Your most common postpartum recovery questions, answered

postpartum recovery

Postpartum recovery is different for everyone. It may take several weeks (or months) to lose your postpartum belly, for example. And postpartum weight loss may take anywhere from 6 to 12 months or more. When you get your first postpartum period will depend in part on whether – and how much – you’re breastfeeding. Just like adjusting to your new life with your baby, taking care of your changing postpartum body can seem like a lot, but you’ll feel more and more like yourself every day as you recover. 

IN THIS ARTICLE

Just as every pregnancy, labor, and delivery is unique, so is every postpartum recovery experience. Postpartum women share many of the same postpartum experiences, though, and they have similar questions – about everything from their postpartum belly and postpartum headaches to postpartum weight loss and exercise, for example.

Here are some of the most frequently asked questions about postpartum recovery, but remember that your healthcare provider is just a call away, too. Don’t hesitate to call them for more information or for answers to your less frequently asked questions.

How long is postpartum recovery?

Every mom is different. Postpartum recovery depends on a number of factors, such as your age and general health, the type of pregnancy you had (with or without pregnancy complications), and the type of labor and delivery you had (vaginal or c-section, assisted with forceps or a vacuum or not, long and difficult or – relatively – easy, and medicated or non-medicated).

Most moms, though, feel somewhat “back to normal” by about six to eight weeks after delivery. If you’re exclusively formula feeding, you may even have your first postpartum period by then.

That’s not to say all of your symptoms will take that long to subside. Postpartum bleeding should slow within days, for example, and afterpains should disappear within a week or so. Perineal pain may quickly disappear, or it may linger – depending on whether you had perineal tearing or an episiotomy. On the other hand, some things may take longer than eight weeks. Your normal hair patterns (growing and resting phases), for example, will take 6 to 15 months to return to normal.

What essentials should I have in my postpartum recovery kit?

Prepare a postpartum recovery kit well in advance of your due date (maybe along with your hospital bag.) Here are the most important things to include:

  • Maxi pads. You’ll have some postpartum bleeding (lochia) right after delivery. In the first few days, the flow might be similar to a heavy period, so stock up on some extra-large pads for those days. You can switch to smaller pads as your flow lightens. Because of the risk of infection, you can’t use tampons or menstrual cups.
  • Disposable underwear. You may at first want to stick with disposable underwear (usually expandable mesh, which they’ll give you at the hospital). These are perfect for holding large sanitary pads, and you won’t have to worry about staining regular undies. Some can be washed a few times and reused. Many moms wear them until they’re done bleeding. Some like to wear incontinence panties instead of postpartum disposables. You may need to wear pads with them at first, until your bleeding slows down.
  • Postpartum underwear. When you’re no longer bleeding enough to need large sanitary pads, you may want to graduate from the disposables to something more like regular underwear. Choose postpartum underwear that’s very comfortable (soft and larger than you’d normally wear), stretchy, and absorbent. If you had a c-section, you’ll want them to be high waisted to avoid irritating the scar area. Some specially designed postpartum underwear have absorbent panels so that you don’t need to wear a pad once your flow is light. Compression postpartum underwear can be used for light support, but don’t make them too tight or they’ll interfere with healing.
  • An ice pack. Ice can numb pain, reduce swelling, and be very soothing for perineal pain. A normal ice pack won’t be comfortable, but there are products on the market that are designed specifically to use on your perineum. These gel packs are shaped like sanitary pads so you can tuck them in your underwear, and they’ll conform to your body.
  • Squirt/rinse bottle. An occasional perineal rinse with water can be soothing and help you avoid infection. (Besides, the last thing you’ll want to do is wipe with toilet paper.) Peri bottles are specially designed for postpartum use – they spray upside down and usually have a narrow, angled neck to make it easy to reach where you need to. You can add a couple drops of witch hazel to the water, if you like, for added cleansing and soothing.
  • Hemorrhoid pads. These are especially helpful if you’re dealing with postpartum hemorrhoids, but – because they help shrink blood vessels – they also help with general perineal pain. 
  • Perineal spray. If you’re uncomfortable or itchy as stitches or wounds heal, a perineal spray – which numbs the area – may be very helpful.
  • Sitz bath. Taking a sitz bath in warm or cool water can clean and sooth the perineal, vaginal, and rectal area.
  • An OTC pain reliever. Both acetaminophen and ibuprofen are generally considered safe postpartum, even if you’re breastfeeding. Your provider may recommend you alternate between them for maximum relief. Don’t exceed the recommended dosages.
  • Stool softener. Postpartum constipation is very common, and there are many things you can do to ease it naturally (such as drinking plenty of water and walking). But if nothing else is working, you may want to take an OTC stool softener. Talk with your practitioner before taking it, however.
  • Support band. A support band provides compression and support and can be especially helpful for moms who have had a c-section or moms who have diastasis recti (a vertical bulge in your abdomen where the muscles have widened to make room for your baby).
  • Postpartum pillow. Also called a donut cushion, a postpartum pillow helps take pressure off the perineal area when sitting. It’s especially helpful if you have hemorrhoids or perineal pain.

