An Overview of the Postpartum Healing Process
What happens to your body postpartum?
Every body, every pregnancy, and every birth is different from each other. Your body will go through many physical changes after birth, what you experience physically postpartum will probably be different than your sister or friend.
I didn't know what to expect to happen to my body after I gave birth to my first baby. Overall, things were pretty smooth, I didn’t tear during birth or have any medical complications postpartum. My postpartum bleeding was ok, though I know I overdid it some days when my bleeding would increase after subsiding a bit. I also experienced what I would classify as severe constipation for 8 months after birth, it seriously took a toll on my body. Don’t even get me started on hemorrhoids! I wish I had learned more about postpartum healing before I gave birth instead of learning about it through experience and then through my doula training.
Today, we're going to take a deep dive into postpartum healing. Trust me, you won't want to miss a word.
In this blog you’ll learn about:
6 major components of postpartum healing
How to manage your postpartum healing
When to seek out professional medical help postpartum
Lochia (or postpartum bleeding)
Lochia is what many people call postpartum bleeding. It is the result of the placenta detaching from the uterus and exiting your body after the birth of your baby. Lochia is made up of blood, placental tissue, mucous and endometrial lining. You may experience lochia for up to 8 weeks after giving birth. There are three stages of lochia:
The first stage lasts 3-5 days and has very heavy dark or bright red blood. You may pass some blood clots as well. If these clots are larger than the size of a golf ball, call your medical provider.
The second stage of lochia can last for about 2 weeks. Your bleeding will lighten in color and flow and you may still see some clots.
The third stage is the longest, lasting 2-6 weeks. It is also the lightest stage of bleeding. Your discharge will be a very light, pinkish color.
Many women choose to manage lochia with disposable pads and mesh underwear provided by the hospital. Some women chose to use disposable absorbent underwear as they feel it’s more comfortable. Others may choose a more sustainable route like period underwear and cloth pads. When choosing how you will manage your bleeding, avoid tampons and menstrual cups as these can increase your risk of developing an infection.
Perineal Tearing
Perineal tearing does not affect every woman. It is more likely to happen if you are coached through pushing or are given an episiotomy. Tearing may be prevented by daily massaging the perineum from 35 weeks onward or by using counterpressure during pushing. There are four degree classifications for perineal tearing.
First-degree tears are small superficial tears that affect only the skin of the perineum. They can typically heal on their own with no medical intervention.
Second-degree tearing affects the skin and muscle of the perineum, this will likely require stitching to repair and help the area heal.
Third and fourth-degree tears are the deepest. These tears affect the skin and muscles of the perineum and surrounding areas, like the anus. A third or fourth-degree tear will require stitches and in severe cases, the stitches may need to be placed in an operating room.
When you use the bathroom after birth, fill a peri-bottle with warm water and spray on the affected area to prevent stinging. If you need to defecate, you can hold a warm washcloth on your perineum over the stitches to provide counter pressure as you push. You can soothe the affected area using certain herbs or herbal blends in a sitz bath or perineal spray. For a more numbing sensation, use an over-the-counter numbing spray. Sometimes these items are provided by your hospital, so definitely ask your nurses if you think they may be helpful.
Postpartum Afterpains
As your uterus involutes and returns to its pre-pregnancy size, you may feel cramping called afterpains. These can be worse in subsequent births. The pain will often resolve itself within the first week or two postpartum. You can help manage the pain by using a heating pad, ingesting or bathing in certain herbs and herbal blends, or over-the-counter pain relief. Discuss any herbs or OTC medical treatments with your care provider.
Postpartum Constipation
Constipation is when you have infrequent or difficult bowel movements. It is a common pregnancy symptom, especially in the later trimesters. Many women are surprised to find that constipation can continue into postpartum. It is completely normal, however uncomfortable.
Some of the most common causes of constipation include fluctuation in hormones, hemorrhoids developed from pushing, painful tearing or an episiotomy site, use of IV fluids in labor, dehydration and lack of proper nutrition, and a decreased activity level.
Easing constipation can be as simple as changing your diet and increasing hydration. Warm, cooked foods are more easily digested, and drinking a variety of liquids like teas and bone broth in addition to water can increase hydration. In addition, you can try over-the-counter medicines like stool softeners, fiber gummies, or laxatives. Discuss any medical treatments with your care provider before starting them.
Postpartum Hemorrhoids
Hemorrhoids are swollen veins in your anus and lower rectum. They often present after birth due to the strain on your body while pushing during labor. They can also occur from the strain of pushing from constipation. Hemorrhoids can be especially painful when it comes to passing a bowel movement. Witch hazel pads can provide relief as well as an over-the-counter hemorrhoid cream.
C-section Incision Care
If you give birth via c-section, you will leave the hospital with a dressing or bandage over your incision. The hospital will provide you with instructions for care including how to clean and redress your incision and when to remove the bandage. Change the dressing over your incision once a day or sooner if it gets dirty or wet. Like any other wound, keep the incision area clean and dry. Use mild soap and water and don’t scrub the area. You can remove your dressing/bandages to shower with your medical provider's permission. Wear loose, comfortable clothes to avoid irritation, and take an OTC painkiller if your incision is sore. Watch out for signs of infection surrounding the wound, like red, sensitive skin or pus, and call your medical care provider with any questions or concerns.
Postpartum healing is not a one-size fits all process. Each woman may experience some or all of these healing processes. The most important thing to remember is to contact your medical care provider with any concerns or questions about your physical healing after birth. Talk to your doula or friends and family about what treatments they recommend (or don’t) for any of these healing processes.
Download my postpartum planning template to guide you in planning for your postpartum.