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Your Postpartum Timeline: What to Expect in the First 6 Weeks

October 9, 2023
Image Credit: Angela Roma

Whether you’ve heard a lot about what happens to your body and mind post-birth or not, it’s likely you haven’t heard when you will experience these side effects of pregnancy and delivery. Will they all occur immediately? Or maybe 10 days after giving birth.

We’re here to tell, but keep in mind that everyone’s pregnancy and birth experience is highly individualized. As such, so is the postpartum phase. With this lingering in the back of your brain as you read this article, know that you may not experience all or any of these symptoms; on the other hand, you may experience these symptoms much differently than most new moms do. Nevertheless, it is important to know not just what might happen to your body, but when.

Week 1:

Congratulations! You’ve had your baby, and you most likely have brought your little one home. Before rushing into thinking about all of the things you have to do, take a moment (or a few days) to just be. Breathe and take in all of the changes –your body and your mind will need it.

Physical State:

Vaginal Discharge: Whether you gave birth vaginally or by c-section, your uterus prepared itself to provide a warm and comforting womb for your child by lining itself with blood and tissues. This preparation, and the fact that you were pregnant, is the reason you haven’t had a period for 40 weeks (although you may have had some spotting). However, the cycle must continue and your period will return. First, you will experience vaginal discharge called lochia. Similar in appearance to a monthly cycle, this discharge will become lighter as time goes on rather than darker. Lochia can occur from a few weeks to up to a few months, so it will be important to stock up on your favorite sanitary pads.

Afterbirth Pains: Shortly after you give birth, your body responds by adjusting itself to not having to carry a baby anymore. Congruently with vaginal discharge, your uterus will begin to shrink to its normal size. The sensation you’ll experience while this happens may be similar to period or labor contractions. If you plan on breastfeeding, it’s important to realize that because nursing releases oxytocin (the same hormone that makes your uterus contract), you may feel the sensation more acutely. Taking pain medications can aid with any discomfort you may be experiencing.

Hemorrhoids and Bowel Movements: Let’s be real –there is a lot of pressure and movement happening in the vaginal area, but also the anal area as well. Especially during the third trimester as your baby becomes larger and blood flow to the pelvic area increases, the chances of hemorrhoids and constipation grow. After birth, the likelihood of abnormal bowel movement continues. You may experience severe constipation, accompanied by the anxiety of having a bowel movement after pushing for so long during labor and by the fear of tearing further. On the other hand, if the muscles were stretched during labor, having a bowel movement may not be a problem; but rather, an ongoing occurrence and trips to the bathroom. Either way, it will be important to get moving as soon as you can–even a short walk will help things to move in the right direction. Furthermore, eating a high fiber diet full of vegetables and fruits will help bowel movements stay regular.

+ If you had a vaginal delivery:

  • Incision Healing: If you gave birth vaginally, you may be experiencing a few things in week 1. There might be vaginal tearing or episiotomy incisions and stitches that may be tender or sore, which may take up to six weeks to completely heal. In the meantime, ask your doctor if you can start kegel exercises in order to strengthen your pelvic floor.
  • Perineal Pain: Giving birth vaginally can result in not only vaginal tears, but also perineum and anal tears. If this is the case, it is likely there will be swelling and discomfort. To combat this, applying cold packs or ‘padsicles,’ will sooth the heat and pain; sitting on pillows or cushioned chairs will provide comfort; and making your own sitz bath will help ease pain and tenderness. For those experiencing stinging sensations from any type of tear, there are numbing sprays available.

+ If you had a c-section:

  • Incision Healing: With a cesarean, the most visible (and possibly uncomfortable) effect your body will experience is the incision on your lower abdomen, which can take up to six weeks to heal. This area will likely be sore and possibly painful. As recommended, pain medications may help. Alongside this, try to get as much rest as you can, don’t move or lift anything heavier than the weight of your newborn, and stay hydrated.

Mental State:

Hormones: By day 3 post-birth, your estrogen and progesterone levels have dropped off, and oxytocin rises and falls if you plan on breastfeeding. The ‘birth buzz’ has begun to wear off and the reality of what just happened will likely begin to set in. Along with the change in hormones, it is likely you will be very exhausted from the hours upon hours of labor. You may also feel overwhelmed with all that has happened.

The Baby Blues: Post-birth, about 70-80% of new moms experience the baby blues. Feeling depressed, anxious, upset, wandering thoughts about motherhood and your worth, are all common feelings that typically start a few days after birth. These symptoms usually subside after a few days. If they continue, talk with your doctor as you may be susceptible to postpartum depression.

Week 2:

Your second week post-birth may be similar to the first week. Any incisions or tearing during your birth may still feel uncomfortable, but managed or alleviated by ice packs and pain medication. Though it has been 7 days, it is important to stay grounded in yourself — think about begin to entertain yourself with minimal tasks, but keep your eyes on the prize(s): you and your baby.

Physical State:

Swollen Breasts: Shortly after birth, and particularly in this week, your breasts will begin to fill with milk and may feel tender, hard, and swollen. If you decide to breastfeed, feeding your child will help with any discomfort you may have. If you are not breastfeeding, discomfort will continue until your body realizes that they are not being stimulated to produce more milk. At this point (about 10 days after giving birth), discomfort should begin to subside. In both cases, wear a supportive and comfortable bra, utilize ice packs for swelling, and if not breastfeeding, practice movements that don’t result in expressing any breast milk as this will signal to the brain to produce more.