If you’re breastfeeding, you’ll also want to stock up on:

  • Nipple cream. If your nipples are dry, cracked, itchy, or bleeding, nipple cream can moisturize and heal them safely. Some moms also find nipple cream useful for lubricating the flanges of their breast pumps. 
  • Nursing pads. Tuck these in your nursing bra to catch leaks. They’re especially helpful in the early days, when your breasts are figuring out when and how much milk to produce. Nursing pads (also called breast pads) also protect sensitive nipples from rubbing and chafing. You can purchase reusable or disposable pads.
  • Nursing pillows. Specially designed nursing pillows help you position your baby comfortably each nursing session. Some parents also use them while bottle feeding and as little loungers for their babies.
  • Nursing bras. You’ll want a few nursing bras, which make it easy for you to breastfeed your baby comfortably. Choose them according to your needs, whether that’s something supportive, something to sleep in, or a bra that you can also use for pumping.

How long do you bleed after having a baby?

Postpartum vaginal bleeding typically lasts for four to eight weeks total. But it’s not the same continuous flow of blood. For the first few days after birth, you’ll bleed quite a bit, like a heavy period. The blood, combined with tissue from the lining of the uterus and mucus, is called lochia.

The discharge will lighten each day, and around two to four days after delivery it may be watery and pinkish. It’ll continue to taper off, and by 10 days postpartum you might only have a small amount of white or yellowish discharge, though you may still have spurts of bleeding occasionally (a few times a day). The bleeding should be completely finished in another two to four weeks.

Some women bleed more than this, and it’s a medical emergency. Profuse bleeding withing the first 24 hours of delivery is considered primary postpartum hemorrhage (PPH). When it happens in the days or weeks after delivery, it’s a late (or delayed or secondary) PPH. If you have any signs of PPH (bright red bleeding that lasts more than a few days after delivery, bleeding that soaks more than one sanitary pad in an hour, blood clots bigger than a golf ball), call your provider right away. Also call if you develop new, significant bleeding after your initial bleeding slowed down Postpartum recovery.

Some women have a small amount of postpartum rectal bleeding, which is usually caused by hemorrhoids. Taking steps to ease constipation may help, because straining during a bowel movement or passing hard stools can cause the swollen hemorrhoid veins to bleed Postpartum recovery.

When will my postpartum belly go away?

Postpartum recovery! It may depend on a number of factors – such as your weight gain during pregnancy, how active you are, and your genes. Your uterus needs to shrink back to its pre-pregnancy size, you need to lose all that pregnancy fluid (through sweat, urine, and vaginal secretions), and you need to burn off the extra weight you put on to nourish your baby during pregnancy. Hormonal changes after delivery will help with the process, but it can take months.

Within minutes of your baby’s birth, contractions cause your uterus to shrink, its crisscrossed fibers tightening just like they did during labor. These contractions also help the placenta detach from the uterine wall. After the placenta is delivered, uterine contractions close off the open blood vessels where the placenta was attached. You may feel cramps, known as afterpains, as this happens.

For the first couple of days after giving birth, you’ll be able to feel the top of your uterus near your belly button. In a week, your uterus will be half the size it was just after you gave birth. After two weeks, it will be back inside your pelvis. By about four weeks, it should be close to its pre-pregnancy size. This process is called involution of the uterus.

