is unique, some common changes to expect during the postpartum period include:

  1. Bleeding. After your baby is born, your body gets rid of the blood and tissue that lined your uterus during pregnancy. This is called vaginal discharge or lochia. It’s bright red and heavy at first, then becomes lighter until it goes away after a few weeks.
  2. Cramps. You may feel menstrual-like cramps or small contractions, especially when breastfeeding. This is just the uterus shrinking back to its regular size. The cramps should go away in a few days. Ibuprofen can help reduce pain.
  3. Menstrual period. Your period could return in six to eight weeks, or sooner if you do not breastfeed. If you breastfeed, your period might not resume for many months. When your period returns, it may not be the same as before you were pregnant. Over time it often returns to the way it was before you got pregnant.
  4. Swollen hands, face, feet and legs. Swelling is common during pregnancy from extra fluids in your body. It may take time for the swelling to go away after you have your baby. Let your doctor know if your symptoms worsen or if you notice pain in your legs, develop headaches that don’t go away, worsening swelling, or visual changes after delivery.
  5. Fatigue. Lack of sleep is a given with a newborn. While it may seem impossible, try to nap as often as you can and limit visitors. Try to sleep when your baby sleeps, if possible. Enlist help from others with cleaning, laundry, meals, etc. Don’t expect to keep your house perfect. Be sure to continue to take your prenatal vitamins.
  6. Breast changes. It’s normal for your breast milk to come into your breast three or four days after delivery. At that time, your breasts often feel tender, sore and swollen. You may also have a low-grade fever (less than 100 degrees) when your milk initially comes in. The discomfort usually goes away in a few days. If you start breastfeeding, it can hurt, your nipples may bleed, and you may experience leakage. Soaking in a warm tub can help. Lanolin nipple cream may help with nipple skin discomfort. Breast pads can be inserted inside your bra to contain breast milk leakage. If you are choosing not to breastfeed, it helps to keep a sports bra on continuously, avoid nipple stimulation, and use ibuprofen for any discomfort. Let your doctor know if you have a fever, redness, localized hardness or extreme tenderness in your breasts.
  7. Constipation and hemorrhoids. You might feel constipated so drink plenty of water, eat high-fiber foods and take a stool softener if needed. Hemorrhoids are common during and after pregnancy, so ask your doctor how to relieve discomfort.
  8. Emotional changes. After childbirth, it’s normal to feel sad, anxious and overwhelmed, thanks to hormonal changes and sleep deprivation, among other factors. These feelings are normal and usually go away within a week or two after delivery. But sometimes symptoms continue and worsen. Perinatal mood and anxiety disorders (PMADs) affect up to one in five women. Let your doctor know if symptoms last for more than two weeks or make it difficult to function.
  9. Urinary incontinence. In the first few days after giving birth, you may feel pain or burning when you urinate, difficulty urinating or urinary leakage. It usually goes away as your pelvic muscles become stronger again. Kegel exercises to strengthen your pelvic muscles can help. If this persists after six weeks, physical therapy can help improve your symptoms.
  10. Sweating. New moms often sweat a bit more than usual, especially at night. This is caused by all the changing hormones in your body after pregnancy.
  11. Skin and hair changes. Your hair may have been thicker and fuller during pregnancy, but after your baby is born, your hair may thin out. Hair loss usually stops within six months after you give birth, and your hair should regain its normal fullness within a year. You may also have stretch marks on your belly, hips and thighs that fade over time. Talk with your doctor about using retinol to improve their appearance. You also may notice darkened patches or darkened skin on your face, nipples and abdomen. This is due to the hormones of pregnancy and may take several months to go away.
  12. Lack of sexual desire/painful sex. Lack of sexual desire is normal as your body recovers. Your doctor may recommend waiting 4-6 weeks after giving birth before you have sex, and it may be painful at first. Use of a personal lubricant may be helpful. It may take several months before your sex life returns to normal. The hormonal changes from pregnancy and nursing will often blunt a women’s sex drive. Most women should wait at least 18 months before getting pregnant again, so talk to your doctor about birth control options.
  13. Thyroid issues. Some women develop thyroid problems in the first year after giving birth. In most cases, thyroid function returns to normal, but some women develop permanent underactive thyroid disease, called Hashimoto's disease.
  14. Weight loss. After giving birth, you will likely lose about 10 pounds right away and a little more as body fluid levels decrease. Most women will easily lose 20-30 pounds by their six week check-up. Gradual weight loss over several months is the safest way to get back to your normal weight. A well-balanced diet, including fruits, vegetables, dairy products and lean protein, can help with weight loss. Avoid gimmick diets. Breastfeeding moms will require additional calories to insure adequate newborn nutrition. Ask your doctor when you can begin exercising. Most women benefit from low-impact activity, such as walking, soon after delivery.

Although the postpartum period ends after a few months, many women may not feel like themselves for a full year. You need to give your body time to heal. It took over nine months to grow your baby and may require many more for your body to recover.

Continue to have regular check-ups with your doctor. Any problems you had during pregnancy, labor and birth (e.g., preterm birth, gestational diabetes, gestational high blood pressure) may affect your health in the future, so find out how you can reduce your risks.

Take care of yourself physically. Drink plenty of water, eat healthy foods. Limit sweets and fatty foods. Don’t smoke, drink alcohol or use harmful drugs. Increase activity slowly over time. Be on the lookout if you develop a fever, which could indicate an infection.

Also, take care of yourself mentally. Many doctors recommend that all expectant and new mothers be screened for PMADs. Be honest about how you’re feeling. If you experienced a pregnancy loss of any kind, it’s essential to get support.

Call the Mom’s Line at 630-527-7294, or connect with other moms in the Nurturing Mom support group.

Explore behavioral health resources, or call 630-305-5027 for a free behavioral health assessment.

Learn what to expect after your baby is born at Edward-Elmhurst Health.

Related blogs:

What nobody tells you about giving birth

Postpartum depression can happen to anyone (even you)

What nobody tells you about breastfeeding

Learn more from Healthy Driven Chicago:

Tips to stay healthy during pregnancy

Getting help for perinatal mood and anxiety disorders

Is there a right way to give birth?

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