Flore Alardo SmitHave you ever wondered what postpartum actually meant? And what to expect during postpartum?Well, the postpartum period, often referred to as the “fourth trimester,” corresponds to the period immediately following childbirth. Although opinions differ on its duration, it usually encompasses the first weeks and months post birth. It is a time of immense physical, emotional, and psychological adjustments for new mothers, a journey paved with a multitude of changes and challenges, each demanding their own unique care and attention.
Pregnant women often focus on preparing for childbirth. Yet the challenges arising in new motherhood, once the baby is born, require just as much, if not more attention. As a future mother, being well informed and prepared can make a great difference.
In this short guide, we’ll share what happens during postpartum from a physical, physiological & emotional standpoint, so you can navigate new motherhood knowing what to expect:
- Breast Engorgement and Milk Production
- Perineal Pain: Healing from Childbirth
- Uterus Involution: The Uterus Contracting
- Lochia: The Post-Birth Bleeding
- Digestive Issues: Constipation and Hemorrhoids
- Urinary Incontinence and Pelvic Floor Rehabilitation
- Baby Blues and Postpartum Depression: The Emotional Rollercoaster
- Battling Exhaustion
- Libido and Resuming Intimacy
- Weight Loss and Body Changes
- Hair Loss and Skin Changes
- Menstruation, Fertility & Birth Control
- Hypersudation: Excessive Sweating
- The “Golden Month” Tradition
1. Breast Engorgement and Milk Production
One of the early experiences to expect during postpartum is the initiation of milk production, known as the “let down reflex.” Typically occurring within the first few days after childbirth, it often involves engorged and tender breasts. Although this process can be uncomfortable, it is essential for nourishing the newborn if you choose to breastfeed. It will last approximately 48h and have different ways to express itself. You may even experience some fever (38*C) and swollen lymph nodes, even under the armpit.
Tip: to relieve the pain, you can use warm or frozen towels. The warmth will soften the breast and the cold will relieve the pain.
2. Perineal Pain: Healing from Childbirth
Following a vaginal birth, you may experience perineal discomfort and may have sutures from episiotomies or tears. To aid in healing, proper perineal care is crucial, including regular sitz baths and the use of over-the-counter pain relief medications. There again, frozen towels may be used.
With this in mind, know that postpartum edema is normal but will only last for a few hours.
A proper hygiene is also important: take a daily shower but do not use soap every time you go to the bathroom. Rinsing with water will have three advantages: keeps the area clean, relieves the pain caused by the acidity of urine and possible stitches.
Tip: a post-birth wash bottle or peri-bottle can be very handy.
3. Uterus involution: The Uterus Contracting
During pregnancy, your uterus (womb) goes through major changes and expands significantly to leave room for the growing baby. After childbirth, it returns to the way it was before pregnancy: this process is called uterine involution. It translates into the uterus contracting and often resulting in cramping pain and discomfort. This process of uterus involution starts right after childbirth and usually last about 6 weeks. Moreover, the uterus may shrink more rapidly if you breastfeeding.
4. Lochia: The Post-Birth Bleeding
Every woman bleeds after childbirth, and this is something you should definitely expect during postpartum. Lochia, or postpartum bleeding, is actually a mix of blood, mucus and uterine tissue. It lasts for several weeks, usually between 4 and 6 weeks and sometimes up to 12 weeks, transitioning from bright red to pink and then yellow or white in color. If they smell bad, you need to call your midwife or GP. It could be a sign of uterine infection (endometritis).
Tip: it is recommended to use maternity pads rather than menstrual pads as they are more absorbent and provide less irritation.
5. Digestive Issues: Constipation and Hemorrhoids
Constipation is not uncommon due to hormonal changes, medications, and the physical toll of childbirth. Some women may also have some apprehensions regarding their first poop after childbirth, whether because of the tenderness of the perineal zone or because they fear the stitches from the c-section may open.
On average, the first bowel movement happens 3 to 5 days after giving birth. But each postpartum period is different and it could also happen before or after.
Hemorrhoids can also be a painful issue for some women.
Tip: High-fiber diets, eating prunes, and staying hydrated can help alleviate constipation, and over-the-counter treatments (magnesium, laxatives, creams…) are available for hemorrhoid relief and constipation.
6. Urinary Incontinence and Pelvic Floor Rehabilitation
Right after childbirth, you may experience temporary incontinence, especially if you had an epidural, a long labor, perineal episiotomy/ tears or forceps. You may just stand up and lose a bit of urine. This can be quite distressing. Don´t worry, it’s not going to last.
Indeed, after childbirth, the muscles and nerves of the pelvic floor can be stretched or torn, which may temporarily affect their function. The recovery of these muscles and nerves can vary from one person to another, from a few hours to a few days.
Perineal muscles are also weakened because of the pregnancy. Indeed, the baby’s weight is on the perineum for a long time. You may lose a bit of urine when you laugh, cough, sneeze, stand, run… or when your bladder is too full. This will require pelvic floor rehabilitation exercises to help strengthen and restore muscle function. Exercises such as Kegel exercises can be useful for strengthening the pelvic floor muscles.
Consult a healthcare professional, such as a physical therapist specializing in pelvic floor rehabilitation, for specific guidance on how to recover more quickly and restore pelvic floor muscle function. If you experience any issues of incontinence or pelvic floor dysfunction, it’s important to report them to a healthcare professional, as appropriate treatment can expedite recovery and improve quality of life after childbirth. You need to talk about it with your GP and he / she will refer you to a fysio.
In some countries like France for example, midwives provide this kind of service, even before you experience any urinary loss, for preventive purposes. Indeed, this complaint can occur long after childbirth, for example during menopause.