Sore Nipples: Breastfeeding moms may come into combat with sore nipples. As soon as you give birth, it is crucial that to meet with a lactation consultant to ensure proper breastfeeding. Keep in mind that soreness, bleeding, or cracking may occur, especially if this is your first time breastfeeding. To remedy, ensure that your baby is latching on correctly and comfortably positioned, utilize your own milk as a moisturizer for cracked nipples as well as Lanolin or Vaseline, and allow your nipples to air dry after a feeding.

Mental State:

Baby Blues: If you’ve started experiencing the baby blues, it is likely that the sadness hasn’t gone away just yet. You may still be adjusting to your new routine of surviving on just a few hours of sleep, as well as physically recovering from a laborious procedure. Be sure to share what you are feeling to your partner, supporting figures in your life, or a therapist if you have one. You are not alone in feeling upset or discouraged after having a baby, but it is important to voice and be aware of your feelings before it develops into something that can significantly impact your health.

Week 3:

They say the third time’s the charm, so after 3 weeks with a new child, you may have developed some routine. However routine your days may be, adjusting to motherhood, experiencing possible changes in family dynamics, and continuing to recover from any physical ailments is still a lot for one to handle. In reality, the third week might be the hardest week postpartum, since everything seems to feel “normal,” but so much is happening at the same time. This being said, the third week will be an important week to focus on your mental health.

Postpartum Depression: After 3 weeks comprised of constant late nights, diaper changes, and feedings with a sore body, your body and your mind may start to significantly signal for help. Postpartum depression affects 10-15% of women during pregnancy and postpartum. If you think your mental health has developed past the baby blues, keep an eye out for these symptoms:

  • Feelings of guilt or low self worth
  • A loss of appetite or overeating
  • Panic attacks and/or general anxiety
  • A fear of touching your baby
  • Feeling overwhelmed, and feeling that you are unable to care for your baby
  • Having trouble sleeping
  • Having low energy and trouble getting out of bed in the morning
  • Thinking about suicide or harming yourself or your baby
  • Losing interest in activities you used to enjoy

These are very common symptoms of postpartum depression, and if you are feeling emotions and having thoughts similar to those above, you must reach out to your healthcare provider as soon as possible. Postpartum depression is nothing to think lightly of, and can come down hard on you during the third week postpartum. In this stage, it is important to remember that you’re not a bad mom, and that it’s not your fault — it’s more common than you think, and can be remediated with the proper diagnosis and help.

Week 4:

At this stage in the fourth trimester, it is likely that you have gained lots of progress with your physical healing. Of course, you may always need more time to completely heal as everyone’s bodies are different–and that is more than okay! After four weeks, it may be time to begin light exercise again, but be sure to consult your doctor before you do so, especially if you had a cesarean section.

Fatigue: Late night cluster feedings, and consistently having to fall back asleep may result in severe fatigue. As this becomes your new ‘normal’, you may realize that it is all catching up to you, physically and mentally. While you may feel protective of your time with your little one, don’t hesitate to reach out to friends and family if you need a little break for a while–as this will help you recover, rest, and be able to be attentive to your baby. Alongside this, to combat fatigue, consider sleeping when your baby sleeps, don’t overdo the chores you have to do around the house–they can wait, limit visits with loved ones in order to save some of that necessary energy, and ensure that you are eating nutritious meals daily.

Week 5:

By week 5, you are likely still recovering and healing from giving birth. but probably noticing that your stitches and incisions will feel a lot better. Your bowel movements are likely to be normal, and you may not be experiencing lochia or afterbirth contractions anymore. As you begin to get a sense for this new cycle in your life, an old cycle may be returning.

Menstruation: Say “Hello” again to your favorite monthly visitor! Yep, that’s right, it’s about time that your period returns. Though it’s estimated that your cycle return around week 5, it also isn’t guaranteed that it will. For instance, if you are breastfeeding, it could be possible that you won’t resume your monthlies until your baby has been weaned off of your milk. This is due to menstrual hormones being inhibited during breastfeeding. If you are not breastfeeding, your periods may resume between this point to eight weeks postpartum. Alongside the randomized return, your periods are likely to be different than they were before you became pregnant. For some, they may be lighter, and for others, they may be heavier with cramps that are harder to bear. In any case, listen to your body, and seek out medical care if anything seems out of the ordinary.

Week 6:

A month and a half into parenthood! You may start to feel comfortable with yourself and role as a parent. Your uterus should be back to its pre-pregnancy size, and scars should be healed, albeit a bit itchy. You may have your routine down pat, sleeping more frequently (and for longer, too), and even feeling content– just in time to rekindle the romance with your partner.

Sex: At six weeks, healthcare providers say that it is usually okay to resume sexual activity if you so wish. Now, you may or may not be interested and you also might just be intimidated, possibly scared. The most important thing to do as you revive intimacy with your partner is to keep communication open and clear. Don’t do anything you don’t want to, but also be assured that amidst the world of parenthood, the relationship you have with your partner outside of parenthood is as strong as ever, whether that be through sex, an intimate conversation or cuddle session, or just sitting around and watching a movie together. Whatever it may be, be sure to find time for the both of you.

Week 6+:

After six weeks, it’s time for your first postpartum checkup. They will verify with you that all scarring and tears have been properly healed and your uterus is back to the normal size, and that everything is running smoothly as it should. To make the most of this appointment, try to write down anything that has been concerning you and be sure that you ask all the questions that come to mind regarding your postpartum recovery. Remember, this appointment is just as much for you as it is for your newborn!

Because postpartum recovery is unique to you and your experience, our timeline can be used as general guideposts to help you navigate what’s to come. Our last word?: whatever your recovery journey may look like, know that it is important to take care of your physical and mental health above all impending deadlines and chores. Prioritize you, and give yourself the time and the care to bounce back as the amazing mama you were made to be.

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