Even after your uterus shrinks back to its normal size, you may continue to look pregnant for several weeks or even months. That’s because your abdominal muscles get stretched out during pregnancy, and it takes time – and regular exercise – to get those muscles back in shape. (Some women may never be able to get rid of their “pregnancy pouch” entirely.)

If you notice a vertical bulge down the center of your abdomen, you may have diastasis recti. This means that the muscles in your abdomen have separated, leaving a gap. Your provider can confirm if you have the condition, and you can do abdominal rehab to help close it.

Keep in mind that you might not be able to return to your pre-pregnancy belly ­– or shape, for that matter. Your hips may be wider, your waistline larger, and your belly softer than they were before becoming pregnant. Try to embrace that and appreciate your postpartum belly and your body for its ability to carry and deliver your little one.

By the way, your stretch marks (which happen as your belly and breasts grow quickly during pregnancy) won’t completely disappear. By about six to 12 months postpartum, they should be lighter, though. If you have linea nigra (a dark line down your abdomen), that line will also fade over the course of a year, though it may not completely go away Postpartum recovery.

When will I lose the baby weight?

You may be able to lose the baby weight around 6 to 12 months after your baby arrives. But that’s not a guarantee. Some women take longer, and many never return to their pre-pregnancy weight Postpartum recovery.

Postpartum weight loss begins right after delivery, when you’ll already be about 13 pounds lighter. You’ll lose the amount your baby weighed (usually 7 or 8 pounds), about a pound of placenta, and another few pounds of blood and amniotic fluid. You’ll continue to lose about 4 to 6 pounds of water weight in your first week postpartum.

By about 6 weeks postpartum, most moms lose half of their baby weight. And this is a good time to start thinking about calorie reduction, if you like. But take your time (no crash dieting) and include exercise in your diet plan, too.

If you’re breastfeeding, wait at least two months to begin dieting. The good news is that breastfeeding – which burns about 400 to 500 calories daily – might help you lose some of those extra pounds. Significant calorie restriction can lead to a dip in milk supply, so start slow Postpartum recovery.

Will my vagina be the same postpartum?

Though you will regain vaginal muscle tone, if you give birth vaginally, your postpartum vagina will probably remain a little larger than it was before.

Right after delivery, your vagina is stretched open and may be swollen and bruised. How much depends on a number of factors, such as:

  • How big your baby was
  • Whether you had an assisted birth
  • How much relaxin you produced (Relaxin is the hormone that loosens the joints, ligaments, and tissues in your pelvis and vagina in preparation for delivery)
  • How long you pushed during delivery (even moms with a c-section might have pushed some first)
  • Your age (your muscles loosen as you age)
  • How many births you’ve had (more deliveries mean more laxity)

Over the next few days, swelling starts to go down, and your vagina begins to regain muscle tone. In the next few weeks, it will gradually get smaller. Most moms with an uncomplicated vaginal delivery can regain full pelvic floor tightness in about six months. For moms with multiple vaginal births or a birth injury during delivery, it may take a bit longer. Doing Kegel exercises regularly can restore muscle tone. Some women find pelvic floor therapy even more helpful.

You’ll need to wait until your postpartum checkup to get your provider’s go-ahead for sex if you’ve had a c-section, episiotomy, or perineal tear. Otherwise, many providers recommend you wait about four weeks after childbirth. That said, it may be much longer before you’re interested, and that’s perfectly fine. Take as much time as you need to adjust physically and emotionally to motherhood Postpartum recovery.

Are postpartum headaches normal?

Yes, about 40 percent of women experience headaches in the postpartum period.

Causes of postpartum headaches include:

  • Sleep deprivation
  • Hormonal changes
  • Psychological stress
  • Postpartum fatigue
  • Physiological changes
  • An epidural during labor and delivery. About 1 in 100 women develop a spinal headache in the days after having an epidural.

Postpartum migraines are also common. Migraine in women is closely linked to hormonal changes. A drop in estrogen levels (just before a menstrual period or right after birth) can trigger a migraine. According to the American Migraine Foundation, about one in four women will experience a migraine within two weeks of delivery, and almost half will have migraine attacks within the first month. About 5 percent of women who have never experienced migraine get their first one in the postpartum period Postpartum recovery.

