Postnatal recovery: What to expect after having your baby

Having a baby is a significant physical and emotional experience. After pregnancy and birth, your body needs time to recover. While some changes happen quickly, your body will gradually return towards its pre-pregnancy state over several months.

The early weeks can be a time of adjustment as you recover from birth, establish feeding, care for your newborn and manage broken sleep. Remember that looking after yourself is an important part of looking after your baby.

Vaginal discharge after birth: lochia

Bleeding following birth is normal and is known as lochia. It is initially red, before gradually changing to a reddish-brown colour and then becoming lighter or clearer.

Lochia usually settles within four weeks, although for some women it can continue for up to six weeks. Bleeding may be more noticeable while breastfeeding because breastfeeding causes the uterus to contract.

Small blood clots can be normal during the first few days after birth. However, tell your midwife if you pass a clot larger than a 50 cent piece, notice an increase in bleeding, or experience changes in the colour or odour of your discharge or increasing pain.

If bright red bleeding continues after you leave hospital, contact your St John of God Hospital, GP or obstetrician.

If you suddenly experience very heavy bleeding and require immediate assistance, please call 000.

Afterbirth pains

You may experience abdominal cramping or contractions after your baby is born. These are sometimes called afterbirth pains and are caused by the uterus contracting as it gradually returns to its pre-pregnancy size.

They can be particularly noticeable while breastfeeding and may be more uncomfortable after subsequent pregnancies. The discomfort generally becomes less severe over the first few days. A warm pack or pain relief such as paracetamol may help.

Recovering after a vaginal birth

If you have experienced a vaginal birth, you may have some swelling, bruising or discomfort around your perineum, particularly if you had a tear or episiotomy.

A physiotherapy approach known as RICE (Rest, Ice, Compression and Elevation) can help support early recovery.

Rest

Rest as much as possible, particularly during the early days. Lying down can reduce pressure on your pelvic floor and perineum and give your body an opportunity to recover.

Try different positions to find what is comfortable for you. Side-lying can also be a comfortable position for breastfeeding, just ensure you don’t fall asleep with your baby in your bed.

Ice

Ice can help reduce perineal pain and swelling. Apply an ice pack wrapped in a protective layer for around 15 to 20 minutes at a time, every two to three hours during the first few days, or longer if you continue to experience swelling or discomfort.

Compression

Firm control briefs, bike shorts or leggings may provide additional support and comfort around the perineum when you are upright.

Elevation

Lying down can help take pressure off the pelvic floor and perineum. Some women find lying on their stomach with appropriate pillow support comfortable.

Caring for your perineum

You can also help support healing by:

• Starting pelvic floor exercises when you feel comfortable. These can improve circulation and support recovery
• Holding a clean pad against your perineum the first few times you open your bowels for additional support
• Keeping the area clean and dry after passing urine
• Asking your healthcare team about pain relief if passing urine is uncomfortable
• Reporting pain, swelling, bruising or anything else you are concerned about to your midwife
• Speaking with your doctor or midwife if your stitches have not healed (after three weeks) or you continue to experience discomfort
• Letting your doctor know if you are still experiencing perineal discomfort at your six-week check-up
• Using a lubricant when you first resume sexual intercourse. Different positions may also make intercourse more comfortable

Physiotherapy may also be available during your hospital stay and after you go home to help manage pain and swelling and support your recovery.

Supporting your pelvic floor after birth

Your pelvic floor has been under significant strain during pregnancy and birth, so it is important to give it time to recover.

Where possible, during the first six weeks:

• Avoid standing for prolonged periods
• Avoid lifting anything heavier than your baby
• Try not to strain when opening your bowels
• Avoid high-impact exercise such as running and jumping until you are further into your postnatal recovery and have been assessed by an appropriate health professional

Your obstetrician can provide advice about when to return to exercise and can refer you to a pelvic health physiotherapist if appropriate.

Recovering after a caesarean birth

A caesarean birth is major abdominal surgery, so your body needs time to heal.

