“Every woman has a different pregnancy, delivery and recovery experience,” says Dr. Erin Myers, a female pelvic medicine and reconstructive surgeon at Atrium Health Women’s Care Urogynecology & Pelvic Surgery.
Some women have minimal symptoms afterward, while others experience more significant issues. There’s also a transition period in the “fourth trimester” of getting to know your baby and learning the best way to care for them.
The more you know what to expect, the easier it is to manage this postpartum period.
Your Body
OB-GYNs typically schedule follow-up appointments about six weeks after delivery to see how you’re feeling emotionally and physically, says Dr. Sasha Davenport, an OB-GYN at Atrium Health Women’s Care Sexual Health. If all is well, they’ll likely clear you to return to exercise and sex. But before that appointment, here’s a head-to-toe look at some things you might experience post-delivery.
Your Mind
In the first days after childbirth, some moms experience the baby blues: fleeting feelings of depression, anxiety or anger. These feelings are normal and typically subside in one to two weeks without treatment.
On the other hand, postpartum depression involves more intense and debilitating feelings of sadness, anxiety or despair, which generally start one to two weeks or longer after delivery.
If you experience these psychological symptoms and they persist two weeks after delivery or you have thoughts of hurting yourself or anyone else, Davenport advises contacting your OB-GYN immediately. They can diagnose you, suggest resources — such as Atrium Health’s dedicated postpartum support group — and recommend treatment options, which may include antidepressants or talk therapy.
In addition, your OB-GYN can connect you with the Atrium Health Maternal Wellness Program, which is run by psychiatrists with specialized training in prenatal (before birth) and postpartum (after birth) mood disorders and anxiety.
Your Heart and Lungs
“Your body produces about a liter and a half of extra blood volume when you’re pregnant,” says Davenport. “That additional fluid eventually dissipates sometime after delivery, but before it does, it can put more strain on your heart.”
In addition, there’s a higher risk for blood clots while you’re pregnant and in the few months afterward, according to the Centers for Disease Control and Prevention.
If you develop shortness of breath, chest pain, a racing heart or unexplained swelling or tenderness, especially in your lower limbs, that’s another reason to immediately call your doctor to rule out a blood clot or other serious issue with your heart or lungs.
Your Breasts
As your milk supply comes in a few days after you give birth, your breasts may become very swollen and painful. This is called breast engorgement and it can happen whether you’re breastfeeding or not.
It typically subsides within a few days, but don’t hesitate to ask your doctor for ways to relieve the discomfort of this condition. If you’re breastfeeding and have questions or need help, you can also take advantage of the breastfeeding support offered through Atrium Health.
In addition, some women experience breast infections in the postpartum period, which is why Davenport encourages breast awareness so that you know what’s typical for your body and can report any breast changes, unusual lumps or discharge to your doctor.
Your Pelvic Area and Abdomen
Some vaginal deliveries and cesarean deliveries (C-sections) after long labors result in a tear in your perineum, the area between your vagina and anus. All but the smallest of perineal tears require stitches, as do C-section incisions. Follow all discharge instructions for wound care and let your doctor know if you run a fever or have severe pain, increased swelling or foul-smelling discharge at the incision site, as these might be signs of an infection.
After delivery, you may feel pelvic heaviness or pressure or experience urine or stool leakage. Some women also suffer from pelvic prolapse, which is when a weakened pelvic floor is unable to support the uterus, bladder or rectum, causing it to descend or press on the vagina. This can occur whether you have a vaginal delivery or a C-section.
For many women, these pelvic floor issues heal on their own or through Kegel exercises, according to Myers. If they persist after three to six months, Myers recommends following up with your OB-GYN to discuss further treatment options, which may include a referral to a physical therapist, pelvic floor specialist or urogynecologist, who can offer advanced treatments or surgical care.
Atrium Health Women's Care Urogynecology & Pelvic Surgery is also available to address pelvic floor disorders. It is home to nationally renowned physicians who are pioneers in their field and are some of the only surgeons in the region to perform certain minimally invasive gynecologic surgeries.
Your Sex Life
At your follow-up visit, your doctor will check to see if you’ve healed enough to return to sex. Once you get the all-clear, Davenport says it's important to realize that between sleep deprivation, the stress of motherhood and hormonal changes, you may experience a change in sexual desire or arousal.
“Ask your partner for help in alleviating some of the stress you’re under. Given how overwhelming life is with an infant in the house, even scheduling time for sex can be helpful,” Davenport suggests.
And whether you’ve had a vaginal delivery or C-section, Davenport recommends liberal use of lubrication during your first intimate encounters after childbirth. This will help alleviate the discomfort you might experience due to still-healing vaginal tissue and the hormonal changes in your body.
Your Baby
The start of your newborn’s life is all about five things: eating, peeing, pooping, sleeping and crying. If that’s all your baby is doing, they’re right on track, says Dr. Anitha Leonard, a pediatrician at Atrium Health Levine Children’s Arboretum Pediatrics.
Here’s what Leonard says you can expect from your baby’s first three months of life:
- Temporary weight loss. It’s normal for your baby to lose weight in the first two weeks after birth, but they should regain it quickly.
- Schedule? What schedule? Is your baby sleeping all day and partying all night? It’s totally normal for newborns to have their days and nights mixed up. It’s hard to see the light at the end of the tunnel at 3 a.m., but soon enough, you and your baby will get on a sleeping and feeding schedule that works for you.
- It’s tummy time. In these first 90 days, you’ll start putting your baby tummy-down on firm surfaces for 20 to 30 seconds at a time. This will help your baby increase core strength. Your baby’s head is heavy, so this isn’t easy for them. But soon, they’ll get stronger and be able to support their head.
- More interaction. During this time, your baby will start to see better since infants can’t see well right away and learn to focus their eyes. They’ll also start responding to what they see and may start to smile.
“Newborns are a lot of work,” says Leonard. “It’s easy for parents to forget about their own needs. But remember that your body is still recovering and adjusting to life with a newborn. Drink lots of water. Eat healthy foods. Rest when you can. And reach out when you need help or don’t feel like yourself.”
Finally, just as your baby is learning about their new world, Leonard has an assignment for you, too: Take infant CPR and basic life support classes. Even if you never use them, the lifesaving skills you’ll learn are invaluable.
Want to learn more about pregnancy and newborn care? Check out our guide to pregnancy and newborn care.
Need an OB-GYN or a care for your baby? Find a doctor and schedule online.
