Every single mum or mum-to-be are often told that pregnancy and childbirth transform your body, but you are not told exactly what happens to your body AFTER you give birth.
Everyone’s body and every experience are different, and postpartum recovery can vary from mum to mum: on how long you were in labour, how long you pushed, on whether it was a vaginal delivery or C-section, and so on.
In this article, we highlight the postpartum recovery timeline – what you can expect from both your body and your mind the first hour, day, week, and year after giving birth.
Postpartum recovery timeline
Immediately after birth: The first hour
If you had a vaginal delivery, right after birth, your doctor or nurse will put your baby on your chest for skin-to-skin contact.
The doctor will inspect your perineum and vaginal wall. If you have had a large tear or an episiotomy, you will need stitches. Your pulse and blood pressure will be checked.
In the case of C-section births, you may receive antibiotics (to minimize your risk of infection) and oxytocin (to control bleeding and help contract the uterus) in your IV. Your blood pressure, pulse, rate of breathing and amount of bleeding will be checked regularly.
The first 24 hours after giving birth
How you feel in the first 24 hours after giving birth can vary will depend on many factors, including whether you gave birth naturally or through C-section.
Here is a rough idea of what to expect in the first 24 hours after giving birth:
You will have bleeding from the vagina. This is called lochia and is similar to a very heavy period. The lochia consists of leftover blood, mucus, and tissue from the lining of the uterus. Don’t be alarmed if you find blood clots—that’s normal.
During this initial phase, doctors and nurses usually recommend wearing 2-3 maternity pads (which are long, thick pads made specifically for heavy postpartum bleeding) at a time.
The bleeding will continue for around 4-6 weeks, and you can expect heavy bleeding in the first 3 to 10 days postpartum. For the first few days, the discharge will be bright red and very heavy. Over the next four to six weeks, it will get lighter in colour (pink, brown and cream colours are all normal) and intensity.
Do inform your doctor if you experience heavy bleeding (soaking a pad in less than an hour), and especially if it’s accompanied by other symptoms like pelvic pain, fever or uterine tenderness.
Postpartum haemorrhage (PPH) is a rare complication where you bleed heavily from the vagina after your baby’s birth.
You will continue to experience cramps after giving birth, though not as intense as the contractions you had during labour. This is because the uterus has started to contract to its pre-pregnancy size.
Did you know that right after birth, your uterus weighs about 1.13 kg? By about 6 weeks after birth, it weighs only 2 ounces (56.7 g).
The cramps may feel like mild labour pain or heavy period pain, and will generally be more intense if it’s your second or third baby. They should reduce considerably within a week.
If you are breastfeeding, the cramps might intensify, though for a good reason. Your baby’s sucking on your nipple triggers the release of the hormone oxytocin, which in turn causes contractions, and help your uterus shrink to normal size more quickly.
For pain relief, you can put a heating pad on your belly, or ask your doctor for medication.
In case of vaginal delivery, your perineum (the area between the vagina and the anus) will most likely be swollen and sore in the first 24 hours after giving birth. It takes time to heal.
If you have stitches in your perineum, they will dissolve in 1 to 2 weeks.
To ease discomfort while you’re recovering:
- sit on a pillow or padded ring.
- cool the wound with an ice pack for 20 minutes every 2 to 4 hours to reduce the swelling.
- use a squeeze bottle to pour warm water on your perineum as you’re passing urine.
- sit in a warm bath just deep enough to cover your buttocks and hips for five minutes. Use cold water if you find it more soothing.
- wipe from front to back after going to the bathroom. This can help prevent infection as your episiotomy heals.
- ask your doctor for pain relief medication or a numbing spray or cream, if needed.
- talk to your doctor about using a stool softener or laxative to prevent constipation.
- do Kegel exercises. These exercises strengthen the muscles in the pelvic area. To do Kegel exercises, squeeze the muscles that you use to stop yourself from passing urine (peeing). Hold the muscles tight for 10 seconds and then release. Try to do this at least 10 times in a row, three times a day.
