What to expect postpartum

Your recovery — like your pregnancy — is unique to you. There isn’t a one-size-fits-all timeline to postpartum. But there’s a general timeline of what you can expect.

Some of the things you can expect in the hours and days immediately after birth are:

• Your uterus needs to shrink back to its usual size

  • This causes cramps and vaginal bleeding. Your provider may even massage your uterus through your belly to help it get smaller

• Hormonal shifts

  • This can cause symptoms like hot flashes, changes to your mood and headaches

• Breast engorgement

  • Your breasts will produce milk, and even if you choose not to breastfeed, you’ll have painful and swollen breasts

• Perineal soreness

  • It’s normal to have pain in the space between your vagina and anus (butthole) if you gave birth vaginally. Up to 70% of people have some degree of vaginal tearing during childbirth.

  • People who have a C-section will feel extra sore around the incision site for a few days

• Swelling from extra fluids.

  • This is typically normal and your body’s way of getting rid of fluid you accumulate during pregnancy. Your swelling should go down within a week.

  • When swelling comes with symptoms like chest pain and trouble breathing, it could be a sign of something more serious.

• Fatigue.

  • Labor, childbirth and caring for a newborn may introduce you to a new level of exhaustion. Feeling tired for the days and weeks after you give birth is very normal.

  • Trying to rest as much as you can whenever possible will help you feel better.

Postpartum physical symptoms:

• Soreness and pain in your perineum:

  • Your perineum is the space between your vagina and anus. This area stretches, and sometimes tears, during vaginal childbirth. Your entire perineal area may be sore, swollen and tender for weeks after childbirth.

  • Sitting on a pillow, squirting warm water to rinse the area and using a cold sanitary pad are ways to help with this discomfort.

• Vaginal discharge:

  • Lochia is the name for the vaginal bleeding you’ll have after giving birth (even if you had a C-section). It begins red and tapers off to brown before it ends as a light brown discharge.

  • This entire process can last up to six weeks.

  • Remember, wear a pad to catch vaginal bleeding after childbirth (no tampons).

• Uterus involution:

  • This is the medical term for your uterus shrinking back to its pre-pregnancy size.

  • The entire process can take up to six weeks, but it begins almost immediately after your baby is born.

  • You can also expect to feel afterbirth pains (or strong cramps) while this happens. Most of the intense pains go away after a few days, but they can also feel more intense during breastfeeding.

• Breast engorgement and nipple pain:

  • You can expect swollen and painful breasts for at least a few days or longer (if you breastfeed). Some people need the help of a lactation consultant to help with painful symptoms of breastfeeding like cracked nipples.

• Sweating:

  • Your hormones shift dramatically almost immediately after you give birth. It’s common to sweat more, especially at night.

  • It’s a normal symptom that should subside within a week or two.

• Constipation:

  • Being unable to poop after childbirth is a normal symptom in the postpartum period.

  • If you had an epidural, this can slow down your bowels and make it harder to poop. Sometimes, the fear of pushing to poop leads to constipation.

  • Some healthcare providers recommend stool softeners after you give birth to help.

  • Hemorrhoids are also common in the postpartum period.

• C-section recovery:

  • If you have stitches due to a C-section, your skin will take up to 10 days to heal. The deeper stitches can take up to 12 weeks to heal completely.

  • Watch for signs of infection like pus seeping from the incision or having a fever.

• Hair loss:

  • Losing your hair is a common occurrence in the postpartum period, mostly due to hormones.

Postpartum emotional symptoms:

• Baby blues:

  • Baby blues is feeling sad and teary after giving birth. While these new feelings can take you by surprise, they tend to go away after a few weeks.

• Postpartum depression:

  • This is a type of depression that causes extreme sadness and despair in the weeks and months after childbirth.

  • Unlike the baby blues, this doesn’t go away and often involves treatment with medication or behavioral therapy.

• Postpartum anxiety:

  • Excessive worrying that occurs after having a baby is called postpartum anxiety. It can be accompanied by physical symptoms like losing sleep or heart palpitations.

  • Postpartum depression and postpartum anxiety can often come together. Treatment for postpartum anxiety can also involve medication or behavioral therapy.

• Weight loss:

  • Your body went through lots of changes during pregnancy and childbirth. It’s common to have loose skin and stretch marks, and stress about extra weight around your hips or belly. Try to relax and give yourself time to recover.

  • You’ll lose between 10 and 20 pounds before you leave the hospital.

  • Focus on eating nutritious foods and taking care of yourself. Remember that your body has just been through a lot.

There are three stages of postpartum:

1. Acute phase:

   1. This is the first six to 12 hours after you give birth. You’re most likely to experience conditions like eclampsia, postpartum hemorrhage and certain medical emergencies during this time. Your care will include things like your provider monitoring your blood pressure, heart rate and bleeding, and checking you for excess swelling.

2. Subacute phase:

   1. This phase begins around 24 hours after birth and lasts for about two to six weeks. Your body is still changing, but you’re less likely to experience a medical emergency. Some of the concerns your provider may have during this period include cardiomyopathy, postpartum depression and symptoms related to urinary incontinence.

3. Delayed phase:

   1. This phase lasts from about six weeks postpartum until six months postpartum. Changes during this phase are gradual and mainly consist of your muscles and tissues returning to their pre-pregnancy state. Your healthcare provider may treat you for conditions like pelvic floor dysfunction, painful sex and uterine prolapse in the delayed phase.

Serious postpartum complications:

• Postpartum hemorrhage.

• Postpartum preeclampsia.

• Deep vein thrombosis (DVT).

• Pulmonary embolism.

• Mental health conditions like postpartum rage or postpartum psychosis.

• Sepsis.

When should I contact my healthcare provider?

• Heavy vaginal bleeding. This generally means you’re filling a pad every hour for several hours. It can also mean that you’re bleeding more each day instead of bleeding less.

• Passing several large clots. A large clot is typically anything larger than a quarter. Passing one large clot is OK, but passing many could be a sign of a problem.

• Fever higher than 101 degrees Fahrenheit (38 degrees Celsius).

• New pains or an increase in pain. You should generally feel better over time, not worse.

• Foul-smelling vaginal discharge.

• Pain in your legs or ankles, especially with swelling.

• Leaking pus or bloody discharge from your C-section incision.

• Dizziness or changes to your vision.

• Severe and persistent headaches.

• Chest pains or shortness of breath.

Read full article at:

https://my.clevelandclinic.org/health/articles/postpartum