Life after childbirth: How woman can recover

What happens in the first stages after childbirth

The first week after the birth of a child is called the postpartum period and lasts approximately 6–8 weeks. Doctors also operate with the number 42 days.

During this time, the uterus contracts and returns to its pre-pregnancy size. This happens especially during breastfeeding, as oxytocin is released, which enhances uterine contractions.

After childbirth, women experience bloody discharge – lochia. This is mucus, blood, and uterine lining tissues being expelled as the uterus contracts. In the first days they are redder, then gradually change color and become clear.

There are changes in the mammary glands: the breasts swell, they begin producing colostrum, which later turns into milk.

Changes also occur in the urinary and digestive systems. Urination may become difficult, and constipation is common. In the first days or weeks, incontinence or leakage of urine or gas may occur, especially after vaginal delivery. Important: This is a normal physiological state that will pass over time.

The perineum or any stitches from childbirth begin to heal. If there were tears or an episiotomy, time is needed for healing. Pain when sitting or walking is possible. Pelvic floor muscles may be weakened, but will gradually strengthen.

When menstruation resumes after childbirth

If the woman is not breastfeeding, menstruation may resume in about six to eight weeks. If she is breastfeeding, periods may be absent for several months or even for the entire lactation period in some women.

How to properly recover after childbirth

Recovery after childbirth is an individual process that depends on the type of delivery, the presence of complications, physical preparation before pregnancy, and general health condition.

Rest and sleep. The postpartum period is hard and exhausting, so it is important to sleep when the baby sleeps and not be ashamed to ask for help from relatives and your husband.

Nutrition should be balanced. It helps the body recover, especially if the woman is breastfeeding. It is recommended to consume proteins, iron, calcium, vitamins, omega-3, and drink plenty of fluids, especially when breastfeeding.

Caring for the body. If there are stitches during the postpartum period, avoid overexertion and follow proper care and hygiene of the stitches. For back or pelvic pain, use special pillows for back support or consult a physical therapist or osteopath.

Quality rest, balanced nutrition, and body care are important during pregnancy and after the baby is born (photo: Freepik)

What is strictly prohibited

Physical overexertion. Do not lift anything heavier than the baby, do intensive workouts, abruptly pull in the stomach, or wear tight abdominal binders without a doctor’s recommendation, as this increases the risk of pelvic organ prolapse, suture dehiscence, hernias, etc.

Sexual activity without a doctor’s approval. Returning to sexual activity is not recommended earlier than six weeks or before a gynecological examination. The vaginal mucosa is still healing and there is a risk of infection or re-injury.

Inserting tampons or douching. Tampons should not be used until lochia has completely stopped. Douching increases the risk of infection and disrupts the natural balance of microflora.

Do not ignore signs of complications: high fever, severe pain, foul-smelling discharge, heavy bleeding. These may be signs of infection, uterine inflammation, or other serious conditions.

Do not ignore your psycho-emotional state, suppress anxiety, depression, severe fatigue, or avoid seeking support. Postpartum depression is a real condition that requires attention. Support is important, especially from relatives and partners who can help alleviate the psycho-emotional state at least partially.

Alcohol and high amounts of caffeine are prohibited. Be cautious with foods that may cause allergies or colic in the baby, because everything that enters the mother's body partially passes into breast milk.

When you can return to sports after childbirth

If the delivery was natural and without complications, from zero to two weeks, it is recommended to do deep breathing exercises and Kegel exercises. But do not overdo them, gradually learn to develop the skills.

From two to six weeks postpartum you can gradually add stretching, light mobility exercises, and more walking, but without straining the abdomen. After six weeks, once the postpartum check-up is done, gradual return to workouts is allowed if the lochia has stopped.

If the birth was via cesarean section, from zero to six weeks, only breathing exercises and gentle walking are allowed. Avoid abdominal exercises, lifting heavy objects, or twisting the torso.

After 8–10 weeks and with doctor’s approval, you can start light workouts like after a vaginal delivery, but very gradually, listening to your body. Avoid exercises that put pressure on the abdomen, especially on the stitches. Avoid running, jumping, planks, and abdominal exercises until the pelvic floor and abdominal muscles are fully restored.

Pay special attention to feelings of pain, pelvic pressure, or increased bleeding after workouts. This is very important because if something unusual happens during or after a workout, it's better to stop.

How to return to sexual activity

Wait for the green light from the gynecologist. Before resuming intimacy, a postpartum check-up is required, usually at six weeks postpartum. The doctor will examine and check if everything has healed, if the mucous membranes are intact, the uterus has contracted, and there are no pathological discharges.

Be ready for changes in your body. These can be physical or emotional. There may be a feeling of vaginal dryness due to low estrogen levels, especially when breastfeeding. Many women feel tired, have decreased libido, fear of pain, or even loss of interest in sex. This is normal at first, and it is important to discuss it with your partner and gradually return to intimacy.

I recommend that women allow themselves not to rush. If you don't feel like being intimate, it doesn’t mean something is wrong. You need to give yourself time; both body and mind need to reboot. If sexual life does not resume over a long period or there is serious discomfort, do not hesitate to consult a doctor or psychologist, advises the obstetrician-gynecologist.

