Postpartum recovery: What to expect

The moment you’ve been waiting for is finally here. After months of nurturing a growing baby in your belly and long hours of childbirth, your little one is part of the outside world now. Congratulations!

You just did an incredibly beautiful and difficult thing. Now comes the transition from pregnancy to postpartum – and chances are you’re going to feel tired, sore and a little anxious. But what exactly can you expect after giving birth?

Your body and emotions are going to experience a lot of changes in the days and weeks following childbirth. Here are some of the key things to expect immediately after giving birth and during the postpartum recovery process.

Postpartum recovery timeline

How long is the postpartum period?

No matter how you delivered your baby, the postpartum recovery period is generally considered to be the first six weeks after childbirth.

This doesn’t mean that at six weeks you’ll magically bounce back to pre-baby condition. Instead, this refers to postpartum healing, which is the physical healing of your body after birth.

How long does it take to heal after giving birth?

By the six-week mark, your vagina, perineum or C-section incision should be healed, and your uterus should be back to its normal size. Throughout those first weeks, you’ll experience a lot of changes – from new levels of tiredness to hormone fluctuations. And you’ll probably continue to see changes in your body and emotions after the initial six weeks of recovery. For example, if you developed varicose veins during pregnancy, it may take up to 12 weeks for them to fade or go away.

Your postpartum body: How your body will feel and change after giving birth

Postpartum hormone changes

Hormones are your body’s chemical messengers that tell your body how to do something and when to do it. During pregnancy, your hormones changed to help support your growing baby and prepare your body for childbirth. After giving birth, your hormones are on a new mission to help you heal, bond with your baby and breastfeed your baby if you choose to.

The first postpartum hormone changes your body will go through are:

Estrogen and progesterone levels decrease when your baby and the placenta are delivered.
Oxytocin – known as the bonding hormone – surges and contributes to the strong parental instinct you’ll feel.
Prolactin increases to signal milk production.

Bleeding and vaginal discharge

As your uterus sheds that thick lining it maintained during your pregnancy, you’ll experience some vaginal bleeding and discharge – which is known as lochia. Even if you had a cesarean (C-section), you’ll experience bleeding and discharge.

Lochia will start out as bright red for a day or two before gradually fading to pink, and then light brown or light yellow. Bleeding and discharge will be the heaviest within the first several days after having your baby, but will become lighter as time goes on. Typically, lochia can last 4-6 weeks, with discharge continually decreasing.

How much bleeding is too much?

Early on, it may seem like you’re bleeding a lot – similar to having a very heavy period. This is totally normal, but there are a few signs to watch for.

If you’re soaking through one pad an hour for more than two hours, call the nurse line or your care provider right away. Also, if you continue to have bloody discharge or pass blood clots for more than four weeks, call your care provider.

Increased bleeding after your lochia starts to decrease can be a sign you’re overdoing it and need more rest. Seeing ongoing clots could mean your uterus is having trouble getting back to its pre-pregnancy size. In either case, it’s always best to call.

When can you expect your first postpartum period?

Several factors can affect when you get your first period after giving birth. One of the biggest factors is whether you’ve chosen to breastfeed your baby and if your breastmilk is their only food source.

Typically, those who do not breastfeed may expect their period to return sooner than those who do – anywhere from four weeks to three months after giving birth. For those that do breastfeed, some may get their period within that same timeframe – but many may not get their period until they’ve begun to wean or stopped breastfeeding entirely.

Vaginal and perineum soreness

Both your vagina and your perineum (the area between your vagina and rectum) will feel very tender and sore from the strain of childbirth.

If you gave birth vaginally, it’ll probably take you a few weeks to heal, especially if your perineum tore or you had an episiotomy. If you labored or pushed at all, but eventually gave birth by C-section, it’s very likely that you’ll still be sore.

In our “Postpartum essentials” section below, we’ll talk about what you can do to relieve postpartum vaginal pain, and promote healing.

After-birth pains (contractions)

Contractions after birth, also called after-birth pains, might be uncomfortable at times but nothing like what you may have experienced during labor. Actually, contractions after birth are signaling something good.

After-birth contractions help reduce uterine bleeding, and help shrink your uterus back to its usual, pre-baby size.

You may notice after-birth pains the most if you breastfeed. This is because breastfeeding causes your body to release oxytocin, a hormone that causes uterine contractions.

Engorged breasts

Your breasts have been changing since the beginning of your pregnancy. And around the third or fourth day after giving birth, you’ll notice the next big change as your breasts will start filling with milk. Your breasts may become engorged and feel firm, swollen and sore.

That initial tightness and soreness will wear off whether you choose to breastfeed or not. But if you choose to breastfeed, your breasts will usually feel full before feeding or pumping sessions. And you may experience more of that tender, heavy feeling if your next session is a little overdue.