If you had a C-section, you are likely to experience soreness around the incision and have other side-effects like nausea (because of anaesthesia), constipation, and exhaustion.
24 hours after surgery, your doctor will remove your wound dressing to check for any signs of infection.
Your breasts will start producing colostrum. Colostrum is a sticky, yellow fluid that is loaded with nutrients and antibodies to help your baby build a strong immune system. Your body will produce colostrum exclusively for about 2-5 days after birth.
Many first-time mums might find it difficult to latch their babies on to their breasts. This might lead to sore nipples. Make use of your time in the hospital to get help from a nurse or lactation consultant to ensure that your baby latches on correctly.
Post-baby belly and weight loss
Most women lose 6 kg during birth, including the weight of the baby, placenta and amniotic fluid.
After you give birth, there is a post-baby belly though, and you still look pregnant. This is normal.
During pregnancy, the uterus, abdominal muscles, and skin are stretched over a nine-month period, and it takes weeks (and months) for them to shrink back to normal.
If you had a C-section, you can expect some extra weakness and swelling in the abdomen due to the incision.
Difficulty in peeing and pooping
If you had a vaginal delivery, a bruised bladder and sore perineum can make it painful to pass urine.
It’s important though to pee within six to eight hours of delivery. This helps to prevent urinary tract infections and prevents any damage and bleeding that can happen when your bladder gets too full.
Soon after delivery, your doctor and nurse will measure the amount of urine you pass, and check your bladder for distension. If you are unable to pee, your doctor will insert a catheter for drainage.
Pooping after birth is a challenge for most mums. If you had an episiotomy, you might be afraid that pooping will damage your stitches.
For C-section deliveries, it can take a few hours or days after your C-section for your bowel to start working again. In some women, this can cause painful trapped wind and constipation.
To help you manage constipation:
- drink 6-8 cups of water a day
- eat regular meals
- avoid straining too hard while on the toilet
- don’t put off going to the toilet
- move around as much as you can.
Mummy, it is perfectly normal to feel happy, excited, confused, and anxious after delivery, all at the same time!
Childbirth triggers hormonal changes, plus suddenly, there’s a lot of physical pain and discomfort, lack of sleep and a newborn to look after. It will take time to adjust to this new normal.
The first week after giving birth
As you get used to your new normal, here are some things you need to know and keep in mind in the first week post-delivery:
You are likely to feel very tired after giving birth. Try to sleep when the baby sleeps. Eat healthy foods, like fruits, vegetables, whole-grain bread and pasta, and lean meat and chicken. Limit sugary and fatty foods.
Your vagina is going to be sore, and it may hurt a lot. You may feel pain or burning when you urinate (pee). Drink lots of water.
Sometimes you may not be able to stop urinating. This is called incontinence. It usually goes away as your pelvic muscles become stronger again. Do Kegel exercises to strengthen your pelvic muscles.
If you have had a C-section delivery, movement, especially getting in and out of bed, will be difficult and your incision can be painful. Still, it is important to move around, at least a little bit, to avoid blood clots. Don’t lift heavy weights (anything heavier than your baby).
If you see redness, swelling, or oozing around the incision 3-4 days after giving birth, inform your doctor immediately.
Postpartum constipation is pretty common in the first week. A diet high in fibre and drinking plenty of water, milk, and juices can help ease the pain.
The lochia or postpartum bleeding is going to be bright red and heavy in the first week. You may still experience contractions, especially if you are breastfeeding, but this shows that the uterus is shrinking back to its pre-pregnancy state.
If you had stretch marks during pregnancy, know that they won’t disappear after giving birth, but they will fade over time from red to silver.
Your breasts will continue to produce colostrum for about 3-4 days after birth. After that, your breasts will swell as they fill up with milk. Your milk may take longer to come in if you’ve had a caesarean.
Remember that breastfeeding shouldn’t be painful. If your nipples are sore, it’s probably a sign that your baby is not getting a good latch. An effective home remedy for sore nipples is to massage some breast milk onto your nipples and let them air dry.
A few days after birth, your breasts might become full, firm and tender, which is known as engorgement. Engorgement can make it difficult for the baby to latch on to your breast.
