the first 6 Weeks
Week One
The first week postpartum is the most intense because there are so many changes to your lifestyle, mind and body. You are pregnant for almost 10 months and in a matter of minutes you suddenly become not pregnant. The physical recovery from that begins almost immediately after you birth your placenta. The bleeding in the initial hours and days after birth will be heavier than a normal period. You should expect some clotting, but if clots are larger than a plum should be cause for concern. Your internal organs will begin to shift and move back into their pre-pregnancy positions. Your may feel contractions as your uterus begins to shrink down to it's pre-pregnancy size, it was about 1000x its normal size.
Your breast milk will begin to mature anywhere from 2-5 days postpartum. You are already producing the first milk your baby will need which is called colostrum. When your milk begins to mature, it might be painful initially and you can also experience some leaking and engorgement as your milk supply regulates. Your nipples might also be a little sore as you and your baby learn to breastfeed.
The postpartum hormonal changes are most significant in the first week. Estrogen and progesterone levels drop off, and prolactin and oxytocin levels rise and fall throughout the day as you feed your baby. It's normal to feel a wide range of emotions as you transition into parenthood and get to know your new baby. These hormonal changes can lead to the baby blues which are frequently experienced within one to two weeks after birth.
Week Two
Most of the vaginal and perineum pain should subside by the second week postpartum. Bleeding should also begin to decrease. Talk to your doctor if your bleeding does not decrease or begins to increase after it was initially decreasing. Your perineum may start to itch as tears and episiotomies heal, you can use a perineum spray to ease the itching.
Your milk will fully mature by 10-15 days postpartum. As your supply regulates you might still experience leaking & engorgement, hand expressing can help reduce pain and won’t increase your milk supply. Your nipples should start to feel less tender, but use a nipple cream or ointment if they are still sore. Feeding on demand, even overnight, will help your supply regulate.
Hormonal changes can lead to hot-flashes, excessive sweating and mood swings. Irritability, sadness and tiredness are all normal feelings. Your mood might fluctuate between these and other emotions. If you are feeling depressed, anxious and/or have thoughts of harming yourself or your baby call a doctor immediately, this is a sign of a postpartum mood disorder.
Weeks Three & Four
You may start feeling a bit more like yourself but it’s important to keep in mind that your body is still healing, your uterus is still shrinking and your organs are still moving back into place. Crying easily or feeling weepy is normal as your hormones begin to level out. If you are feeling up for it and your healthcare provider signs off you can begin to incorporate light exercise, like walking into your day. It is perfectly ok if you don’t feel ready, continue taking time to rest and let your body heal.
Breastfeeding should be pretty well established. If you are experiencing pain or slow weight gain (for your baby) reach out to a lactation consultant, postpartum doula or breastfeeding coach. These professionals can help you determine the best course of action for you and your baby. Your bleeding should be subsiding, however it can continue for up to 6 weeks. If you are still passing large clots, call your healthcare provider.
Weeks Five & Six
Typically, the uterus returns back to its original size by six weeks postpartum. Bleeding should stop by about six weeks as well. With your providers permission, you can resume more physical activity including sex. Don’t feel pressure to jump right back in the sack, some women don’t feel mentally ready for sex until much later. If you do engage in sex and it is painful or uncomfortable, consider reaching out to a pelvic floor therapist to discuss your options and find a therapy that will work for you. A pelvic floor therapist can also help you if you had any form of pelvic floor prolapse or issues with leaking.
At this point it is normal to feel exhausted and overwhelmed, life with a newborn is not a walk in the park! Deeper feelings of resentment, despair and sadness should be talked about with a healthcare professional, these can be a sign of a postpartum mood disorder. Your body may not go back to its pre-pregnancy size right away and that’s ok. Your hips and ribs shift during pregnancy and don’t really return back to “normal”. Your body just went through the ringer. Give it some grace. Remember to take care of yourself and your new baby first during this time.
Week Seven & beyond
Hair loss can begin to show around three months postpartum. To manage your hair loss you could change up the cut or style and keep your hair moisturized. Hair loss should ease up around 6 months to a year postpartum. You might start feeling “back to normal” around 8 weeks postpartum, but don’t be alarmed if your body doesn’t feel the same. It can take a few months and even up to a year for you to feel “back to normal.” Keep in mind that having a baby is a life changing event, you might not feel like your pre-pregnancy self again but you will also evolve into a new person.
Your menstrual cycle can return at any point postpartum, even if you are exclusively breastfeeding. Breastfeeding is not an effective form of birth control. Even if you haven’t gotten your cycles back, you can get pregnant. If you are not looking to get pregnant, consider starting a form of birth control or natural family planning; talk to your provider about your options.
To learn more about how to plan for your postpartum, download my FREE guide: The Third Trimester Checklist.
6 tips:
Rest for at least the first two weeks
Call in your support team to help with chores or cooking
If your bleeding increases its an indication that you need to slow down
Find breastfeeding resources in your community before you give birth
Feelings of despair and resentment or thoughts of harming yourself or your baby should be taken seriously
Go easy on yourself, your body and your newborn