Recovering from Delivery (Postpartum Recovery)

Recovering from Delivery (Postpartum Recovery)

Your body has just done one of the most remarkable things it will ever do: grow another human being. After nine months of waiting, you are probably excited to finally be home with your new baby. Much of your focus and energy during the coming weeks and months will be on baby, but remember that you also need to take care of yourself, too.

Your delivery may have been complicated or easy. You may have had a cesarean birth (C-section) or vaginal delivery. You may have labored for a few hours or a few days. No matter what your delivery looked like, your body has been through a trauma just the same. It is going to need time to recover.

Your postpartum recovery won’t be just a few days. Fully recovering from pregnancy and childbirth can take months. While many women feel mostly recovered by 6-8 weeks, it may take longer than this to feel like yourself again. During this time, you may feel as though your body has turned against you. Try not to get frustrated. Remember that your body is not aware of your timelines and expectations. The best thing you can do for it is rest, eat well, and give yourself a break.

Also during this time, your hormones will be fluctuating. You may not be thinking clearly and will be more emotional. Again, give yourself time for this to pass. However, if at any time you think about hurting yourself or your baby, tell someone.

Path to improved health

It took the better part of a year to grow and have a baby. Take comfort in knowing that, for the most part, you will begin to feel like yourself much sooner than that. In a few months, you should be well on your way to recovery.

That is not to say that postpartum recovery won’t have its challenges. It is very common to feel as though your body is not healing as quickly as you’d like. Remember, the more you can rest your body and let it fully recover, the better you’ll be for it. Even if you can only manage to eat, sleep, and care for your baby, that is enough.

During the first six weeks, pay attention to your body. You’ll be tired and focused on your baby, but try to notice changes with your own body. This is very important as you heal.

As you begin to feel better, resist the temptation to do more. Overdoing things at this point can set you back in your recovery. Concentrate on nourishing your body with good foods, drinking plenty of water (especially if you are breastfeeding), and getting enough rest.

If you’ve had a C-section, you’ll have more restrictions about what you can do in the days and weeks following childbirth. Common don’ts include: climbing stairs, driving, and lifting anything heavier than your baby. Your doctor will let you know when you can resume normal activities.

Here is more of what you can expect during your postpartum recovery.

Abdominal pain. As your uterus shrinks back into its normal size and shape, you will feel pain in your abdomen (lower belly). These pains are called “afterpains.” Most of these pains will be dull, but some will be sharp. You may feel more of these pains as you breastfeed your baby. That is because breastfeeding stimulates a chemical in your body that causes the uterus to contract (tighten). For many women, applying heat to the area helps control the pain. Consider using a heating pad or hot water bottle. Your abdominal pain should ease up over time. If these pains get worse or don’t let up, you should call your doctor.

Baby blues. You are so excited and happy to bring baby home. The next minute, though, you are sad. It can be confusing, especially to new moms. Know that many women (70-80%) struggle with feeling sad the first few weeks after having a baby. It is commonly called the “baby blues” and is caused by hormone changes. It is nothing to be ashamed of. In fact, confiding in a friend of family member can often make you feel better. If these feelings last more than a few weeks or you are not able to function because of them, you could have postpartum depression. Postpartum depression is more serious than baby blues. If you have severe feelings of sadness or hopelessness, you should call your doctor.

Constipation. It is very common to be constipated in the days following childbirth. There are several things that could cause this. If you received any pain-relieving drugs in the hospital, they could slow down your bowels. If you had anesthesia (a pain blocker) for any reason, that also can cause it. Sometimes, postpartum constipation is brought on simply by fear. This is true especially if you have stitches because you had an episiotomy (a surgical cut between the vagina and anus to widen the vaginal opening for childbirth) or tore this area during delivery. You may be afraid of damaging the stitches or be afraid that a bowel movement will cause even more pain in that area. To help ease constipation, drink plenty of water and try to eat foods that offer a lot of fiber. In many cases, you may want to talk to your doctor about prescribing a stool softener (such as Colace or Docusoft). If you haven’t had a bowel movement by four days postpartum, call your doctor.