During the first six weeks, where possible:

• Support your incision with a pillow or towel when coughing
• Roll onto your side when getting in and out of bed
• Avoid lifting anything heavier than your baby
• Avoid strenuous household activities, including mopping and vacuuming
• Follow your obstetrician's advice about returning to driving and other activities

Your healthcare team can provide individual advice about your recovery and when it is safe to return to particular activities.

Your skin, hair and stretch marks after pregnancy

Pregnancy can cause a range of changes to your skin and hair.

Stretch marks are pink or purple lines that can appear as the skin stretches during pregnancy. They commonly develop on the abdomen, breasts, thighs and buttocks. They may feel itchy or sore while the skin is stretching but are not dangerous.

There is currently no evidence that creams, lotions or procedures can reliably prevent stretch marks. However, moisturisers and creams may help relieve the itchiness associated with stretching skin.

Stretch marks generally become less noticeable over time, gradually fading to lighter or white lines.

Other skin and hair changes

Pregnancy hormones can also cause increased pigmentation, including chloasma or melasma, which can appear on the cheeks, nose, lips and forehead. These changes often fade during the months after birth. Protecting your skin from the sun and using broad-spectrum sunscreen can help reduce further pigmentation.

Moles, freckles and other areas of pigmentation may also become darker during pregnancy. Some women develop a dark line down the centre of the abdomen, known as the linea nigra. These changes generally fade gradually after birth.

You may also notice changes to your hair, including increased hair growth or oil production. These changes generally settle as your hormones return towards their usual levels.

Your emotions after birth

It is common to feel teary, emotional or overwhelmed after having a baby. Hormonal changes, physical recovery, lack of sleep and the adjustment to parenthood can all contribute to how you feel.

Be kind to yourself during this time. Rest when you can, limit visitors if you need to and accept offers of help from family and friends.

If you are struggling with your emotions, feeling unable to cope or concerned about your mental wellbeing, talk to your doctor, midwife or other healthcare professional.

Managing fatigue after having a baby

Fatigue is one of the biggest challenges for new parents. Broken sleep, concerns about your baby's wellbeing and hurried or skipped meals can all contribute to tiredness.

Some things that may help include:

• Resting or napping during the day when your baby is asleep
• Having everything you need ready for night feeds, such as water, a night light and nappies
• Keeping night feeds and changes as calm and simple as possible
• Limiting visitors when you and your baby need to sleep
• Eating regular, nourishing meals and keeping easy snacks available
• Preparing extra portions of meals so you have something ready during busy periods
• Asking for support if you are finding your baby’s sleep patterns difficult to manage

Remember, accepting help is not a sign that you are struggling as a parent. It is one of the ways you can give yourself time to recover.

Finding a new routine with your baby

Having a newborn often means your usual routines go out the window for a while. Gradually, you and your baby will find a pattern that works for your family.

Babies respond well to consistency, but sleep patterns change as they grow and their needs develop. Learning your baby’s cues can take time, but you will gradually become more familiar with how they communicate when they are hungry, tired, uncomfortable or need comfort.

Some babies are naturally placid, while others cry more, are harder to settle or need more attention. This does not mean you have done anything wrong. Babies have their own personalities and temperaments.

If you are finding it difficult to cope or comfort your baby, ask for help. Your child health nurse can connect you with local parenting, breastfeeding and support groups and other resources.

Tips for new parents

The early months can be challenging, so try to take the pressure off yourself.

• Your baby needs love, comfort and connection - you cannot spoil them by giving them affection
• Crying is one of the ways your baby communicates. As you get to know them, you will gradually learn what different cries and cues may mean
• Share household chores and shopping with your partner or support network
• Don’t expect too much from yourself when it comes to cooking and housework
• Accept offers of help from family and friends
• Make time for your relationship with your partner and talk about things other than the baby
• If possible, arrange for someone you trust to care for your baby while you have some time for yourself or with your partner
• If financial pressures are causing stress, talk openly with your partner and consider working out a household budget

Most importantly, give yourself time to recover. There is no single timeline for adjusting to life after birth. Your body, emotions and family routine will continue to change as you and your baby grow together.