Frequent breastfeeding is recommended to avoid or minimise engorgement. Before you breastfeed your baby, express a small amount of milk from your breast with a breast pump or by hand.
To ease breast discomfort due to engorgement, alternate between taking a warm shower or applying warm washcloths before breastfeeding or expressing, and placing cold washcloths on your breasts after breastfeeding.
Talk to your doctor or lactation consultant if your breasts stay swollen and are painful.
If you’re not breastfeeding, wear a firm, supportive bra, such as a sports bra. Don’t pump your breasts or express milk, as this will cause your breasts to produce more milk.
Your body is still getting used to fluctuating hormone levels, breastfeeding, physical discomfort and sleep-deprivation. It is okay to not feel okay.
Your baby blues should subside or get better within two weeks. In the meantime, if you feel low and unable to cope with all the changes around you, share your feelings and ask your partner, loved ones or friends for help.
If you continue to experience severe mood swings, loss of appetite, overwhelming fatigue and lack of joy in life for more than two weeks after childbirth, you might have postpartum depression.
Contact your doctor if you feel that the symptoms are not getting better, and you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
The first year after giving birth
By 6 weeks, your bleeding stops and your uterus should go back to its pre-pregnancy size. You will have a postpartum checkup, and your doctor will confirm if you have hit your recovery milestones. If all is well, mums are cleared for exercise and sex (though it’s perfectly normal to not feel ready for sex for a longer time).
If you want another baby, do remember that it’s best to wait at least 18 months (1½ years) between giving birth and getting pregnant again. Too little time between pregnancies can increase your risk of premature birth (before 37 weeks of pregnancy).
C-section mummies, please go slow with lifting heavy things. Your scars probably won’t hurt anymore, but it might be numb or itchy around the incision.
Ask your doctor about exercising and being active. Begin slowly and increase your activity over time. Walking and swimming are great activities for new mums.
Also, breastfeeding helps you burn calories and lose pregnancy weight faster.
Mums, don’t try to lose too much weight too fast. Your body needs nutrients from food to heal and to regain strength. If you’re breastfeeding, losing weight too fast can reduce your milk supply.
It might take time to lose your pregnancy belly and for your body to get back in shape. So, it is important to maintain a healthy diet and continue to stay active and exercise.
If you’re still having painful sex, prolapse, or urinary incontinence one year after delivery, consult your doctor.
All that thick, extra gorgeous hair you flaunted during pregnancy may go back to its normal state. Your hair is going to fall out, and compensate for the lack of hair fall during pregnancy.
It is going to be upsetting, but thankfully, hair loss usually stops around 6 months after giving birth. Your hair should go back to its normal pre-pregnancy state within a year. Meanwhile, make sure you eat plenty of fruits, vegetables and other nutrient-rich foods.
Periods after pregnancy
If you’re not breastfeeding, your period may start again 6 to 8 weeks after giving birth. On the other hand, if you are breastfeeding, it may not start again for months. Some mums don’t get their periods until they stop breastfeeding.
When your period returns, expect some changes initially – it may be shorter or longer than usual. Over time it usually returns to pre-pregnancy state.
A lot of your mental health depends on how well you are adapting to motherhood, how much help you have and how much sleep you get.
Taking care of a baby is hard work, so do set aside some ‘me time’ and practise self care. Remember to eat healthy and be active – it has a positive impact on your mental health too. Ask your friends and family for help with looking after your little one.
Joining a community that supports new mums is a great way to meet mummies with the same kinds of concerns. theAsianparent app is one such community where you can ask questions, get insights from fellow parents and track your child’s development.
As you near the end of your maternity leave, you are likely to get anxious about getting back to work. Discuss with your partner about what type of childcare is best for your baby. If you feel bad about leaving your baby with someone else, talk to your boss about flexi-work options.
A lot of mummies at this stage are torn between career and being a mum, and if you feel like a failure at anything and everything, know that you are not alone.
Get daily updates about our top stories when you follow us on Telegram at https://t.me/theAsianparentSG.