Overview of the Postpartum Period

Postpartum refers to the time period after you have a baby. It's usually considered the first 6 weeks after delivery.

The following are what you can expect your body to be like after delivering your baby:

• Your vagina will be sore until the tissue heals, and it may sting when you pee
• You'll have a discharge from your vagina for up to 6 weeks
• Your breasts will swell up as they begin to make milk and may feel tight and sore
• It's common to be a little sad or anxious in the first week or two, but see your doctor if you feel really depressed—you may have postpartum depression
• You may have cramps as your womb (uterus) shrinks back to its normal size over about 2 weeks
• Even if you exercise, it may take several months for your belly to go back to its normal size
• It may take longer to get back to your normal weight
• Stretch marks don't go away, but they fade over time

For the first 3 or 4 days the discharge from your vagina is bloody, sometimes with blood clots. Then the discharge becomes pale brown, then yellow or white.

You'll usually see your doctor 6 weeks after giving birth unless you're having problems and need to see your doctor earlier.

The most common problems during the postdelivery period are:

• Bleeding
• Infections
• Trouble breastfeeding (including breast infections )
• Postpartum depression

What happens right after I deliver?

Right after delivery , doctors and nurses keep a close eye on you for a few hours to make sure you're not bleeding too much.

To keep you from bleeding too much, doctors may:

• Press on your belly to help your womb (uterus) shrink

If you lose a lot of blood, doctors will give you IV fluids and sometimes a blood transfusion.

You can start eating normally shortly after delivery.

Immediately after delivery you may not feel the need to pee even though your bladder is full, so:

• You'll be asked to pee regularly
• Nurses may press on your belly to help empty your bladder
• If you can’t pee and your bladder is full, a nurse may put a catheter (a thin, flexible tube) into your bladder for a minute to drain your urine

You may be constipated after delivery, especially if you got an opioid pain medicine. Your doctor may suggest laxatives or stool softeners.

You may also need certain vaccines after delivery:

• Rubella vaccine , if you’ve never had it
• Diphtheria-tetanus-pertussis vaccine (Tdap)
• Rh factor if your blood type is negative and the baby’s is positive (a problem called Rh incompatibility )

When can I go home?

If you and your baby are both healthy, you usually leave:

• Within a day or two after a vaginal delivery
• Within 4 days after a cesarean delivery (c-section)

How soon can I exercise?

After delivery, you should get up and walk around as soon as you can.

• If you had a vaginal delivery, you can start gentle exercise when you feel up to it, but don't do your full pre-pregnancy exercise routines until your doctor says it's okay
• If you have a c-section, it takes about 6 weeks to fully recover and heal, and you shouldn't exercise at all until your doctor says it's okay

What should I expect as my body heals from delivery?

If you had a vaginal delivery, it's normal for your vaginal area to feel sore. Passing urine may sting. Try the following:

• Apply ice or cold packs for the first 24 hours after delivery
• Use numbing creams or sprays
• Wash the area with warm water a few times a day
• Sit in a warm shallow bath (sitz bath)
• Sit on a donut-shaped pillow

If you had a c-section:

• Call your doctor if your wound becomes red or starts to drain fluid
• You can shower after about a day but don't take a bath until the stitches are removed
• Be careful with your stitches—don't scrub over them in the shower
• Don't put anything (including tampons) in your vagina for at least 2 weeks
• Avoid heavy lifting and hard activity for about 6 weeks
• Avoid sex for about 6 weeks

With either type of delivery, you'll have discharge (fluid) from your vagina for several weeks:

• Bloody fluid for 3 to 4 days
• Pale brown fluid for about 2 weeks
• Yellowish white fluid for up to about 6 weeks after delivery

Vaginal bleeding may actually increase for a few days about a week or two after delivery. That bleeding is normal. It comes when the scab where the placenta was attached in your uterus falls off. You can use sanitary pads.

Hemorrhoids

Hemorrhoids are swollen veins in the wall of your rectum and anus.

Pushing during delivery can cause or worsen hemorrhoids. Pain from hemorrhoids can be relieved by:

• Warm sitz baths
• Applying a gel with pain medicine in it

Breastfeeding

Breastfeeding is healthy for both you and your baby.

If you choose to breastfeed, doctors recommend you feed your baby only breast milk for the first 6 months, then breast milk and food for the next 6 months. After a year, you can continue breastfeeding until you or your baby is ready to stop.

To help with nipple soreness and cracking:

• Help your baby latch onto your nipple so the baby's bottom lip isn't sucked in while feeding
• To reposition your baby, gently ease your baby’s lip out with your thumb or slide a finger into the baby’s mouth to break suction and then try latching again
• Use cotton pads, if needed, to absorb leaking milk

Take good care of yourself while breastfeeding:

• Drink plenty of fluids
• Eat about 500 extra calories each day (make sure the extra calories are from fruits, vegetables, and a good source of protein)
• If you're on a special diet, such as a vegetarian or vegan diet, talk with your doctor about how to have a healthy diet while breastfeeding

When is it okay to have sex?

You can resume intercourse when you feel ready and any lacerations or surgical incisions have healed.

Most women delay intercourse for 6 weeks after giving birth until they're fully healed. This may take longer if:

• You have a c-section
• Your delivery caused tearing
• You had an episiotomy (a small cut in the vaginal area made by your doctor to widen the opening)

Birth control

It's possible to get pregnant again soon after giving birth. Women who breastfeed are less likely to get pregnant right away. But some women can get pregnant in just a few weeks even when they breastfeed.

It takes a year or two for your body to fully recover from pregnancy. Doctors recommend you wait at least 6 months, but preferably 18 months, before getting pregnant again.

Birth control pills with estrogen can't be used while breastfeeding. You must wait 4 to 6 weeks to have an IUD (intrauterine device ) put in your uterus and 6 to 8 weeks to be fitted for a diaphragm . Talk to your doctor about which birth control is right for you.

What are warning signs of problems after delivery?

If you have any of the following symptoms, call your doctor right away:

• Heavy bleeding (soaking through a pad every hour for more than 2 hours)
• Passing blood clots larger than a golf ball
• Bad-smelling discharge
• Fever
• Belly or chest pain
• Pain while peeing, trouble emptying your bladder, or needing to pee very often
• A hard lump in your breast
• Breast pain, redness, and swelling
• Pain or discharge around your c-section incision
• Shortness of breath
• Leg pain
• Extreme sadness, tiredness, or trouble caring for yourself or your baby

These could be the sign of a postpartum infection or other serious problem.