Sore or cracked nipples

Blood flow to your nipples increases throughout your pregnancy, so you’ve probably noticed some tenderness for several months. But the first few days after giving birth brings that blood flow to a new height, making them particularly sensitive. And naturally, if you choose to breastfeed, that will have an impact, too.

As your baby learns how to properly latch on to your breast, it’s common to experience a little pain at first. But once baby gets a good latch, that should go away. A little discomfort as baby gets into a rhythm is normal, but feeling constant pain throughout your feeding is not.

If you find that you have breastfeeding problems, a lactation consultant can be a big help – and you can ask for one right in the hospital.

Sore muscles

You’ve just finished the mother of all workouts, so it's normal to feel some muscle soreness throughout your body following birth. And you may feel the aftereffects of your hard work for a few days.

You can expect to feel especially sore anywhere you held a lot of tension during labor, such as in your arms, neck or jaw.

Tiredness

Fatigue is another perfectly normal postpartum symptom. Again, your body has just gone through (and is still going through) a lot, so it’s important to get as much rest as you need.

Many care providers recommend sleeping whenever your baby does. You and your baby’s well-being are the most important things right now. Eating healthy and staying hydrated will also help you restore and maintain your energy levels over time.

Night sweats

Many people experience postpartum night sweats due to changing hormones. While they can be uncomfortable, they aren’t anything to worry about. Just make sure you’re drinking enough water and try to stay cool. Night sweats should subside in a couple weeks.

Lower abdominal pain on and near your incision (if you had a C-section)

After a C-section, you’re going to feel pain and tenderness on and near your incision, especially for the first few days and weeks as you recover.

C-section recovery timeline

The postpartum recovery process after a C-section tends to be a bit longer than a vaginal birth. You’ll likely stay in the hospital for an extra day, and you’ll have certain restrictions on bending and lifting. You may also be prescribed pain medication to take for one to two weeks after delivery.

Before you go home, you’ll get detailed instructions for how to care for your incision and promote healing. Your incision should be healed around six weeks after giving birth.

Caring for your C-section incision

When taking care of your incision, it’s important to be as gentle as possible while keeping it clean and dry. This may mean:

Cleaning your incision once or twice a day with mild soap. Either run soap and water over it in the shower, or gently use a washcloth or bath sponge.
Dabbing away excess water with a clean towel, then air drying the rest.
Wearing gauze bandages to absorb drainage and protect your clothes, and changing the gauze daily or if it gets wet.

How your mood, attitude and emotions can change after childbirth

Having a new baby can bring a wide range of emotions along with it. Of course, it’s going to be beautiful and exciting, but it’s also going to put new pressures on you, your time and your energy. Here are a couple changes you can expect.

You’re very likely to experience some baby blues

After all the excitement and beauty of birth, it can be surprising and confusing to suddenly feel bouts of sadness, anxiety or irritability. But this isn’t just normal, it’s incredibly common.

In fact, about 80% of new moms experience a range of emotions or mood swings during their first days with their baby. This is what’s known as the baby blues. The baby blues may also give you insomnia or make you feel overwhelmed at times. But they usually go away on their own within two weeks.

During this time, it’s important to be particularly kind to yourself. It can help to talk to your partner or loved ones about how you feel. Share how you’re feeling so they can support you and help you get through it.

If your baby blues last more than two weeks or your symptoms become more severe, call your care provider. You may be experiencing postpartum depression.

Your interest in sex may decrease

There are several reasons you may not feel like being intimate with your partner after giving birth. You’re tired and spending a lot of time and energy on being a great parent. Your body may still be healing or experiencing hormonal shifts.

Talking about what you’re experiencing with your partner can help them better understand your feelings. Also, knowing when sex is considered safe again is important for setting the right expectations for yourself and your partner.

How long after giving birth can you have sex?

Typically, you can begin having sex – if you feel comfortable and your care provider says it’s okay – around six weeks after giving birth. Keep in mind that hormonal changes can cause your vagina to feel dry and tender, especially if you’re breastfeeding. Using a personal lubricant will help ease discomfort.

It’s also possible to get pregnant in the postpartum period, even if you’re breastfeeding and haven’t noticed your period yet. It’s hard to know when ovulation will return after giving birth, so be sure to use protection. Your postpartum visit is a great time to discuss birth control options.

You may notice changes in your relationship with your partner

You and your partner probably know that your relationship is going to change with your baby’s arrival, but it may still come as a shock. It’s perfectly normal. Your lives are both different now, and it’s going to take some getting used to. Open and honest communication is going to be your best tool as you both adjust to your new life together as parents.

