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The real deal on post-birth recovery

By Paula Ford-Martin

The days and weeks after birth are both exhilarating and exhausting. It’s a special time, getting to know your baby. But after the physical changes that being pregnant and giving birth bring, you need to recuperate. Helping your body return to normal — after 9 months of anything but — is a gradual process. It can be so gradual, in fact, that you may find yourself experiencing symptoms you had during pregnancy — even though you're no longer pregnant! Here’s what’s normal to experience once you return home, and how to manage it.

You’ll Be Tired

You’ve probably heard that you should “sleep when the baby sleeps.” There isn’t a better piece of advice for a new mom. In the early weeks when your baby is waking up for middle-of-the-night feedings, you’ll be sleep deprived. As tempting as it may be to take care of to-dos when the baby naps, use that time to get some rest yourself.

If you’ve had a C-section, take this suggestion even more seriously. A C-section is major abdominal surgery and you need plenty of downtime for your body to heal. Also, despite the temptation to do otherwise, listen to your doctor's advice about a gradual return to your everyday life: You’ll likely be advised to avoid lifting anything heavier than your baby for at least 8 weeks, so you don’t strain your incision. During the first 2 weeks post-delivery, your provider will advise you avoid driving a car (riding in one is fine, but always buckle your seat belt). Baths are prohibited for 6 weeks (showers are fine). If you have any questions or concerns, don't hesitate to contact your provider.

You’ll Need to Heal 

If you delivered vaginally, you’ll be sore in the day or two that follow delivery. If you’ve had stitches to repair tearing, you may be particularly sensitive. Numbing sprays and ointments, often provided by the hospital, can help. Gauze pads soaked in witch hazel (look at your neighborhood pharmacy or online for pads for hemorrhoid relief) are also effective for pain and itch relief, especially if you chill them in the fridge. If sitting for prolonged periods hurts, a pillow or foam donut (a round cushion with a hole in the center) can help ease discomfort. (Foam donuts can be purchased at medical supply stores and online.) 

You’ll Bleed and Have Discharge

Regardless of the way you delivered, you can expect postpartum bleeding, called lochia, that will potentially last for several weeks. “Bleeding is like a very heavy period,” describes Mary Rosser, MD, PhD, ob/gyn at Montefiore Medical Center in Scarsdale, NY. “Early on, it will be red, then the lochia will turn pinkish, and then a whitish color. It will take about 4 to 6 weeks to go away.”  

Rosser recommends the disposable panties sold at baby supply stores for the immediate postpartum period, if the hospital doesn’t send you home with some. Use them along with pads meant for heavy menstrual flow. She also cautions women not to be concerned if they pass blood clots, especially after resting. “If you sit or lay down, the blood will pool in your vagina and form a clot. This is perfectly normal.” 

What isn’t OK is excessive bleeding. Linda Burke-Galloway, MD, FACOG, author of The Smart Mother’s Guide to a Better Pregnancy, defines this as “going through more than one pad per hour with bright red bleeding. This is a medical emergency.”

You May Be Swollen

Swelling doesn’t always go away after birth. “In the last 3 to 4 weeks of pregnancy, women produce 1/2 liter of fluid each week. After the baby is born, they should lose this fluid — but sometimes, they retain it,” explains Burke-Galloway. Fluid, or water weight, should go down over the first postpartum week. If your legs or ankles remain very swollen after this time, call your provider for guidance. 

Your breasts will also be swollen, but for a very different reason: you’ve begun making milk to feed your little one. Be aware that they can become very firm and enlarged as your body adjusts; sometimes this is simply uncomfortable, while at other times it can be quite painful. Warm showers and releasing some of the milk by hand (called expressing) can help relieve the pressure.

You May Still Look a Little Bit Pregnant 

Weight is a big concern to many new moms. In a recent study from the Royal College of Midwives, 67% of women surveyed said that they were anxious about their postpartum weight. But it's normal to lose only some of the weight at first: on average, most women lose just 13 pounds at delivery and, following the birth, an additional 5 to 15 pounds in fluid and mass from your uterus (which takes about 6 weeks to shrink to pre-pregnancy size).

“Don’t try to force weight loss too rapidly, especially if you’re breastfeeding,” warns Burke-Galloway. Women who breastfeed need additional calories to feed themselves and their babies; talk to your provider or a registered dietitian about your specific needs. Bottom line: focus on taking good care of yourself, not the numbers on the scale. After all, you can only take care of that little bundle of joy who’s depending on you if you’re healthy yourself. 

You May Have Trouble with Your Bladder and Bowels

You’re probably already used to the constant potty breaks that come along with pregnancy. But did you know that nearly half of women have urinary dribbling or incontinence following childbirth? “The sensitivity is not as on point in that area as it usually is, and it takes a while for that to come back,” explains Rosser. “Try to start working Kegel exercises into your routine; they really do help.” Aim for 10 repetitions of these exercises, in which you tighten the muscles that control your urine, about 6 times a day. 

Post-delivery soreness might make you fearful to pass a bowel movement, too. Most women receive stool softeners in the hospital to lessen any pain associated with this. You can continue to take these at home. Eating high-fiber foods and drinking plenty of water will make bowel movements easier to pass.

Your Moods May Be Unpredictable

Exhaustion, hormonal changes, and stress cause many women to experience sadness after delivery, also known as the “baby blues.” These feelings should fade within the first few days or so after delivery. If they don’t, or if they interfere with your daily functioning, you may have postpartum depression (PPD). If you suspect PPD, call your doctor right away — don't try to “be strong,” figure it out on your own, or suffer in silence, as there are many treatments available.

In due time, all of you — from your emotions to your waistline — will get back in shape after pregnancy, especially if you take the needed time to heal.

Published on December 30, 2015.

Paula Ford-Martin has authored more than a dozen consumer health and parenting books, including the bestselling Everything Pregnancy Book, 4^th edition, and The Only Pregnancy Book You’ll Ever Need.