The postpartum period begins immediately after a woman gives birth and lasts for approximately six weeks. During this time, great changes occur as the body adjusts to being “not pregnant” and the uterus returns to its normal size. Many other changes occur during this time, including the decline of pregnancy hormones, beginning of lactation, and gradual recovery from pregnancy and from the trauma of a vaginal or c-section delivery. Certain problems may arise during the postpartum period and need swift attention.
The uterus is designed to expand during pregnancy and return to a normal size once it no longer accommodates a fetus. In the first few weeks of the postpartum period, women may experience cramping, and most have bleeding comparable to a very heavy menstrual period. Bleeding tends to continue if women are very active during this time, but it also gets lighter. Bright red, extremely heavy bleeding is not normal and could be indication of uterine hemorrhage; it should be reported right away to a doctor. Generally, within the first six weeks, bleeding will get lighter and then cease altogether.
A big change occurs during the postpartum period as lactation begins. In the first few days, women have a thin secretion called colostrum from the breasts that is full of immune properties from which the baby can benefit. About three to four days after a baby’s birth or earlier, the milk lets down, which at first can be a very uncomfortable sensation, with the breasts being prone to sudden leakiness or spraying. This feeling passes as supply and demand is worked out between mother and child, or if a woman is not breastfeeding.
Another bodily change in the postpartum period is the decline of pregnancy hormones, which tends to cause some mood disturbance. Most women will experience a few days of discouragement, depression or moodiness, often called the baby blues. For some women, this condition becomes more severe, and their mood doesn’t improve, which is called postpartum depression. Because it can be potentially serious, women should get help for it right away. A very rare complication is postpartum psychosis, and anyone with severe mood disturbance who thinks of harming oneself or the child needs medical care.
In the first few weeks of the postpartum period, women experience soreness, especially if they’re recovering from episiotomies or tears of perineal tissue. Constipation is common, which can cause additional discomfort and is best handled by drinking plenty of fluids and eating high fiber foods. Recovery from surgery takes even longer, and most women need to refrain from most physical activities for several weeks if they had a c-section. Doctors ask women to refrain from sexual activity too, until the postpartum period is over.
Physicians generally schedule an appointment with new moms for six weeks after birth. This gives them an opportunity to assess moms for any additional problems and to determine uterine size. In the majority of cases, the body has recovered from pregnancy and the postpartum period is considered concluded.