Things No One Told You About Postpartum, But We Will

After babies are born, women are no longer in the pregnancy spotlight. While your main focus will be on your new baby, remember to still take care of yourself.

The postpartum period lasts for six to 12 weeks after you deliver your baby. As your body recovers from childbirth, expect emotional and physical changes.

“During the postpartum period, you may not feel like yourself,” says Regina Kaplan, M.D., OBGYN from the OBGYN Academic Faculty Practice of Hackensack University Medical Center. “Your body may seem foreign to you, you may feel more emotional or be mentally and physically exhausted.”

Your New Body

You may never look or feel exactly the way that you did before getting pregnant. But roughly three months after your baby is born, you may feel more like yourself.

“Women experience hormone fluctuations in the postpartum period, which settle after six to 12 weeks,” says Dr. Kaplan. “Also, your mind and body should begin to feel more like your pre-pregnancy mind and body.”

Your Bond With Your Baby

“The quality of your maternal-infant bond is strengthened when you allow your mind and body to recover and fortify your support system in the first three months postpartum and beyond,” adds Dr. Kaplan. “Self care is an important maternal behavior that helps parents and babies.”

What to Expect During the Postpartum Period

After your baby is born, your body goes through a variety of physical changes:

• Cramping. Your uterus gradually shrinks back to its pre-pregnancy size, which causes cramps at first. To treat the discomfort, consider over-the-counter painkillers, abdominal support garments, and local heat.
• Bloody discharge. You’ll have a bloody discharge, called lochia, for up to six weeks after giving birth. You’ll need to wear maxi pads during this period; tampons are not to be used.
• Soreness. 
  • If you delivered vaginally, your perineum (between the vagina and anus) will feel sore. Ice packs or warm compresses and painkillers may help.
  • If you had a C-section, your scar will hurt. Your doctor should prescribe pain medication and limit certain activities, such as lifting, squatting and stretching, for several weeks.
• Hold off on sex. Your doctor may tell you not to have sex until sometime after your six-week checkup.  Women may require additional time before sexual relations are safe or pleasurable. 
  • Check with your doctor before becoming sexually active if you have genital pain postpartum, if you suspect scar tissue, or if you had vaginal repair for a more extensive vaginal laceration which complicated your delivery.
  • By around six weeks your lochia should stop, and you may feel less sore. However, decreased estrogen levels postpartum result in changes to the genital tissues. The genitalia and vagina may experience thinning and vaginal dryness also occurs. This can continue while breastfeeding even after 6 weeks postpartum. Sexual contact may cause discomfort due to the low estrogen levels; lubricants and vaginal moisturizers are beneficial to improve comfort during sex.
• Resume birth control. Remember to begin hormonal birth control for at least one week prior to resuming sexual activity.
• Full, sore breasts. Your breasts may feel sore and engorged, particularly if you’re breastfeeding. Frequent breastfeeding may help; so may warm compresses.
• Exhaustion. You may feel physically exhausted, caused by hormone fluctuations and lack of sleep. (It’s hard to rest much when your newborn doesn’t sleep more than a few hours.) Try resting when your baby sleeps, instead of doing chores.
• Hemorrhoids or constipation. You may develop hemorrhoids or constipation after childbirth. Drinking water and eating a high-fiber diet may help. Seek care if hemorrhoids continue to worsen after the first two weeks postpartum.
• Hair and skin changes. Some women experience acne or temporary hair loss, due to hormone changes. These changes should resolve within a few months.

The postpartum period may affect your mind

Hormone fluctuations, physical exhaustion, and the circumstances or complications from your delivery may contribute to mental and emotional changes. It’s possible for new moms to experience:

• Mood changes. New moms may feel sad, weepy or briefly have the “baby blues.” This dip in mood typically lasts less than a week, then improves.
• Postpartum depression. Often triggered by drastic hormone changes, postpartum depression is a mental illness that requires treatment by a doctor. It causes sadness, emptiness or thoughts of harming oneself or the baby. 
• Postpartum psychosis. This rare condition may cause hallucinations, paranoia or obsessive thoughts about the new baby. Women with this condition need immediate treatment.

If you experience lingering sadness or have trouble bonding with your baby, seek help. Postpartum depression will resolve more quickly if you get treatment right away. You can start by talking to your primary care physician or your OB/GYN, they can guide you towards the help you need.

Mothers may feel embarrassed or guilty about their postpartum sadness. “Some people try waiting it out, thinking that they can ‘snap out of it,’” Dr. Kaplan says. “It’s not a matter of being strong enough; it’s a very dangerous illness. Get help.”

Next Steps & Resources:

• Meet our source: Regina Kaplan, M.D.
• To make an appointment with, or a doctor near you, call 800-822-8905 or visit our website. 

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.