9 Things to Expect in Early Postpartum: Emotionally and Physically
Becoming a new mom is such an exciting time! You’ve just completed such an incredible feat by giving birth, and you got to meet your incredible new bundle of joy. But, are you prepared for the first few weeks of postpartum? Not everyone is ready for what comes next as your body and soul heal. Here are a few tips for what to expect both emotionally and physically early postpartum.
What to expect physically
- Your body may not look the way it used to, especially within the first week.
The truth is that every woman loses her postpartum weight at different rates. Regardless of the number you read on the scale, it simply just takes time for your uterus to shrink in size and nestle itself back into the pelvis. You may feel “after pains,” or contractions, that cause this shrinkage to occur. This could take up to 6 to 8 weeks, so having more of a belly than you’re used to could just be good ol’ anatomy (1). You are also still eliminating a lot of fluids, especially if an IV or epidural was administered during birth (2). Healthy eating habits, intentional movement, and rehabilitative exercise (I’m not talking about hitting the gym hard) are the best ways to assist your body in this transition. I can’t recommend enough the BIRTHFIT blog on grieving the loss of your pre-baby body written by Melissa Hemphill for more insight on appreciating your postpartum body (3).
- Bleeding, or what I like to call the ‘bloody show’ (and I’m not talking about losing a mucus plug!)
This is something I wish someone would have told me about. Yes, I knew I would bleed for weeks following delivery, but what I didn’t realize is how much blood there would be the first time I went to the bathroom. It looked as though something had endured a very unpleasant death in the toilet. I looked at my nurse wide-eyed and asked her if this was normal. Turns out, it is, so just be prepared for this. The vaginal bleeding and discharge that occurs after a vaginal delivery or Cesarean section is called lochia. This is your body’s way of getting rid of the extra blood and tissue in your uterus that nourished your baby until birth, and is also a result of the wound left behind from your placenta detaching from the uterine wall. The first 10 days or so are the heaviest, but after that, you should see less blood. You may have light bleeding or spotting for up to 6 weeks after delivery. You should only use pads at this time because tampons can lead to infection. Be aware that heavy bleeding after birth, called postpartum hemorrhage, affects up to 5% of women. It’s most likely to happen the first 24 hours after delivery, but it can happen anytime within the first 12 weeks after your baby is born. Definitely contact your doctor if this is the case (3).
- Troubles with the sewer system – constipation and/or hemorrhoids
Normally, bowel movements resume as usual within the first few days of giving birth. In some cases, constipation can occur. Some ways to help alleviate constipation naturally is:
- Drink plenty of water – half your body weight in ounces
- Eating prunes, a natural laxative
- Get plenty of sleep
- Drink warm liquids in the morning
- Eat a high fiber diet
A hemorrhoid is a painful swelling of a vein in the rectum and can commonly occur following birth, especially a vaginal delivery. You may feel pain, rectal itching, bleeding after bowel movements or swelling around the anus. Some natural ways to help hemorrhoids include:
- Sitz bath two to four times a day
- Witch hazel
- Essential oils
- Drink plenty of water
- High fiber diet (5)
- Discomfort “down there” — or perineal discomfort
I knew that there would be discomfort after having a vaginal birth, but I truly underestimated how sore I’d be and for how long. I remember reading about making witch hazel ice pads, or “padsicles,” for after birth. I made two of them! I was so proud of myself, not realizing I needed to make 100. I used a padsicle every couple hours the first few days. I also may have over-exerted myself a few times during the first week postpartum, in which case, I paid for it later. About 5-6 days postpartum, I was icing about every 2 hours or so again: lesson learned. Make sure you have plenty of padsicles in stock. There are several ways to make these, but here is one example.
I also didn’t realize that you weren’t able to wipe after going to the bathroom. Instead, a “peri bottle” is used. I placed one in every bathroom at home. All you do is fill it up with lukewarm water and rinse after, or even during, urination. The less touching, the better as you heal. Maybe even go the extra mile and add tea tree or lavender essential oil to it as well. It will be soothing and help you heal faster due to the anti-inflammatory, analgesic, and antiseptic properties of essential oils (7). Finally, take BIRTHFIT’s advice and try to do nothing but cuddle and rest for the first two weeks. Don’t over-do it.
- Breastfeeding discomfort
At first, it may not seem like you are producing enough milk, but remember that your baby’s stomach is very small at birth and the amount of colostrum that you produce is exactly what your baby needs. Colostrum is the very concentrated milk produced early on that is full of nutrients and disease-fighting antibodies, and provides everything that your baby needs in the days after birth. Milk production typically begins to increase between 30-40 hours after delivery of the placenta, but it may take even longer than this for you to actually feel as though your milk “came in.” You will feel breast fullness, may leak milk, see changes in your baby’s feeding patterns, and also see changes in the color of the milk from golden to more white. Twenty-five percent of mothers may not notice these changes until three days or more postpartum. The timing of this is hormonally controlled; however, mothers who breastfeed early and often have higher milk production on days 3-4, and their infants lose less weight and have less jaundice. Skin to skin contact can also help with milk production (8).