Postpartum essentials: What you’ll need on hand as you recover

Your care team will make sure you have what you need to begin the postpartum healing process during your hospital stay. (And they may even send you home with a few things.) But there are several postpartum necessities you should have on hand at home for when you return from the hospital.

Pain relief medication – Acetaminophen (Tylenol) or ibuprofen (Advil) can both help relieve aches and pains. Your care provider may even recommend alternating between the two medications during the first few days of recovery. Just make sure you follow their instructions and ask any questions you may have. If you’ve had a C-section, your care provider may prescribe a pain relief medication for you to take during the first couple of weeks post-delivery.
Postpartum belly band – Belly bands use light compression to help ease some of the aches and pains as you heal. Bands wrap around your abdomen, from your hips up to your ribs. Some women find that wearing a band reduces their back pain, supports their pregnancy-stretched core muscles and takes some of the pressure off their incision if they had a C-section. You may be given a postpartum belly band at the hospital if you have a C-section.
Absorbent maxi pads – Tampons will be off limits until you’ve fully recovered, so you’ll need comfortable yet absorbent maxi pads for the bleeding and discharge you’ll experience.
100% cotton underwear – Cotton is breathable and can wick away moisture. Since you’ll be bleeding on and off for several weeks – and more heavily at first – choose underwear you’ll be okay with throwing away if it becomes stained. You can also find disposable cotton underwear, similar to what the hospital will provide for you. (Tip: Ask for a few extra pairs of disposable undies from the hospital. Many people find them to be incredibly comfortable, especially the first few days after having a baby.)
Ice packs – Ice packs in various forms will be an effective way to get relief from pain and inflammation. You can even get wearable ice pads for your perineal and vaginal areas. But the classic ice pack wrapped in a towel will still do wonders. Ice packs can also reduce discomfort from sore or engorged breasts.
Peri rinse bottle – As your vagina and perineum recover, use a peri bottle or spray bottle filled with warm water to promote healing and protect any stitches. The warm water is soothing and will enable you to gently rinse off your perineal area after you go to the bathroom. You’ll receive a peri bottle in the hospital that you can take home.
Sitz bath – A sitz bath, which is when you sit in warm, shallow water, can also be used both to soothe irritation and clean your perineum. You can take a sitz bath in your bathtub or buy a kit with a plastic bowl that fits onto your toilet.
Witch hazel pads – Witch hazel pads are great for soothing postpartum hemorrhoids, but they can also help ease perineal soreness.
Hemorrhoid spray with lidocaine – Lidocaine is a local anesthetic and is used as an ingredient in certain sprays. These sprays can give you fast, cooling relief from pain and irritation caused by postpartum hemorrhoids.
Stool softener – You may experience constipation in the weeks following birth. A stool softener can be a gentle way to help things move along smoothly, and put less strain on your vaginal and perineal areas – especially if you’ve received stitches.
Nursing bras for day and night – Nursing bras are designed to give you comfort and support without irritating sensitive areas. They also come with flaps that open to make it easy for your baby to feed without having to remove your bra. Even if you aren’t breastfeeding, a snug, comfortable bra that provides firm support will do wonders. Wear bras that do not have an underwire.
Lanolin and nipple creams – These special creams are a go-to treatment for sore, dry or cracked nipples. They can be applied any time you’re feeling discomfort. And many creams are made with baby-safe ingredients, so that you don’t have to wash them off before you breastfeed. HealthPartners’ Health and Care Stores carry an organic, herbal salve that our lactation consultants recommend, along with other helpful breastfeeding products.
Nursing pads – If you’re breastfeeding, it’s common to experience some milk leakage between feedings. Even if you’re not breastfeeding, you may still leak a little colostrum or milk from your breasts early on. Nursing pads fit comfortably inside your bra to soak up leaks and help prevent a wet shirt. You can get reusable pads or disposables depending on your preference. Both need to be changed throughout the day.
Heating pad – As far as self-care tools go, the heating pad is a classic. Resting against a source of gentle, focused heat can help with a variety of aches and pains, from your lower back to your breasts.
Help – Your partner, family and friends can be good resources for you as you recover. You have an important job to do, so be ready to ask for and accept help with chores, meals and anything else.

Get answers to all your postpartum recovery questions

During your postpartum healing period, you’ll experience a lot of physical and emotional changes, and some may surprise you no matter how prepared you are. Just know that we’re here for you if you have questions or need help. Our nurse lines are staffed with experienced nurses who are available 24/7.

HealthPartners patients can call 800-551-0859. Park Nicollet patients can call their clinic directly during business hours, and 952-993-4665 after hours. And if you have questions or need advice about taking care of your new baby, our BabyLine is also available 24/7 at 612-333-2229.

And if you’re looking for more resources, check out our pregnancy and parenting resources guide that connects you with helpful information no matter where you are in your journey.