What to Expect from Postpartum Physical Recovery
When you’re pregnant, it can feel like there are constant appointments and checkups, but after you’ve given birth, it’s back to business as usual. The general vibe is that you no longer require that same level of concern and compassion, and the focus shifts to your baby. We expect mums to squeeze back into their jeans and return to the endless unpaid labour of cooking, cleaning, and shopping whilst also meeting the needs of their baby.
But physical changes during postpartum are far more rapid than during pregnancy. For example, your uterus expands for about 40 weeks but takes only six weeks to contract back to its original size. There are also brain changes, hormone changes, breast changes, family and relationship changes and whole identity changes!
That’s a lot of change, and you deserve a lot of support!
And that is precisely what postpartum professionals like myself are here to do; support you.
Here’s your ultimate guide to navigating some of the physical changes associated with postpartum recovery.
First I’ll step you through some common physical changes, and then we’ll go through some tips and tools to support you.
Postpartum Recovery
To compare postpartum recovery times is to compare apples and oranges - there’s no right or wrong with how long the process should take. Everyone’s bodies are different, and everyone’s experiences are different.
Generally speaking, both traditional cultures and modern science recognise the first four to six weeks postpartum as a significant time for rest and recovery. During this stage, your body will undergo rapid changes including establishing milk supply, contracting your uterus to its original size and stopping bleeding.
But recovery isn’t linear and most mothers find themselves on a bit of a rollercoaster for months and even years after birth. There will be times when you feel strong and capable and times when you just want to crawl back into bed. Take as long as you need to rest and recover, even if it’s longer than expected or more time than other parents seemed to require.
Postpartum Contractions
Post-birth contractions are common regardless of how you gave birth and usually get stronger with subsequent babies. These contractions are your uterus returning to its original size and whilst some birthing parents barely notice them, they can be surprisingly painful for others. Dehydration can make muscle cramps worse, and heat can help. Have a glass of water and a heat pack ready before you sit down to breastfeed, as breastfeeding stimulates uterine contractions. Emptying your bladder can help to ease contractions too, so do a wee before you breastfeed if you can.
Postpartum Bleeding
It’s normal to bleed after birth, similar to a heavy period, transitioning from bright red to brown red after about a week, and finally a pinkish colour until it stops about 4-6 weeks after birth.
This bleeding is called lochia and is your uterus is shedding the blood and tissues it no longer needs. Bleeding will last for about 2-4 weeks and change colour and heaviness during this time, and may also include clots and mucous.
It’s common for your bleeding to increase or to pass a clot once you start moving about more. Massage and breastfeeding can also increase lochia. It’s usually safe to simply rest and give your body some more time to heal.
If your flow gets very heavy (soaking through a pad in an hour) or you pass a very large blood clot (the size of a lemon) give your midwife a call just to be on the safe side. If you are worried, you can take photos of your blood in your underwear, on a pad or even on the toilet. Midwives are very comfortable with seeing this, and it will help them determine if your lochia is normal or if you need to have a check-up.
You may not bleed as much if you have a surgical birth, including a caesarian, because the doctor will clean some of the blood and tissues from your uterus during surgery.
By the sixth week, the bleeding should have stopped. By this stage, your uterus will be back to the size it was pre-pregnancy.
Breast Changes
Your breasts will start changing, growing and even producing colostrum during pregnancy. After birth, breast changes can be rapid and sometimes uncomfortable.
The first milk your body makes is called colostrum and it’s normal to have just a few drops. A newborn baby's stomach is only the size of a pea, so colostrum is concentrated - packed with more fat, protein and nutrition than regular breastmilk.
After 3-5 days your breast milk will come in, and your breasts can become large, engorged and sore. Your breasts might feel very hard and heavy and your skin may feel warm. The Australian Breastfeeding Association has some good tips for relieving and preventing engorgement here.
You might also feel a tingling sensation indicating “let-down” - the release of milk from your breasts, but some parents don’t feel anything during let-down and that’s normal too.
Your breasts may leak during the first few weeks and months whilst your milk supply is regulating, especially when you hear your baby cry or go for longer than usual between feeds. Some people’s breasts leak for as long as they are breastfeeding, but others find that their breasts don't leak as much once their milk supply establishes around 6-8 weeks.
The feeling of let-down and the leaking of milk does not indicate whether or not breastfeeding will be successful.
Other Physical Changes
Hair loss is common during postpartum, and it can feel disconcerting to see so much hair in the shower drain! However, this is generally nothing to worry about and not considered ‘true’ hair loss. You are losing the extra hair you grew during pregnancy, which is a part of normal hormonal changes.
Hot flushes are also a result of normal hormone changes. Whilst it’s usually nothing to worry about it can be very annoying having to strip off your layers or waking up in a puddle of sweat! You can carry a change of clothes, or sleep on an absorbent bed sheet to make changes easier.
