Post-partum Recovery
Most people are aware that pregnancy and especially childbirth come with extreme challenges for the female body—the body does not magically reset the minute the baby is born. Although it is a natural part of the childbirth process, the struggles of the post-partum recovery period may come as a surprise to some because it is discussed much less often. However, with proper care and preparation, new mothers will be better able to take care of themselves and their babies and will be more confident in asking for the support they need.
The post-partum period can last for anywhere from six weeks up to one year after childbirth. It is a period of physical recovery from ten months of physiological changes, but more than that—it is a period of intense psycho-emotional adjustment to the 24/7 needs of an infant who depends on you for everything. New mothers are often portrayed as glowing, nurturing and happy at all times. That is not a realistic expectation.
Most people are aware that taking care of a new-born includes sleepless nights for the parents, the effects of which will also be discussed here, but there are aspects of the mother’s own recovery that are barely ever mentioned, even in the 21st century when many taboos around discussing personal challenges have been lifted.
Taking care of injuries
The most obvious heightened changes in the body and yes, sometimes even injuries, occur during birth. Vaginal tears, episiotomies (incisions made to make the vaginal opening larger), perineal tears, C-sections are all highly possible components of giving birth that require surgical involvement. Many of them include incisions and stiches. The surgical aftercare is often not discussed, but that makes dealing with it harder than necessary.
The perineum—the area between the vulva and anus—will be especially sensitive after giving birth—vaginally or by C-section—even if there have been no tears or incisions. Toilet paper, washcloths, and sponges will most likely feel too rough to use on this area in the first days or even weeks after birth. After using the toilet or when bathing many women now use “peri” bottles (perineal irrigation bottles) for gently rinsing the genital area. These are squeeze bottles that come with different nozzles you can use to gently your sore and swollen perineum area with warm water. Some women also find cold compresses help soothe the raw feeling in this area.
If you have had an incisions or other surgical procedure during labour, you should be extra careful of overworking your body. Do not lift heavy objects until you have healed. This is especially true after a Caesarean.
The scar from a C-section will require daily cleaning and follow up visits to the doctor. While any scar is healing it is important to check for signs of infection—redness, extra soreness, puss or other secretions coming from the scar, and also high fever. A light watery discharge from a C-section scar in the first days is normal.
It is all still a part of giving birth
Another huge surprise for many is the fact that contractions do not stop when the baby is born, or even after the placenta leaves your body. Contractions can continue for several days after birth, as the uterus returns to normal size. The pain you feel in your lower abdomen might be slightly different than that of birth contractions, but it is completely natural. These contractions are sometimes referred to as “afterpains”.
Vaginal discharge
For several days after giving birth there will be heavy vaginal discharge. The specific combination of mucus and blood leaving the uterus after birth is known as lochia. It resembles period blood in many ways but often contains a larger number of blood clots.
Although vaginal discharge is normal, certain symptoms indicate there may be a problem. You should consult your doctor if the blood clots are very large (the size of a golf ball or larger), if the discharge is bright red on the day after giving birth or later, if it has a very strong, unpleasant odour, or if you feel a general dizziness and have fever.\You will need to use extra-large pads for your vaginal discharge after giving birth. Specific maternity care sanitary pads are available. The lochia will gradually become darker and then turn brown and dissipate. It is usually present for 4 to 6 weeks after delivery but may continue longer with breastfeeding.
Going to the bathroom
Most women report a burning sensation when peeing after giving birth. If the pain is too strong, you might try using your peri bottle while you pee to soothe the area with warm water. If the pain does not go away, it may be a sign of infection that should be discussed with your doctor.
Bladder control in general will most likely be disrupted in some way after giver birth. Temporary incontinence is very common—you may drip of urine now and then throughout the day, especially in the first week or so. However, the opposite problem—the inability to pee when you feel the urge—is just as common. Don’t worry. As uncomfortable as it is during recovery, for most women these are passing concerns.
Constipation is also very common, which is especially unpleasant with the general soreness in the perineal area. Straining the abdomen on the toilet due to constipation can also reopen postnatal scars, so stool-softening medication is sometimes prescribed for new mothers. Eating foods with a high fibre content will make things easier.
And—as if that weren’t enough—you are also very likely to have haemorrhoids for a while. Haemorrhoids are swollen veins around and inside the anus that can cause pain or itchiness and often bleed. They emerge due to the stress placed on the perineum during pregnancy and childbirth and in the postpartum period.
You can soothe haemorrhoids by applying a cold compress to the rectal area and by gently rinsing it with a peri bottle. Avoid using hygiene products that can cause irritation and lie down as much as possible instead of sitting until you are feeling better down there. Your doctor may have additional suggestions.
Hormonal changes
After pregnancy the body goes through intense and dramatic hormonal changes. Levels of oestrogen and progesterone—the hormones responsible for pregnancy and the menstrual cycle—drop suddenly and dramatically after a long slow build up over nine months.
When the level of progesterone drops, this sends a signal to the body that the pregnancy is over, and it is time to start producing prolactin—a hormone responsible for activating your milk production. Although the presence of prolactin has been linked to increased levels of dopamine—the “happiness hormone”—during breastfeeding, levels of dopamine are often low after birth.
A new mother’s body does, however, produce oxytocin—one of the most important hormones for regulating contractions during birth, initiating the “let-down” reflex and encouraging milk production, human bonding and nurturing behaviours, and general feelings of happiness and love. Oxytocin is released during skin-to-skin contact and allows mothers and babies to learn each other’s scent helping the baby to latch on to the nipple for breastfeeding, but because bonding is so strong during this period oxytocin can also trigger anxiety in new mothers who are programmed to protect their babies from all danger.
Other hormonal changes occur as well, the normal hormonal cycle has been completely disrupted and it takes some time to readjust. Many women report experiencing “baby brain”—feeling emotionally overwhelmed and finding it difficult to think. Learn more about hormone-induced mood swings here.
Along with the emotional rollercoaster, these hormonal changes also affect your physical body. For up to five months after birth, your joints will still be extra flexible and less stable due to the hormone relaxin that helps the body accommodate physical changes during pregnancy and allows the hips to open for childbirth.
Hormonal changes are also likely to cause acne and hair loss—but don’t worry, you are just losing the extra hair that grew while you were still pregnant. After giving birth your body’s weight distribution may be permanently altered, your breasts will swell with milk—at least for as long as you are breastfeeding, and sometimes joints such as the arches of your feet might remain changed after birth.
Psychological changes
So, as a new mother you have to deal with all of these changes, heal from injuries, AND take care of a new human 24/7. The good news is that your body will recover and is adapted to do exactly this. The psychological aspects, however, are less instinctive than we would like.
You might have had a clear plan on what to do and an idea about what life with baby will be. Preparation is obviously key and will be of immense help. However, things will almost definitely not go as planned—including the way you find yourself feeling and acting.
As disappointing as it may be to find you are feeling irritated when you should be brimming with love, or that you are unable to instantly find solutions to the new problems that keep cropping up, it is normal. You are in a completely new situation, do not despair if things don’t go as planned.
Each woman will have her own postpartum journey. Don’t let societal pressure make you shy away from the needs of your own body as it recovers, and don’t let the many challenges ahead scare you too much.
Be prepared, but not scared. Physical recovery after childbirth is easier and safer than ever before thanks to modern medicine, specialised products, digital technologies, and better overall education. Follow your doctor’s orders, monitor your body, and respect your limits and the first six weeks will go by before you know it. As for the psychological and emotional changes ahead? Well, that’s what it’s all about.
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