After ten months of pregnancy cravings, and physical, mental and emotional changes, the baby is here. Now, the real work begins. We’re talking about the “fourth trimester," specifically the first month after giving birth. The first 30 days after labor and delivery are a huge adjustment period for new parents taking care of a baby, but you should also prioritize your healing and recovery. We’re sharing what you can expect from your body one month postpartum and why taking care of yourself is important.
What Does Postpartum Mean?
‘Postpartum’ generally refers to the time after labor and delivery when the mother’s body reverts to its pre-baby state, which traditionally we believed to be in about six to eight weeks. This time can be intense and overwhelming and requires comprehensive care for both you and your baby. For many, the adjustment period lasts well over eight weeks. In fact, it's not uncommon for the first year to feel like a significant life shift. That said, recovery looks different for everyone, but there are certain physical and mental recovery milestones to give you a baseline understanding of your postpartum recovery journey.
What are the Three Stages of Postpartum?
Postpartum is segmented into three distinct but continuous stages. During each stage, you may be at risk for certain conditions or need specific care, so it’s critical that you know each stage and what to expect.
- Acute phase: The first six to 12 hours after giving birth are critical as you are most likely to develop conditions like eclampsia or postpartum hemorrhaging. You will most likely stay in the hospital, or your provider will regularly monitor your blood pressure, heart rate and bleeding patterns.
- Subacute phase: Within 24 hours, you’ll transition to the subacute phase, which will last between two and six weeks. During this time, your body is undergoing massive changes to return to its pre-pregnancy state. Your healthcare provider will continue to monitor you for signs of cardiomyopathy, postpartum depression and symptoms related to urinary incontinence.
- Delayed phase: This phase lasts about ~six months to six weeks. During this time, changes are more gradual, and you will likely feel like you’re returning to ‘normal.’ During the delayed phase, long-term conditions may arise, such as pelvic floor dysfunction, painful sex and uterine prolapse in the delayed phase.
What to Expect One week postpartum
Vaginal birth Recovery
During the first week after vaginal birth, you may experience the following:
- It’s normal to have vaginal bleeding, called lochia, which starts a red or brownish-red color with a very heavy flow and then tapers off to a pinkish-red color with a low to moderate flow.
- Even if you didn’t tear during birth, your perineum is still very sore and tender, making using the restroom challenging. Ice packs, warm soaks and witch hazel can help.
- You may have intense cramping called “afterpains,” which is your uterus shrinking back to its pre-pregnancy size.
- Your breasts may produce a thick, yellow substance called colostrum that’s full of nutrients and good for the baby. You may also deal with engorgement, sore nipples and leaking, even if you aren’t breastfeeding.
- Due to fluid retention, swelling is normal and can last the first two weeks but should improve quickly.
- Fatigue is expected due to recovery, life adjustments, and sleep deprivation. Ask for help and consult your provider if needed.
- Hormonal changes may cause sweating; research suggests that up to 35% of postpartum people experience night sweats.
C-section Recovery
C-section recovery shares many of the same patterns as vaginal birth, but you have also just undergone major abdominal surgery, so there are a few other considerations:
- Your incisions should begin healing, and the pain should decrease, but they will still be sore and may intermittently feel tingly or numb.
- Your stitches will start to dissolve at this point. If you have any coverings over your incision, like Steri-Strips, consult with your healthcare provider about when to safely remove them.
- You may have issues with constipation, digestion and gas and might need to use a stool softener.
- You can lift your baby, but you should not lift anything heavier and should not engage in any rigorous physical activity.
What to Expect Two Weeks Postpartum
Vaginal birth Recovery
Two weeks in, you are likely still adjusting physically and mentally, and if you’re breastfeeding, you are still learning your baby’s habits and needs. Here’s what you can expect:
- Vaginal bleeding and discharge are tapering off, but you may still experience occasional small bursts of bleeding. If you are still heavily bleeding or having intense cramps, you should seek medical attention.
- You’re likely still sore, but any first-degree tears should heal. If you had a second-degree tear, it will likely heal this week. Stitches may feel itchy, which is a sign of healing.
- If you’re breastfeeding, you likely still have nipple soreness as the baby is still working to latch or if there are issues like thrush or tongue-tie. Consult a lactation consultant for guidance.
- Your uterus has shrunken back down and relocated back to the pelvis.