7. Baby Blues and Postpartum Depression: The Emotional Rollercoaster
Postpartum emotional changes vary widely. Many women experience “baby blues,” characterized by mood swings, tearfulness, and irritability. This usually starts a few days after the childbirth and resolves within a few weeks.
Postpartum depression however is a more severe and persistent condition, impacting a mother’s daily life. It’s crucial to seek professional help if the symptoms are severe or prolonged. These symptoms include:
- profound and persistent sadness
- frequent mood swings and irritability
- excessive anxiety or worry
- extreme fatigue and lack of energy
- significant changes in appetite
- difficulty sleeping, even when the baby is asleep
- loss of interest in daily activities
- a sense of hopelessness and despair
- difficulty bonding with the baby
- thoughts of self-harm or suicide
8. Battling Exhaustion
The birth of a baby can be an overwhelming experience, and sleep deprivation is often a significant factor contributing to postpartum exhaustion. As a new mom, accepting or seeking help from friends, family or professionals can help you when sleep deprivation becomes an issue that affects your life and wellbeing.
If you don’t feel like it, do not feel guilty for avoiding unnecessary or stressful visits. Do not hesitate to decline or postpone them, and to only accept those that are beneficial to you, such as people who can assist with grocery shopping, some housekeeping, or taking care of the baby while you rest. This is an aspect of postpartum that your partner/ co-parent can help organize.
9. Libido and Resuming Intimacy
It’s important to remember that resuming sexual activity is a personal journey, and there’s no set timeline for it. You may feel apprehensive or encounter discomfort due to hormonal shifts, fatigue, or other physical challenges. Open communication with your partner is essential during this phase.
Intimacy also doesn’t have to be sexual. Find your own path with your partner, or don’t. There is no wrong or right.
10. Weight Loss and Body Changes
Postpartum weight loss varies among women. While some may shed pounds quickly, others may struggle with it. But as your uterus contracts back to its pre-pregnancy size, it is perfectly normal for your body and belly to not instantly snap back to their original shape and size.
Prioritizing a balanced diet and doing some light exercise, while being patient and compassionate towards your body can contribute to overall well-being. Your body has been doing an amazing work so it’s ok to give yourself some grace and time for recovery.
11. Hair Loss and Skin Changes
Postpartum hair loss is a common occurrence during postpartum, resulting from hormonal fluctuations. It may occur around 3 months after childbirth. You can start some vitamins to prevent it. Make sure it is compatible with breastfeeding if needed.
Many new mothers also experience skin changes, such as acne or pigmentation. A balanced skincare routine and consulting a dermatologist if needed can help manage these changes.
12. Menstruation, Fertility & Birth Control
The timing of the return of menstruation varies. You may experience it within a few months postpartum, or you may not menstruate until you cease breastfeeding.
But keep in mind: you can get pregnant again even before your menstruation. Ovulation typically precedes menstruation by about two weeks. It’s crucial to discuss contraceptive options with a healthcare provider if you’re not ready for another pregnancy.
Here are your options regarding birth control:
1. Hormonal birth control :
- the pill:
- Combined Oral Contraceptive Pill (COC): This pill contains both progestin and estrogen hormones, inhibiting ovulation and thickening cervical mucus to prevent pregnancy. This is not an option during breastfeeding nor immediate post partum
- Progestin-Only Contraceptive Pill (POP): This pill, often referred to as the “mini pill,” contains only progestin hormones, working by thickening cervical mucus and altering the uterine lining to prevent fertilization. This is an option during post partum.
- intra-uterine device (IUD): disposable a few weeks after childbirth, it contains only progestin.
- other devices: the ring, patch… are like COC (progestin and estrogen), therefore are no option during post partum period.
2. Non-hormonal birth control :
- copper intra-uterine device: also disposable a few weeks after childbirth, it has no hormon, so your natural biological cycle will be on. It is a small, T-shaped device, inserted into the uterus by a healthcare provider. Copper is toxic to sperm and eggs. The presence of the Copper IUD may also change the uterine lining, making it less receptive to a fertilized egg.
- condom : the hormones during postpartum and breastfeeding period can lead to vaginal dryness. Using condom and lubricant can make the sexual intercourse more comfortable.
Natural contraception methods such as symptothermal tracking and cervical mucus analysis are not reliable during the postpartum period.
You can also discuss vasectomy (male sterilization procedure) or tubal ligation (female sterilization method) with your GP.
13. Hypersudation: Excessive Sweating
Excessive sweating is a temporary postpartum phenomenon caused by hormonal changes. Staying well-hydrated and wearing breathable clothing can help manage this issue.
14. The “Golden Month” Tradition
Many cultures celebrate the postpartum period as a “Golden Month,” a special time for the new mother to rest and recover. It involves specific dietary practices, self-care rituals, and social support to aid in the recovery process.
The postpartum journey is a unique and transformative time for new mothers. It encompasses a range of physical and emotional changes that demand attention, care, and understanding. Seeking support from professionals, friends, and family can make a great difference in ensuring a smoother transition into motherhood. Just remember that each woman’s experience is distinct but that each new mother goes similar challenges. Take care of yourself, let others also take care of you, and be gentle with yourself, you got this!
Browse through our selection of Postpartum Care Providers and get in touch now!
Want to get in touch or book an appointment now? Browse through our network of Postpartum Doulas and Postpartum Coaches, select the one who most closely meets your needs and get in touch or plan an appointment whenever suitable. If you have any questions, do not hesitate to reach out to our team at hello@parentally.nl. We are here to help!
Looking for other types of postpartum support? Discover our Breastfeeding support services, Postnatal massages & Belly Binding, Rebozo closing ceremonies, Postpartum Nutrition Support & Meal services,
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