Your body will start to heal itself immediately after childbirth. The natural course is to return to its non-pregnant state, but the changes will not just be physical—there’ll be some emotional and mental hurdles as well. And yes, postpartum hormones will play very big roles in this.
How long is the postpartum period?
The postpartum period, also known as puerperium or the fourth trimester, typically lasts for 4 to 12 weeks.
It could go on until 6 to 12 months after delivery in some cases. But just as women’s prepartum experiences vary, you can expect the postpartum journey (its extent, joys, and challenges) to also look different from mom to mom.
RELATED: Stages of Pregnancy & What to Expect per Trimester
How difficult does it get after pregnancy?
There’s really no fit-for-all answer here. But what I can tell you is that it does get tough. And it does get better (with the right interventions and support system).
Personally, I’ve experienced both easy and extremely difficult postpartum journeys. My recovery period after my first childbirth was a breeze. No serious baby blues, and I was back on my career groove just 2 months after I gave birth.
But the period after my second childbirth? That one is indescribable. Not only did I experience postpartum depression, but I also had trouble breastfeeding, maintaining my self-esteem, and controlling my urge to binge eat (which made my self-esteem issues worse!).
I can’t begin to explain how low that period was. Thankfully, there were people who helped me with my recovery, and I sure hope you have a supportive community to help you out, too!
RELATED: Postpartum Recovery & How to Not Sabotage Your Healing
Postpartum for normal & C-section delivery: Is there a difference?
Giving birth vaginally is different from giving birth via C-section, even in terms of your postpartum period symptoms, possible complications, and the time you’ll need for recuperation.
One obvious difference is where you’d feel pain and soreness. A momma who had a C-section will feel soreness and pain in the incision area for the first couple of weeks and itching in the same area as the wound heals.
For vaginal delivery, mommas will feel the soreness and pain where the tearing occurred, and the itching will also occur in the same area as the tear heals.
Both birth methods come with their risks, though healing time is generally shorter for moms who had a vaginal birth. Apart from these, the overall puerperium experience could look almost the same—with some differences that may be attributed to your unique body and health status instead of your method of giving birth.
What are the 3 phases of the postpartum period?
The Journal of Prenatal Medicine says that puerperium is made up of three phases: the acute period (6 to 12 hours after delivery), the subacute period, (2 to 6 weeks after delivery), and the delayed postpartum period (6 months or more postpartum).
Keep reading to know more about each postpartum phase and the changes you can expect.
1. Acute postpartum period
This period covers the first 6 to 12 hours after the mother expels the placenta.
It’s the postpartum phase with the most number of health risks, so it’s ideal that you’re closely monitored by your nurse or midwife during this time. Below are some risks that medical professionals keep a close watch for in this period:
- Postpartum hemorrhage
- Amniotic fluid embolism
- Anesthesia complications
You can expect some rapid changes as your body starts to adjust to the fact that it’s no longer pregnant. There’ll be a sharp drop in your estrogen and progesterone levels, which could induce certain mood changes and baby blues.
If you do experience baby blues, it helps to know that the sad feelings are normal and would usually go away after a week or two.
It’s common for new moms to go through sudden mood highs and lows. You might even feel irritable and anxious, but your oxytocin surge (which is another hormonal change you should expect) should help you deal with the negative feelings and trigger some physical processes that’ll help with some mothering roles (like breastfeeding).
2. Subacute postpartum period
This second stage begins 12 to 24 hours after the acute phase and lasts somewhere between 2 to 6 weeks. This is when a lot of postpartum healing happens, including the return of your uterus and cervix to their pre-pregnancy conditions.
You should know, however, that the process will not be as rapid as during the initial phase. You should also ready yourself for some physical, emotional, and mental challenges, which your doctor should orient you about during one of your postpartum follow-ups.
Vaginal bleeding and discharge
This is called lochia and can last somewhere between 4 to 8 weeks. This postpartum vaginal discharge is normal for both vaginal and cesarean births—it’s the result of your body removing the remaining tissues and blood in your uterus.
The blood-red discharge usually lasts a few days, followed by a brownish-red watery discharge that lasts up to 3 weeks. The final stage of lochia is more yellowish in color and lasts for a week or two.
If you feel that your discharge is heavier than normal (that is, you’re soaking more than one pad per hour or you’re expelling blood clots as big or bigger than the size of an egg), then you should immediately contact your doctor.
You and your doctor should ideally talk about afterbirth bleeding weeks or months prior to your due date. As one 2019 qualitative study shows, postpartum hemorrhage prevention methods are more likely to succeed if the mother and her healthcare provider agree on the condition’s causes as well as consequences. So please do talk openly to your doctor.
Afterbirth pains and contractions
As your uterus shrinks to its pre-pregnancy size, you will experience some contractions that may feel a bit like labor pains or menstrual cramps.
