What to expect after birth

After birth

The period after the arrival of your baby is the most important.  It takes your body around 4-6 weeks to return to its non-pregnant state.  This time is called the post partum period.

The uterus

The uterus expands to roughly 11 times its size during pregnancy.  It weighs roughly two pounds after birth and is the size of a grapefruit.  It takes about 6 weeks to return to its pre pregnancy weight of just over 2 ounces.

After birth the uterus will shrink caused by contraction in the muscles fibres.  These are less painful then contractions and usually most noticeable in the 3-4 days after birth.  Breastfeeding can cause these contractions too as the body is releasing hormones to get it back into shape.  They also help reduce blood loss post partum.

Lochia (Vaginal Discharge)

Once you’ve had a baby then your body will need time to return to normal.  Part of that process will be Lochia which is like a vaginal discharge  that will be like your period and it will gradually taper off.  Its caused by the healing of the site where your placenta was and also there is the remains of blood, fluid and tissue from birth. There may be occasional cramping.  The lochia has a slight smell which is usually described as earthy – this is completely normal.

  • Up to the first five days after birth your flow will be red, like a period. You may pass some clots.
  • 5 -10 days the flow will turn pink, then brown.
  • You may have discharge for a month after birth – this is normal.
  • Make sure you use pads and not tampons, and that you change them every four hours.
  • You can use a sitz bath for healing and a cold compress can help things feel better.
  • Make sure you wear breathable underwear.

Post Partum Bleeding

 Call your doctor IMMEDIATELY if:

  • you pass a clot larger then an egg
  • you soak through more then one pad in an hour
  • if in the first three days or you soak more then one pad in 3 hours after the first three days
  • your flow smells bad
  • you have pain in your abdomen that doesn’t go away
  • you have a fever with chills and feel unwell for more then 2 days

Birth canal

 The vagina which stretches to give birth to your baby will return to its previous shape by the end of the third week post partum.  The supporting structures may take a bit longer and episiotomies can take up to four weeks.

It is really important to carry on doing your pelvic floor exercises as they will make you heal quicker after the baby has been born.  

Periods

If you are breastfeeding then your first period may be delayed until you have finished breastfeeding especially if you only breastfeeding and not supplementing with formula.  Do not think that means you cannot get pregnant as egg production begins before the first menstrual period.  Some women will have their first period a month after their baby has been born so be prepared!

Bladder

Sometimes you will be unable to urinate after birth and you may have to have a catheter inserted to help.  Make sure to drink plenty of water and urinate every three to four hours to help remove any excess water from the body.

Bowels and bowel movements

Hormones, medication, dehydration, pain and decrease in physical activity can all make the bowels sluggish after birth.  Temporary constipation is not harmful and can be alleviated with laxatives (but please check with your doctor before taking if you are breastfeeding).  

Exercise, plenty of water, fibre (especially from fruit and vegetables and whole grains) can be used as a source of relief from constipation.  

Weight loss and exercise

Once you have given birth then there will a weight loss and more will happen over the post partum period as you continue to lose any fluid gainer over pregnancy.  Your body will take time to return back to normal after birth.  

If you are breastfeeding then you may need to consume an additional 300-500 calories a day to help maintain supply.

Do not diet or attempt to ‘starve,’ yourself back to your pre pregnancy weight.  You will need to ensure that you have a nutritious, balanced diet in the post partum period

You should see a doctor to make sure that you are physically ready to exercise after birth.  Give yourself time to recover both physically and mentally before starting any exercise programme.

Muscles and joints

In the first few days after childbirth it is common to feel stiffness in your muscles (especially your neck and shoulders) due to the exertion of labour. Your hands can be stiff too from intravenous drips.

For many women the stomach area remans flabby for a while after birth – you may even feel a gap in the muscles just below the belly button.  Your doctor should be able to advise you on an exercise programme that can help and also when would be the best time to start.

Skin and hair changes

Your skin and hair will have reacted to all the hormones going around your body and may take a while to go back to normal.  Stretch marks will just fade rather then disappear (a new study has shown that the daily application of breastmilk can really help reduce the red lines of stretchmarks). You may also find that you lose more hair, or that it is greasier or drier – again this a reaction to the hormones and will settle down with time.