It is normal for breasts to become larger, feel heavy, warm and uncomfortable when your milk increases; however, some women experience engorgement. With engorgement, the breast will feel hard, warm and very tender while the skin will be tightly stretched and shiny. This can be so painful! A gentle breast massage, cool compresses, and hand expression can help.
Finally, you may also experience nipple pain. Some mothers never experience any nipple pain at all, but the majority of women do.
Typical nipple pain includes:
- Latch on pain that lasts no more than 30 seconds into the feeding
- Pain that peaks on day 3 postpartum and diminishes within 2 weeks
- No skin damage, like cracks, blisters, or bleeding
- Nipple looks the same before and after feeding
Pain that is not normal includes:
- Intense, excruciating pain
- Pain that ensues throughout the entire feeding
- Pain between feedings
- Pain that persists more than 2 weeks
- Skin damage – cracks, blisters or bleeding (9)
If the latter is experienced, I would highly recommend hiring an experienced lactation consultant to come to your house for an assessment. There is something to be said for being evaluated in the comfort of your own home, in your own space, and time.
What to expect emotionally
- Breastfeeding is not as easy as people make it out to be
Breastfeeding can be so emotional on both sides of the coin. On one hand, the connection you build with your little is overwhelmingly magical, but on the other hand, being needed constantly is exhausting. Add breastfeeding difficulties to the mix and issues can occur. Some studies suggest depression may be more common in women who attempt to breastfeed but experience difficulties (10). It took me and my little 10 weeks to figure out breastfeeding! I wanted to quit so many times, but persistence and motivation finally paid off with a successful feeding from start to finish, which led to a breastfeeding journey that lasted 25 months: the most rewarding 25 months of my life.
- Baby blues and postpartum mood disorders
The birth of a baby is a joyful and happy time, but as many as 60-80% of women experience a mild and temporary form of depression referred to as “baby blues.” This is due to sudden hormonal changes following a delivery, stress from inheriting a new role in life, and sleep deprivation. This usually occurs within the first week or two postpartum. Symptoms include exhaustion/tiredness; mood swings; feelings of loss, frustration or anger; unexplained weeping; irritability; and difficulty sleeping. You may find yourself crying simply because you are so happy and so full of love you don’t know what to do with yourself. This is still categorized under the “baby blues” umbrella. You should start to feel better within a few weeks, but if symptoms are persistent or worsen after 2 weeks, then postpartum depression or other mood disorders could be the case (5). Postpartum anxiety has become more common now than depression and includes symptoms like feelings of restlessness, excessive worry, inability to relax, or even physical symptoms like stomach aches or being unable to sleep, even when you are exhausted (12). Be sure to find a healthcare professional qualified to help and social support who understand what you are going through. I would also recommend the BIRTHFIT podcast #115 featuring Dr. Alyssa Berlin, a clinical psychologist specializing in pregnancy, postpartum, and parenting. This is one podcast that I have listened to over and over again, learning something new each time. You can find it here (6).
- The detriment of sleep deprivation
It is easy for new parents to ignore their own needs, especially sleep. While sleep deprivation is one of the most common post-birth side effects, it can also be one of the most damaging. Sleep is essential for your body to cope with stress. Without proper sleep, our brain is not able to process memories as well, leading to memory lapses. Normal daily activities can be more challenging due to reductions in cognitive abilities, and the quantity and quality of milk being produced can also be affected. A more serious side effect of sleep deprivation is severe depression. The best way to avoid the detrimental side effects of sleep deprivation is to set your priorities by taking time for yourself and asking for help on things like housework or chores. Consider a schedule that ensures you or your partner is resting while the other is tending to the baby, or try sleeping when your baby sleeps. This may seem cliche, but works for some (11). Lastly, work on mindset. While this is a challenging time, it is also such a gift that passes quickly.
- Your relationship with your partner may change
It is almost inevitable that the relationship between you and your partner will change. The focus will shift from being a couple to being parents. This is an amazing change, but it does take time to adjust. Your sex drive may be down and you may not have the time or energy for each other you once did. Sex is usually off the table in early postpartum anyway, as your uterus is healing and vaginal intercourse can not only be painful, but also increases your risk of infection. While you heal emotionally and physically, you need to be patient with each other. Evaluate your love languages and try to keep each other’s “tank” full. If I can offer one piece of advice, it is to keep your partner involved as much as possible. Give him/her tasks that will help them bond with your babe. This will not only make them feel involved and useful, but also take some things off your plate. This will also help to diminish “marginalization” that can occur if one caretaker does most, if not all, of the parenting. I will refer you again to the BIRTHFIT podcast with Dr. Alyssa Berlin. She addresses changes that occur in the relationship postpartum. Her wisdom is invaluable!
I hope after reading this you will feel more comfortable with what to expect during those first few weeks after having a baby. Welcome to motherhood, and thank you for letting BIRTHFIT be a part of your journey. Here’s to health and happiness for your growing family!
Love & Peace,
Elizabeth Sweers, DCBIRTHFIT Des Moines @birthfit_desmoines @birthfitdesmoines