By month six, the physical changes will slow, but you’ll still be on that rollercoaster! It’s ok to ask for help and take as much rest as you need for months and years after childbirth.
Postpartum Essentials
Bleeding, leaking milk and night sweats!?!?! I know this all sounds overwhelming! Here are some things that might make postpartum life a little easier.
Pads and undies.
Many years ago when I first started working in postpartum care I used to recommend adult nappies for postpartum bleeding, but now there are so many awesome options for women! You can use any maxi or maternity pads, but there are also now specific reusable maternity underwear. Look for something that is designed for heavy flow, has a generous cut for comfort (think granny pants style!) and has absorbency at the back so you don’t leak when lying down. I really like eco-period super briefs. If you want to make laundry more manageable, you’ll need at least 6-10 pairs of reusable underwear. This sounds expensive, but you can continue to use them as period underwear after your postpartum time.
Maternity Bras.
Whilst your breast size is changing rapidly it can be more comfortable to have a soft, stretchy crossover bra that will adjust to your changing body, rather than something fitted.
Breast pads.
There are many options to choose from, which can all feel overwhelming! But basically you’ll want something absorbent to wear inside your bra to prevent milk leaking through your clothes. Some people like to wear them at night too which is another reason to get a super comfy bra. If you use reusable breast pads, I’d recommend at least 16-20 (8-10 pairs) to make laundry manageable. You can also check out local makers and support a small business.
Mattress protection.
One of things I’ve used most since having babies are Brolly Sheets. They now come in all shapes and sizes, and there are many other brands available too. But the concept is still simple. It’s an absorbent bed pad that sits on TOP of your sheet, making nighttime changes much quicker and easier. Whether it’s a nappy explosion, night sweats, bleeding or leaking milk there will be so many times you need to quickly whip off the bed pad and go back to sleep on the sheet below. You can also use them for bed wetting when your baby gets older.
Pain relief.
Paracetamol and Ibuprofen are safe to take during postpartum and breastfeeding, and some people find rest and drinking plenty of water can help ease the pain.
Heat packs and ice packs.
Heat packs are affordable and reusable for all sorts of postnatal pain. Heat is usually preferred for postpartum, but some people find ice gives them more relief. You can even find them as a 2-in-1 ice pack/maxi pad hybrid from Frida Mom, along with other postnatal essentials.
Peri bottle.
While you heal, urinating can often cause unpleasant stinging. To ease sensitivities check out Australian-made peri bottle from Pouchie.
Healing Herbs.
Herbs can be used in so many lovely ways for postpartum healing - in teas, baths, balms and tonics. Julie Bell is a trained herbalist with a wide range of beautiful herbs for postpartum care.
Can You Speed Up the Postpartum Healing Process?
Postpartum is full of joy and also full of hard work! I can understand why you’d want to speed through those physical changes and get the whole process over and done with. But think of it this way - allow your body the same time to heal as it took to grow your baby in the first place - 40 weeks. Whilst you can’t skip over this time, several factors will help this process flow more smoothly.
Nourish your body. Aim to eat every 2-3 hours to provide your body with enough fuel and nutrition to heal and grow strong. Ask for help with meals from friends, fill your freezer in advance and try a meal delivery service. You can find recipes and postpartum meal planning tips in my book Nourishing Newborn Mothers.
Prioritise rest. In many cultures, new mothers are protected from usual household chores and cultural obligations for 4-6 weeks after giving birth and are only expected to rest during this time. Unfortunately, this probably won’t happen automatically for you and you’ll likely need to build your own village of support. Get help with everything else (including shopping, cooking and cleaning) so you can rest, heal and spend time with your new baby.
Gently move your body. There’s no pressure to get back into rigorous exercise straight after giving birth, but gentle stretching, breathing and walking will improve circulation and strength and make you feel good. You may be more sensitive to weather, crowds and noise, and also get tired quickly, so don’t stray too far from home.
We’ve all heard the cliche it takes a village to raise a child, and it’s true. But many women today feel unsupported and wind up exhausted and overwhelmed. You’ll likely need to build your own village to have a more peaceful and joyful postpartum, but asking for help is hard! I talk about village building often on my blog, in my books, and on my podcast, so stick around if you want to learn more.
How long is Postpartum?
We live in a fast-paced culture, and parents might feel pressured to be more productive or impatient about how long healing takes after having a baby.
Give yourself time, and get all the help you can. Loving and caring for your baby takes enormous amounts of energy, and your needs are usually last on a very long list. Take a moment to tune in to your own body, communicate your feelings to those you are close with, and reach out to a professional if necessary.
There you have it - my ultimate guide to postpartum recovery! If you want more tips and tricks on navigating postpartum, check out my books designed to guide you through the transformation to motherhood.
And if you are interested in training as a professional postpartum support person, check out Newborn Mothers Collective.