Most causes of postpartum headaches aren’t dangerous, but headaches can be a warning sign of postpartum preeclampsia. Call your provider if you have a headache that:

  • Gets worse over time or won’t go away
  • Is very intense
  • Lasts even after taking medication and fluids
  • Starts suddenly, like a thunderclap
  • Throbs and is on one side of your head or above your ear
  • Is accompanied by blurred vision or dizziness
  • Goes away when you’re lying down and you’ve had an epidural

How can I take care of myself postpartum?

After your baby arrives, it’s important – for both of you – that you take care of yourself by eating well, getting enough rest, and exercising when it’s safe for you to do so. But good postpartum care also includes your mental health.

To take good care of your mental health:

  • Develop a support system. Make sure you have other new parents to talk to and make a point of talking to them or seeing them at least once a week. Accept help and an empathetic ear from family and friends.
  • Express and accept your negative feelings. The baby blues are very common, affecting up to 80 percent of moms right after birth. These feelings of sadness, exhaustion, and/or overwhelm often subside in a couple of weeks. In the meantime, don’t bottle them up.
  • Focus on your positive feelings. Look for ways in which you do feel good and pay attention to those, too.
  • Take breaks by yourself, with your partner, or with another adult. No one can work at a job nonstop without some time off every day.
  • Keep your expectations realistic. You can’t do it all, let alone do it perfectly. Work toward reasonable, achievable goals, whether dealing with feelings, doing housework or losing your pre-baby weight.
  • Nurture your sense of humor. Try to laugh daily, whether at yourself, your situation, or something outside of all this.
  • Structure your day. Plan loosely how you’ll spend your day, designating time for all the items on this list. Keep the plan flexible and realistic so you can stick to it.
  • Postpone other major life changes. Avoid taking on a new job, a new home, or a new partner until you feel more settled in your new role of mother.
  • If you have intense feelings of sadness or severe mood swings, are crying often, having trouble sleeping, or having overwhelming feelings of worthlessness or guilt, contact your provider. These are some of the signs of postpartum depression (PPD). PPD requires treatment, and the sooner you get help the better.

When will I get my first postpartum period?

The date of your first postpartum period depends in part on when (and how much) you’re breastfeeding. When you nurse your baby, your body produces the hormones prolactin and oxytocin, which typically suppress ovulation Postpartum recovery. (And if you don’t ovulate, you probably won’t have a period – though it’s possible.) 

Most moms who don’t breastfeed will get their first postpartum period in 6 to 8 weeks, while breastfeeding moms typically resume their periods between 9 and 18 months after childbirth Postpartum recovery.

Generally, the more you breastfeed, the more likely your period is to be delayed. Some moms who exclusively breastfeed don’t get a period until they stop nursing. Other nursing moms get a period once their baby starts sleeping through the night, which cuts back on feeding times. Supplementing with formula or introducing solids is also likely to have an effect Postpartum recovery.

Don’t depend on breastfeeding for birth control. You can get pregnant while breastfeeding. And keep in mind – breastfeeding or not – you can get pregnant before you have your first period (ovulation usually comes first!). If you get your period sooner than 6 weeks, don’t use tampons. These can introduce bacteria and increase the chances of infection while your body is still healing.

When is it safe to exercise postpartum?

Check with your healthcare provider for individual guidelines. Your return to exercise will depend in part on how your pregnancy and delivery went.

Some pregnancy complications will affect your return to exercise. For example, if you had preeclampsia, your provider will want you to take it slowly because strenuous exercise can worsen your blood pressure Postpartum recovery.

If you had an uncomplicated vaginal delivery and exercised throughout your pregnancy, your practitioner may give you the go ahead to do light exercise – such as walks, postpartum yoga, modified push-ups and stretching – within days of delivery, as long as you’re not in any pain. If you had complications, though, or you weren’t active throughout your pregnancy, your provider will give you other guidelines for exercising. If you had a severe tear, for example, your provider may refer you to a physical therapist and urogynecologist before you jump back into exercise.

If you had a c-section, you can probably ease back into exercise six to eight weeks after delivery. Your provider will examine you – to make sure your incision is healed – and give you the go-ahead at your postpartum visit if all is well. Before that, you can walk for exercise and do stretches.

Whenever you start exercising postpartum, you may want to begin slowly, with 10 minutes or so of low-impact activity.  You can increase the length of time or number of activities as you regain strength Postpartum recovery.

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