Hemorrhoids. You may have developed hemorrhoids (painful swelling of a vein in the rectum) during your pregnancy. If not, you may have gotten them from the strain and pushing during delivery. They can cause pain and bleed after a bowel movement. They also itch. You can get some relief from the pain and itching by applying witch hazel to your hemorrhoids. This is especially effective if you keep the witch hazel in the refrigerator. Your hemorrhoids should shrink over time. If not, contact your doctor.

Hormonal shifts. Besides fueling your mood swings (see “Baby blues,” above), hormones are also responsible for other postpartum symptoms. You may be sweating more, especially at night when you sleep. Just make sure that your sweating is not accompanied by a fever. That could be a sign of infection. Hormonal changes also cause hair loss for many new moms. This is only temporary. When your estrogen levels increase, your hair will return to its normal thickness.

Perineum soreness. The perineum is the area between your vagina and anus. Many times, this area will tear during childbirth. Other times, your doctor may have to make a small cut in this area to widen your vagina for childbirth. Even if neither of these things happened during your vaginal birth, you perineum will be sore and possibly swollen postpartum. You may feel discomfort in this area for several weeks. While you recover, sitting on an icepack several times a day for 10 minutes will help relieve the pain. This is especially good to do after going to the bathroom. During the first week postpartum, also use a squirt bottle to rinse the perineum with warm water after using the toilet. Notify your doctor if your perineum area does not get less sore each day or you have any sign of infection.

Sore nipples and breasts. The first few days of breastfeeding, it is normal for women to have sore nipples and breasts. If the soreness continues beyond a few days, it could be that the baby isn’t latching correctly. Try changing positions or consult a lactation expert (breastfeeding expert) for help. Do this before your nipples develop painful cracks, which could sideline your breastfeeding. The American Academy of Family Physicians (AAFP) recommends that all babies, with rare exceptions, be breastfed and/or receive expressed human milk exclusively for the first six months of life. Breastfeeding should continue with the addition of complementary foods throughout the second half of the first year.

Stitches. If you have stitches due to a torn or cut perineum (see “Perineum soreness,” above), it will take 7-10 days to heal. The stitches will absorb over time. It is important that you keep the stitches from getting infected by gently cleaning them with warm water after each time you use the toilet. Do this by using a squirt bottle to rinse the area and pat it dry. Do not wipe the area with toilet paper or you could irritate the stitched area. No matter how eager you are to check the healing progress, try to keep you hands off the stitches. If the area begins to hurt worse or the stitches seem weepy, contact your doctor. It could be a sign of infection.

If you have stitches from a cesarean birth (C-section), these heal in varying degrees. The stitches in the skin should heal in 5-10 days. The underlying stitches in your muscle layer will take longer to heal. These won’t completely heal for 12 weeks. For the stitches that you can see, make sure to watch for any signs of infection. These signs include if the incision area is red, swollen, or weeping pus; or if you have a fever.

Vaginal bleeding and discharge. After giving birth, it is common that you will have vaginal bleeding and discharge (this is called lochia), even if you had a C-section. This is your body’s way of eliminating the extra blood and tissue that was used to grow and nourish your baby. Expect for this to be heavier at first (up to 10 days), but then taper off. Light bleeding and spotting can last up to six weeks after delivery. It is important that you use only sanitary pads during this time. Using tampons can introduce bacteria and lead to infection. Also expect to pass some clots, especially the first week. If clots are bigger than a quarter, you should contact your doctor.

Water retention. You may be eager for that swelling you noticed during your pregnancy to go away. It won’t, though, for a while longer. Also known as postpartum edema (swelling), your body will continue to hold on to water because of an increase in a hormone called progesterone. You may notice the swelling in your hands, legs, and feet. It shouldn’t last much longer than a week after delivery. If it does or if it seems to get worse over time, be sure to tell your doctor.

