Childbirth is one of the most extraordinary journeys a parent can experience in their lifetime. Throughout pregnancy, the body undergoes many changes to help nurture new life for the next few months – be it skin, hair, nails, weight, and pelvic floor. When it comes to post-delivery, the body begins transitioning into its recovery stage. Motherhood can be a difficult time as you try to get back to how you were before getting pregnant while taking care of a newborn.

Now that you’ve entered the postpartum period, here are some changes you will encounter throughout the recovery.

Physical Symptoms

Breast Engorgement

During this time, your body fills your breasts with milk as preparation to feed your newborn, which can feel sore, tender, and swollen. When the breasts have too much milk (engorged), they can feel hard and throbbing, with skin looking shiny and tight, and nipples look flat, which typically last 24 – 48 hours.

Postpartum Cramps (Uterus Involution)

After birth, your uterus begins shrinking back to its pre-pregnancy size – a process called involution – which can take up to six weeks. During this time, you will experience postpartum cramps (afterpains), and possibly more intense pain during breastfeeding due to a rise in oxytocin. These contractions are completely normal.

Urinary Incontinence and Pelvic Floor Issues

Pregnancy and childbirth stretch the pelvic floor muscles. Postpartum pelvic floor recovery takes time, and common to experience temporary urinary incontinence when coughing, laughing, or sneezing. There may be some discomfort, and possible burning and stinging when urinating.

Postpartum Vaginal Discharge and Bleeding

Blood, tissue, and postpartum discharge (lochia) is expelled from the body. Heavy bleeding occurs during the first few days with possible small blood clots. Lochia lasts for up to six weeks, gradually changing from heavy red to pink/brown, until the discharge changes to yellow or white.

Night Sweats (Diaphoresis)

Sudden postpartum hormone changes – due to the dramatic drop of estrogen and progesterone – can cause your body to sweat more than usual, especially at night (night sweats). This typically lasts for about six weeks.

Constipation

Delayed bowel movements are very common after birth. Contributing factors include perineal soreness, decreased physical activity, dehydration, or pain medications from an epidural or C-section. The use of an epidural can also increase constipation and cause hemorrhoids. Eating high-fiber foods and staying hydrated helps ease bowel movements and prevents hemorrhoids.

Emotional Symptoms

Baby Blues

Baby Blues occurs typically a few days after giving birth. Symptoms include sleep troubles, crying spells, anxiety, and mood swings and is normal when adjusting to the life with a newborn. This can last for a few weeks.

Postpartum Anxiety and Depression

If emotional struggles persist or intensify after two weeks, it may be a sign of postpartum depression (PPD) or postpartum anxiety (PPA). PPD and PPA can occur simultaneously. Symptoms of PPA includes excessive worrying, lack of sleep, and hearth palpitations. For PPD, symptoms include severe exhaustion, intense sadness, lack of connection with your baby, changes in appetite, and loss of joy. PPD does not go away on its own – it is important to reach out to a medical provider for effective treatment and support.

Critical Postpartum Symptoms

Most symptoms and healing responses are normal. However, seek medical attention right away when experiencing these symptoms:

• Blood clots largar than an egg
• Unusual heavy bleeding (changing pads every 1 hour, twice in a row)
• Foul smelling of postpartum discharge
• High fever
• Worsened abdominal cramps or pelvic pain
• Red and painful breasts for more than 48 hours
• Thoughts of harming yourself or the baby

Importance of Self-Care

During this period, it can be difficult to find time to take care of yourself when your focus is mainly on your newborn. However, it is important to give yourself a break as postpartum can easily take a physical and mental toll. Prioritizing your health is not selfish, and is essential in caring for your newborn. Postpartum care includes:

• Prioritizing Rest: Rest whenever possible to reduce severe fatigue
• Nourish your Body: Eat a variety of nutrient-dense foods and drink water to stay hydrated and support milk production
• Support System: Talk to friends, family, community, or postpartum support to help with basic tasks and emotional processing
• Pelvic Floor Care: Pelvic floor exercises help strengthen pelvic floor muscles to improve bladder control. Talk to your healthcare provider on how to do so.

Be patient with yourself as you heal. Your body has done something remarkable and needs its time to restore itself.

References

1. Cleveland Clinic. “Postpartum.” Read the Cleveland Clinic article.
2. StatPearls. “Physiology, Postpartum Changes.” Read the StatPearls chapter.
3. Mayo Clinic. “Postpartum care: What to expect after vaginal birth.” Read the Mayo Clinic guide.
4. Elsevier. “The impact of breastfeeding on postpartum pain after vaginal and cesarean delivery.” Journal of Clinical Anesthesia. Read the article.
5. WebMD. “What You Can Do About Postpartum Night Sweats.” Read the WebMD article.
6. Public Health Agency of Canada. “Your guide to postpartum health and caring for your baby” Government of Canada. Read the Government of Canada’s guide.