- Any other pain or swelling should drastically subside–if you have either of these or intense pain anywhere, seek medical attention.
C-section Recovery
Two weeks is still early for major surgery recovery, so you should still take precautions and limit physical activity so you don’t run the risk of ripping open your incision wound. Here’s what you can expect:
- You may still feel a bit sore, but you should be moving around more easily by now. If your healthcare provider is okay, you can even do low-impact exercises, like walking.
- If you’re still feeling pain, you can take OTC pain medication, provided your healthcare provider is ok with it.
- Your C-section should not be swollen or red/raised. It may feel itchy, which is a good sign that it is healing well.
- If you had steri-strips or glue on your incision, they should be falling off or ready to be gently removed.
- Most people have their first c-section follow-up appointment after the first two weeks.
What to Expect Six Weeks Postpartum
Vaginal birth recovery
The six-week mark is considered the ‘delayed phase’ of postpartum, marking a common postpartum recovery milestone. Here’s what you can expect:
- For most women, postpartum bleeding has stopped by this time, though occasional spotting may still occur.
- Your uterus has returned to its pre-pregnancy size, shrinking from 2.5 pounds to about 2 ounces, but your abdomen may still need time to recover.
- Within these six weeks, many women lose about half of their pregnancy weight (more if they are breastfeeding), and you should be cleared to exercise and have sex at your six-week postpartum checkup
- You should have fully healed from any tears of lacerations–including third- and fourth-degree lacerations
- If you are bottle- or combination-feeding, you can expect your first postpartum period around this time.
- You may start discerning any long-term issues as you heal, such as pelvic floor strength or diastasis recti, which is when the abdominal muscles separate during pregnancy. Physical therapy can drastically help both conditions.
- Exercise and sex: Your healthcare provider may clear you for exercise and sex at your six-week postpartum checkup.
C-section recovery
By six weeks, you should be fully recovered from the c-section and, barring any complications, able to return to pre-pregnancy activities. Here’s what you can expect:
- Your c-section scar may still be a bit itchy or uncomfortable, but it has mostly healed.
- You can return to strenuous activity, including heavy lifting and exercises.
- You may still experience some light spotting and pain localized to your lower belly area.
- Your healthcare provider should clear you to drive, bathe and have sex by the six-week mark.
Hormones and Mental health
During the first 2-6 weeks after giving birth, your hormones are still in flux, and you’ll likely feel some mental and emotional changes. Estrogen and progesterone levels are dropping, while prolactin and oxytocin fluctuate with breastfeeding. Combined with sleep deprivation, it's no surprise that you might feel a bit off-balance.
It is not uncommon to experience the baby blues–feelings of sadness, weepiness and emotional sensitivity–which can feel like an extreme version of PMS. About 50-75% of new mothers experience some sort of negative feelings or mood swings after childbirth, but they usually subside within 10 to 14 days.
If you’re still feeling down after that or your emotions are particularly intense, it’s important to talk to your healthcare provider. You may be dealing with postpartum depression, a form of depression that is treatable and can improve with early support. As your hormone levels settle and you learn to adjust, you should start to feel settled around the six-week mark, but that does not mean you will feel completely back to ‘normal,’ which may take much longer for some people.
What Are Ways to Take Care of Myself After Having a Baby?
Taking care of yourself after having a baby is crucial for your physical and mental recovery. One of the best things you can do is give yourself permission to rest and heal, even if it feels challenging. Rest allows your body and mind to recover, so don’t hesitate to ask for help—whether it’s limiting visitors, asking someone to help with childcare, or getting assistance with meals and household chores. Other recovery tips to consider:
- Focus on staying nourished and hydrated by eating healthy foods like lean proteins, fruits, vegetables, and whole grains and drinking plenty of water to avoid constipation.
- Adequate nutrition while sleep-deprived and taking care of a newborn can be challenging; consider a postpartum supplement to help fill the gaps where needed.
- If you had a vaginal delivery, care for your perineal area by using a peri bottle and soothing witch hazel pads.
- While it’s tempting to rush getting back in shape, take it slow with physical activity; your healthcare provider will tell you when it’s safe to start gentle exercises.
- Finally, don't forget about your mental health. Talk to a friend, partner, or healthcare provider if you're feeling overwhelmed, anxious, or sad. There are plenty of resources to support you through this challenging time.