Weight loss. If you were hoping for immediate weight loss after your baby was born, you were probably very disappointed. No mother is that lucky, no matter what you read in the tabloids. You can expect to lose about 6-12 pounds (depending on the size of your baby) during the birth. After that, your weight loss will slow considerably. Depending on how much weight you gained during pregnancy (the average is 25-35 pounds), it may take several months to lose the baby weight. For many women, breastfeeding seems to help promote weight loss. Other moms don’t see weight loss associated with breastfeeding. Try to keep your nutrition consistent while you are breastfeeding and do not get frustrated if it takes longer than you’d hoped to lose the weight.

Things to consider

Pay attention to your body after giving birth. If something doesn’t seem right, it probably isn’t. Soreness is to be expected, but too much pain could mean something is seriously wrong. Don’t be so wrapped up in caring for your baby that you ignore your own health.

Just because you’ve made it through delivery, you are not necessarily out of danger for health complications. There are life-threatening problems related to childbirth that can happen days or weeks after delivery.

  • Postpartum hemorrhage is rare, but can happen. If your postpartum bleeding is filling more than a pad every hour, you should contact your doctor immediately. Without treatment, postpartum hemorrhage can be fatal.
  • Headaches that are severe and don’t go away can also signal an underlying problem, especially coupled with high blood pressure. You could be in danger of having a stroke.
  • Deep vein thrombosis (a blood clot in a deep vein) is a somewhat uncommon problem (1 in every 1,000 pregnancies) that can occur during or after pregnancy. Symptoms include leg pain or feeling like you have a pulled muscle. Your leg may also be red and hot to the touch. Left untreated, these clots can break away and travel to your lungs. When this happens, it can be life-threatening.
  • Postpartum preeclampsia is rare and can develop within 48 hours after childbirth or as late as six weeks after childbirth. It is similar to preeclampsia (also called toxemia), which can occur while your pregnant. Both preeclampsia and postpartum preeclampsia cause your blood vessels to constrict (get smaller). This results in high blood pressure and also distresses your internal organs. Sometimes there are no obvious symptoms, unless you are monitoring your blood pressure. When you do have symptoms, they may include severe headache, swelling of your hands and feet, blurred vision, and sudden weight gain. If you suspect you may have postpartum preeclampsia, call your doctor immediately.

When to see a doctor

When you are recovering from delivery, it is best to err on the side of caution if you feel that something is not right with you or with the baby. You should expect to have some discomfort as you heal. You should not begin to feel worse.

In general, if you have any of these postpartum symptoms, call your doctor.

  • Heavy vaginal bleeding that soaks more than one pad per hour or vaginal bleeding that increases each day instead of decreasing
  • Passing large clots (bigger than a quarter)
  • Chills and/or a fever of more than 100.4°F
  • Fainting or dizziness
  • Changes to your vision or a severe headache (persistent)
  • Painful urination or difficulty urinating
  • Vaginal discharge with a strong odor
  • Heart palpitations, chest pain or difficulty breathing
  • Vomiting
  • Incision from C-section or episiotomy is red, weepy (with pus), or swollen
  • Abdominal (lower belly) pain that is getting worse or new abdominal pain
  • Sore breasts that are red or feel hot to the touch
  • Pain in your legs with redness or swelling.

 Questions to ask your doctor

  • How long until I will feel like myself again?
  • Why am I still retaining water?
  • How many calories should I eat while I’m breastfeeding?
  • When can I begin exercising?
  • How long should I wait before having sex again?
  • Can I get pregnant while I’m breastfeeding?
  • Why is my hair falling out?
  • Are there foods I shouldn’t eat while breastfeeding?
  • Why aren’t I losing weight?
  • What are my options for birth control?
  • Will my breasts go back to normal?
  • Why do I have no interest in sex?

Resources

Centers for Disease Control and Prevention (CDC), Depression Among Women

National Institutes of Health (NIH): MedlinePlus, Postpartum Care

Postpartum Support International

U.S. Department of Health and Human Services: Womenshealth.gov, Pregnancy: Recovering from Birth