Postpartum Recovery
Doctor Explains What to Expect After Labour
Congratulations, you’ve welcomed a little miracle into the world, but what comes next? In this article I discuss the post-partum period and what to expect over the next 6 weeks following delivery.
Whether you’ve had a vaginal delivery or c-section, your body is about to undergo some major changes, both physical and psychological.
After Birth Pains
These are pains that occur following the birth of your baby. They represent the womb, or the uterus, shrinking back to its pre-pregnancy state. The uterus is a muscle which has expanded throughout your pregnancy to accomodate your little one. Now that your little one is earth side, the uterus needs to contract back to its normal size. This process is called uterine involution. This occurs with the help of hormones, in particular oxytocin. Oxytocin during labour helped the uterus contract to aid with delivery. Following birth it is still released and one of it’s functions is to continue contracting the uterus. Oxytocin is also released if you choose to breast feed. Therefore you might experience the uterus contract each time you feed. It is thought that those who breast feed go through uterine involution faster.
The pain itself is often described as mini contractions or a feeling of a muscle being squeezed tight. Generally speaking for the first pregnancy, these pains may be non existent or short lived. However, as the number of pregnancies you have increases, so does the pain. The pain itself can last anywhere from a few days to a few weeks. It is important to check that your symptoms are not related to anything else, for example, an infection, as often this can present as pelvic pain with associated fever and or discharge. So make sure you always get an individual assessment from an adequately qualified healthcare practitioner.
Sweats
Aside from the uterus involuting, hormonal shifts are also responsible for sweats. These can occur in the day, but during the night they can be much greater. At night time, you may find yourself in a puddle of sweat and it can be very uncomfortable as you may have to change your sheets and clothing. The good news, however, is that these sweats are short lived and should only last a few weeks whilst your hormones are going back to normal. Some people choose to sleep on towels to avoid changing their sheets regularly but it’s useful to sleep in cotton, or breathable clothing for your own comfort.
Breast Changes
As you can see, there are a lot of hormonal changes that occur in the postpartum period. This can also include the change in appearances of the breasts. During pregnancy, the breast size increases to accomodate for possible lactation (breast feeding), the colour of the areolar also darkens helping your newborn to see the nipple (think of a target), as their vision is not yet fully developed. Breast changes continue in the postpartum period.
Should you choose to breast feed, the milk producing cells in the breast increase in size and the breasts feel heavier. Typically, straight after birth the breast milk is not yet mature. You will only be producing small quantities of colostrum — which is a very rich substance packed with essential nutrition for your newborn. The newborn stomach is very small after delivery and so their milk requirements reflect this. However as they grow, so do their stomach sizes and hence their need for more milk. We refer to ‘milk coming in’ as the change from colostrum to breast milk. This typically happens around 2–5 days postpartum and can be associated with a larger breast size and some discomfort. Breast milk tends to be established by about 4 weeks after birth.
If you are not breast feeding your child, the breasts may feel full, or you may have some leakage from the breasts for a day or two. As breast feeding works on a supply — demand method, if your newborn is not suckling then no breast milk will be made and soon the symptoms should settle down.
Bowel Motions
Thanks to the hormonal shifts, bowel motions may also be slightly altered. It could be that you are either constipated or you may have diarrhoea. If you have given birth vaginally, then sometimes haemorrhoids can occur. These are dilated vessels at the anus which can be painful and sore and can sometimes bleed. If you are experiencing any bleeding from the back passage it is vital to have this checked out by your own medical doctor.
If you are constipated in the postpartum period, then it is really important to manage this well. By drinking plenty of water and eating fibre, your stool should be softer. Often you may need additional help with a laxative, which your doctor may advise you to do. These measures will help to avoid any flare ups of haemorrhoids or any new haemorrhoids developing as they tend to occur if you strain for too long on the toilet.
Your bowel motions should return to normal after a few weeks, however, if they have not and you are concerned, you should bring this up with your doctor during your appointment.
Rest
It might be tempting to do all of the housework whilst your newborn is sleeping (if you feel up for that!), but as doctors, we always recommend rest, especially in the postpartum period. Your body needs time to accomodate all the changes following pregnancy and it does this best when you are well rested.
Sleeping whilst your newborn sleeps is a good way to keep fatigue at bay. Your newborn will be feeding day and night and it is unlikely you’ll get a full nights sleep for some time, so make use of the day time cat naps. Not only will it aid your recovery, but it will also aid your mental health which in turn will have an impact on your child. If you can call on help from a partner, friends or family, now is the time to do so.
As well as getting adequate rest, its also important to eat well. As you would have already been doing whilst pregnant, eating a healthy balanced diet with plenty of water will not only aid your recovery but will also help your newborn if you are breast feeding — as remember a lot of our food choices are passed on through breastmilk.
Mental Health
There are a number of physical changes that take place in the body as you can see above, however, there are also a number of psychological changes too. Hormonal shifts can cause ‘baby blues’, these are common, temporary mood changes that can be experienced following birth. They typically tend to occur around day 3–5. Symptoms include:
- feeling low
- feeling irritable
- difficulty sleeping
- feeling overwhelmed
- crying.
Usually symptoms should improve after a few weeks, however to aid your recovery, it’s best to focus on self care. Sleeping well, eating healthily, going for short walks if possible and speaking to friends can all help.
Sometimes however, these symptoms can be prolonged and more severe. This is known as postpartum depression. Symptoms typically last more than two weeks and include:
- mood swings
- anxiety
- sadness
- irritability.
If this sounds like you, then it is important to seek medical help from an adequately qualified healthcare practitioner for help.
If you are experiencing more severe thoughts, such as hurting yourself or others including your newborn, it is imperative to seek urgent help.
Other than the expectant mother, expectant fathers can also experience some mood changes and help is also available for them. Introducing a newborn into the world, whilst it is very exciting, also causes a shift in the family dynamic and can put strains on relationships.
Reach out to your doctor, family and friends for additional support.
Exercise
One way to aid your recovery during the postpartum period is to consider going out for walks if you are able to. Most doctors will advise against doing exercise until your 6 week check up. This is because your body is still recovering and by doing exercise, it may put strain on your core muscles and lead to injury. You may however, wish to get some fresh air by going for gentle short walks. This could be as simple as going around the block with or without your little one. Getting fresh air will help you to change your environment as it’s too easy to get sucked into a routine of seemingly endless feeds and nappy changes.
6 Week Check up
Hurrah! You’ve made it to your 6 week check up. Your newborn is not so little anymore and you’ve done a great job so far. Your doctor will usually see you at this time to check on your recovery and progress as well as your baby. At this time, any issues can be discussed and an examination is usually performed to ensure adequate healing and recovery. It is at this point that your doctor will give you the ok to return to exercise including intercourse and will discuss with you any contraceptive requirements that you may need. Your doctor will also check in on your mood and your support network.
Conclusion
As you can see, there are many changes that occur in the postpartum period. It is vital to treat your body well to aid your healing and recovery. It is also vital to look after your mental health so that you can enjoy your new addition to the family. I hope that this article has helped you to understand the changes that can occur to your body after birth and I wish you the best of luck on your journey.
Take care and stay healthy,
Dr Nora x
Please note that the contents of this article are not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or medical condition.
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