Postpartum Care

What to Expect Physically in the First Few Weeks

After your baby arrives, you’ll notice some changes — both physical and emotional. Physically, you might experience:

  • Sore breasts. Your breasts may be painfully engorged for several days when your milk comes in and your nipples may be sore.
  • Constipation. The first postpartum bowel movement may be a few days after delivery, and sensitive hemorrhoids, healing episiotomies, and sore muscles can make it painful.
  • Episiotomy. If your perineum (the area of skin between the vagina and the anus) was cut or torn during delivery and required stitches, it may painful to sit or walk initially. The stitches will eventually dissolve and tissue should progressively heal over the next few days to weeks.
  • Hemorrhoids. Hemorrhoids (swollen blood vessels in the rectum) may be a result of pregnancy or delivery. These usually improve with time and can be controlled by avoiding constipation and using over-the-counter (OTC) or prescription medications if needed.
  • Hot and cold flashes. It is normal to have hot or cold flashes initially after delivery. It will take time for your body to adjust to changes in blood flow and fluctuations in hormones after delivery.
  • Urinary or fecal incontinence. The stretching of your muscles during delivery can cause you to inadvertently pass urine when you cough, laugh, or strain or may make it difficult to control your bowel movements, especially if a lengthy labor preceded a vaginal delivery. These also should improve with time and Kegel exercises or physical therapy may be helpful if these symptoms persist.
  • “After pains.” After giving birth, your uterus will continue to contract for a few days to weeks after giving birth. These are most noticeable when your baby nurses or when you are given certain medications. Uterine contractions are important to control bleeding and help the uterus return to a normal size.
  • Vaginal discharge (lochia). Vaginal bleeding usually continues for two to six weeks after delivery. Initially, you will have bright red flow and possibly a few small clots, but this will change to a yellowish color as the discharge resolves.
  • Weight. After delivery there may be significant fluid shifts within your system. If you have concerns about your weight please speak to your provider.

What to Expect Emotionally in the First Few Weeks

Emotionally, you may be feeling:

  • “Baby blues.” Many new moms experience irritability, sadness, crying, or anxiety following delivery. These baby blues are very common and may be related to physical changes (including hormonal changes, exhaustion, and unexpected birth experiences) and the emotional transition as you adjust to changing roles and your new baby. Baby blues should resolve within a week or two.
  • Postpartum depression (PPD). More serious and longer lasting than the baby blues, this condition is present in 10% to 25% of new moms and may cause mood swings, anxiety, guilt, and persistent sadness. PPD can be diagnosed up to a year after giving birth, and it’s more common in women with a history of depression, multiple life stressors, and/or a family history of depression.

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