What contraception to use

After childbirth, the choice of contraception depends on many factors: whether the woman is breastfeeding, whether she plans to get pregnant again, whether there were complications.

The lactational amenorrhea method (suppression of ovulation during breastfeeding – ed.) is considered a method of contraception, but it has conditions. It lasts no more than six weeks, provided that the woman breastfeeds regularly. During this time, before menstruation begins, the method is considered effective.

The second method is condoms. They are accessible, safe, and can be used from the first sexual contact, especially if quality condoms are used. They do not affect lactation and do not require any hormonal interventions.

Hormonal contraceptives for breastfeeding mothers are progestin-only pills. They can be started three to six weeks after childbirth.

Injections such as Depo-Provera can be used. One injection every three months provides a contraceptive effect. These methods do not affect lactation.

There is also an intrauterine contraceptive. It can be hormonal or non-hormonal. It should not be used earlier than six weeks postpartum, after the postpartum check-up. Its advantage is that there is no need to think about contraception daily, and it works for up to five years, depending on the type.

What personal hygiene rules to follow

Hygiene of the intimate area, vagina, perineum stitches. After each urination or defecation, especially in the early postpartum stages, do not use toilet paper but rinse with warm water. This is necessary to avoid spreading bacteria.

You can use mild, unscented soap or just clean water. If the woman has an intimate gel she used before childbirth that caused no discomfort or allergic reactions, she can continue to use it postpartum.

It is also important, if there are stitches on the perineum, to use disposable wipes instead of a towel. If using a towel, change it every time to reduce the risk of infection.

Always change sanitary pads every two to four hours, regardless of how much discharge is present.

Wash your breasts once a day. If there are cracks or nipple irritation, it is better to use creams, especially those based on lanolin. If cream is unavailable, you can apply breast milk to the cracks.

Keep your hands and nails clean. Wash your hands before every contact with the baby, before changing diapers, using the toilet, or breastfeeding.

A new mother needs to take care of her health not only for herself but also for the well-being of the baby (photo: Freepik)

What happens to a woman's hormones

There is a sharp drop in pregnancy hormones, namely estrogen and progesterone. This can lead to sudden mood swings, tearfulness, irritability, sweating, chills, and postpartum depression.

There is a significant rise in prolactin. This is the main lactation hormone, which also suppresses ovulation. It may reduce libido, cause fatigue and tearfulness, and lower estrogen levels.

Oxytocin is also released – the love hormone. Its level increases during childbirth and especially during breastfeeding. This hormone helps the uterus contract and strengthens the bond between mother and baby.

What is postpartum depression (PPD)

Postpartum depression is a clinical diagnosis that requires monitoring and treatment. It is caused by hormonal, physiological, and psycho-emotional changes in a woman's body.

This form of depression, which arises after childbirth, is fundamentally different from the "baby blues," which is a short-term, unstable emotional state that passes within a few days without treatment.

Postpartum depression can begin within a few weeks after childbirth or, in some cases, within a few months.

Symptoms of PPD

• Insomnia, loss of appetite
• Persistent feelings of sadness and despair
• Feelings of guilt, devaluation of motherhood, and the maternal role
• Lack of interest in usual activities that previously brought pleasure
• Suicidal thoughts or thoughts about harming the baby
• Inability to emotionally connect with the child and a lack of desire to bond

If postpartum depression is not treated, it can become prolonged, worsening the condition of the young mother, which in turn negatively affects the mental and cognitive development of the child.

Who to contact in case of depression

If such symptoms are present and persist for more than two to three weeks, it is necessary to contact specialists who can help address the issue.

A psychiatrist diagnoses depression and, if necessary, prescribes medication (antidepressants) depending on the severity of the symptoms. Today, some medications are safe during breastfeeding, but a doctor must prescribe them individually in each case.

If the doctor determines a mild degree of depression, they may prescribe cognitive behavioral therapy with a psychotherapist, which helps to adjust the young mother's reactions and behavior. Typically, during PPD, it is necessary to work through anxiety, guilt, and loss of meaning due to the new status of being a mother.

The psychiatrist and psychotherapist always emphasize the importance of full rest and quality sleep during the times when the baby sleeps.

Relatives and loved ones can take on household or other responsibilities to help the mother adapt to this new period (photo: Freepik)

What loved ones can do

Physical and emotional presence is essential. It is important to ask about her condition and emotions with understanding, without any criticism, to listen to complaints and wishes, and try to help meet her needs.

Relatives should take over household responsibilities so the woman is not burdened with laundry, cleaning, or cooking. It is necessary to monitor the young mother’s condition, and in case of deterioration, such as when the woman does not want to hold the baby or refuses to feed, an immediate visit to the doctor should be arranged.

The partner, even while acting as an "emotional container" for the wife, must not forget about their rest to replenish the energy needed to effectively handle the situation.

A woman undergoing treatment for PPD needs attention, patience, support, and love. If all of this is provided, combined with therapy, the results will not take long to appear.

This material is for informational purposes only and should not be used for medical diagnosis or self-treatment. Our goal is to provide readers with accurate information about symptoms, causes, and methods of detecting diseases. RBС-Ukraine is not responsible for any diagnoses that readers may make based on materials from the resource. We do not recommend self-treatment and advise consulting a doctor in case of any health concerns.