The good news is that these pains will not last long. Plus, contractions may cause your lochia to gush out more, so that should help you get rid of your vaginal discharge sooner.
Peeing and pooping problems
Peeing and pooping can be rather challenging after you give birth.
Moms who went through vaginal delivery may have had their baby pressing into their urethra and bladder during the birthing process. Plus, for as long as your birthing wounds are still fresh, peeing may sting or cause that uncomfortable, burning sensation.
Meanwhile, moms who went through a C-section are also prone to peeing pains due to the catheter used during the operation.
You may also find yourself constipated during the first few weeks of puerperium. If this happens, you should drink lots of water and eat high-fiber foods. If that doesn’t work, then you may want to ask your doctor about safe stool-softening foods or medication.
You will notice that your breasts have grown bigger. After your body produces colostrum, your breasts will then start producing transitional milk followed by mature milk. These milk stages offer the nourishment your baby needs at different stages of their development. Sadly, breastfeeding doesn’t come easy for all women.
If your breasts aren’t emptied regularly, you become susceptible to breast engorgement, which then makes breastfeeding more difficult or painful. You may feel swelling or tenderness in your breasts, and you may also experience low-grade fever.
But even with the difficulty, breastfeeding your baby is actually the easiest way to relieve the pain that comes with engorgement. It’s also the best way to signal your body to keep producing enough milk to sustain your little one.
The key is to do your best to persevere in breastfeeding and ask for help (from your doctor, your peers, or a breastfeeding specialist) when needed.
After giving birth, a momma can experience significant weight loss of around 15 to 20 pounds. This weight loss isn’t only due to the fact that you’re no longer carrying your baby in your tummy, but also because of the discharge of the amniotic fluid, the shrinking of your uterus, and the delivery of your placenta.
Lochia discharge will also make you lose some weight during the first few weeks after giving birth. And if you experienced swelling during pregnancy, then you’ll begin to lose those retained fluids as well.
Keep in mind that plenty of other factors will also affect your weight. It’s possible to gain instead of lose weight after pregnancy, but you can manage that through exercise and a healthy diet.
Baby blues or postpartum depression
As mentioned previously, it’s normal for moms to experience hormonal drops. These drops could cause you to feel sad, irritable, anxious, or indecisive, which is why it’s not surprising that baby blues is experienced by 80% of new moms.
Note, however, that baby blues shouldn’t last for more than a few weeks. If your roller coaster of feelings persists and grows worse, it’s possible that you may be suffering from postpartum depression or PPD. More on this later!
Early diagnosis of this issue is crucial to your and your family’s well-being. So if you find yourself feeling the baby blues longer and more severely than normal, then you should immediately seek the help of a professional.
3. Delayed postpartum period
This third phase can take somewhere between 6 to 12 months or even longer for some women. The changes during this period are gradual—most of which are affected by your infant’s size at birth, the degree of your birthing lacerations, your collagen support, and your lifestyle during and after pregnancy.
It’s during this phase that resuming physical exercises is safe and beneficial, especially if you’re eager to tone your muscles and get back your pre-pregnancy bod. But of course, it’s always best to consult your doctor before resuming (or starting) any physical routines.
Let’s talk more about postpartum depression
As a new mom, it’s quite normal for you to feel out-of-sorts. The term baby blues isn’t just for the color of Frank Sinatra’s eyes, but it’s also used to describe that jumble of emotions a woman feels after giving birth.
Normally, this feeling lasts only a few days to a couple of weeks and will include bouts of crying, unpredictable mood swings, and even sleeplessness. This is attributed to the hormonal changes that happen after the baby is born. When these feelings extend beyond the usual 2-week period, however, then it can be considered postpartum depression.
What is postpartum depression?
Postpartum depression is a mental illness that affects more than just the behavior of a new mom—it can also affect their physical health and life altogether. This problem can result in feelings of resentment towards the baby, feelings of emptiness, and even losing interest in life. This can also present with a plethora of other symptoms, such as having no energy to do anything, sleeping and eating problems, memory problems, and isolating oneself from the rest of the world.
PPD can be triggered by the sudden drop in hormones a momma experiences after giving birth. It can also be triggered by a combination of issues like the many changes a new mom goes through: changes in relationships, changes at work, worries about life after giving birth, and even the changes she sees in her physical self.
What to do when you suspect that you have PPD?
There are a lot of symptoms that can indicate the onset of postpartum depression, apart from the ones that are already mentioned above. Worsening feelings of depression, inability to carry on with normal life on a daily basis, thoughts of hating being a mom, and thoughts of hurting yourself or the baby are some of the most telltale signs of this issue. If you are experiencing any of these, you may be suffering from PPD, and you should get in touch with your doctor immediately.