What Is Realistic to Expect in Early Postpartum Life?
I know firsthand how difficult early postpartum life can be – mentally, physically, and emotionally. You are probably sleep deprived, you may have pain, and your body is healing, all while you are navigating how to care for a newborn. It can be overwhelming to say the least.
Especially for first time moms, there can be a lot of confusion on what to expect during those first few weeks and months. No one really prepares you for what postpartum life is like. Women don’t “bounce back” after only 4 to 6 weeks. Let me give you the scoop and help you set a few realistic expectations.
Week 1 of Postpartum Life
Hormone Fluctuations
In the first 48 hours after birth, your estrogen and progesterone levels will rapidly decrease back to pre-pregnancy ranges. And, if you’re breastfeeding, your estrogen level will actually drop even lower than it was pre-pregnancy. What does low estrogen do to your body (besides helping you produce milk for your cute newborn)? It gives you super fun symptoms of night sweats, hot flashes, and vulvar dryness. I vividly remember waking up drenched in sweat and needing to change my clothes at every night feeding for the first couple weeks after giving birth to my son.
Discomfort
You most likely will have some sort of discomfort in early postpartum life – abdominal if you had a C-section or perineal if you had a vaginal birth. Additionally, you may also have muscle soreness in other areas from positions you were holding during labor and delivery, such as leg soreness from squatting or arm soreness from holding onto your legs or a countertop. After the birth of my daughter, I felt like my arms had the biggest workout of my life!
To help ease your discomfort in early postpartum life, ice, ice some more, and then ice again! Icing 20 minutes on and off can be so helpful for both the perineal area or on your C-section incision. If you haven’t heard of padsicles (aloe vera + witch hazel on a pad that is placed in the freezer), those are great for your perineal area too.
Bowel Issues
Something no one told me about postpartum life (that I wish I knew before I was postpartum) was that the first poop after having your baby can be uncomfortable or difficult. It was definitely uncomfortable after my first (but I also had a ton of pelvic floor tightness – check out this blog post to read more about my birth stories). However, postpartum pooping was much easier after the birth of my second child. This is because I knew what to do during labor and delivery (so that I didn’t hurt as much afterwards) and because I knew tips for proper pooping.
Here are some helpful tips to help get the bowels flowing regularly again:
- Start taking a stool softener right away after birth.
- Place your feet up on a squatty potty or garbage can tipped on its side. This position allows for a better alignment of your colon and helps the pelvic floor relax.
- Try splinting your perineum. Wrap toilet paper around your first 2-3 fingers and use these fingers to support your perineum (the area between your vaginal opening and your anus) as you poop.
- If you had a C-section, try hugging a pillow to support your abdomen while pooping.
- Blow as you go! Breathe out as you poop.
- If you had a vaginal birth, instead of using toilet paper try a peri bottle to cleanse the area. A lot of rubbing can irritate things. This is also a great way to make sure you are keeping things clean down there.
- Stay well hydrated.
Speaking of hydration, did you know that it is recommended to drink 91-104 oz of fluids daily while breastfeeding postpartum?! You read that correctly – keep sipping on that water bottle all day! Hydration is SO important not only for milk production, but also for aiding postpartum healing.
Leaking
You may leak a little bit during the first few weeks of postpartum life, and that’s ok! Your pelvic floor has gone through A LOT and may be weak for a bit. That weakness can lead to leaking or the feeling of pelvic heaviness. You may also notice some leaking accompanying your bleeding.
Bleeding
Wait, I bleed postpartum too?! Yup. It is called lochia, and you will experience this if you had either a vaginal birth or C-section. It will last for a few weeks and will change color over time.
Caring for Your Incision
You may have some sort of incision to take care of in postpartum life either from a C-section or a perineal tear. It is estimated that over 85% of vaginal births result in some degree of perineal tearing. However, you can decrease the risk of perineal tearing by massaging and stretching this area during your third trimester of pregnancy.
A lot of the tips we’ve mentioned thus far apply to taking care of your perineal incision. These include icing regularly and using a peri bottle instead of toilet paper. You can also try a sitz bath after day 5.
When it comes to C-section scars, modify your movement to avoid overstressing the incision. For the first few days or weeks of postpartum life, try to avoid heavy lifting as much as possible. Ice this incision too!
Month One of Postpartum Life
I have some good news for you – you will feel A TON better one month into postpartum life. There is a lot of healing that happens during that first month, and things should progressively improve. Most things should be resolved or close to resolved at this point – bleeding, discomfort, leaking, and difficulty pooping.
Start Building Your Exercise Foundations
The first 2 (ish) weeks postpartum is all about resting and recovering. Now that you’re feeling so much better at one month postpartum, it’s time to start moving and establish your foundations as you ease back into life and exercise. For most women, they feel ready to begin this step anywhere from 2 to 4 weeks postpartum.
These exercise and movement foundations include:
- Regaining good breathing mechanics
- Reconnecting to your pelvic floor
- Getting those abs firing again
Check out this blog post for a general guideline of exercises to begin restoring your body during postpartum life.
Week 6 of Postpartum Life – The “Clearance” from Your OB
Usually we see our OB once around 6 weeks postpartum. We get the “all clear” from them to return to activity. Despite what many think, this should be a VERY GRADUAL return to activity. At this point, you should have a solid foundation with your core, pelvic floor, and breathing, so it’s time to start some body weight strengthening exercises for your core, arms, glutes, and legs.
At this 6 week OB appointment not only do we get the green light to return to activity, but we usually also get the green light to return to intercourse. Yes, it may be a little uncomfortable the first time (try a little extra lubrication and take your time). HOWEVER, if you are continuing to have discomfort beyond that, that is NOT normal. Tightness in the pelvic floor muscles or perineal scar sensitivity may contribute to this discomfort. These can be addressed in pelvic floor physical therapy!
Remaining Symptoms
Your body will continue to feel better and better as the weeks progress. Around this 6 week postpartum mark, you should no longer have these symptoms:
- Leaking (any amount and with any activity)
- Feeling like you’re not going to make it to the bathroom in time
- Heaviness or pressure
- Back, hip, or pelvic pain
- Difficulty going to the bathroom (starting the urine stream, incomplete emptying, chronic constipation)
- Coning/doming in your abs (see picture below)
If you are still experiencing these symptoms or if you begin to experience these with returning to activity and exercise, who are you going to call? Your pelvic floor physical therapist!
Month 3 of Postpartum Life and Beyond
Usually somewhere around 3 to 6 months postpartum is when many women START returning to their sport or exercise of choice. Depending on how things are going with your postpartum journey, this return to sport may be earlier or later than this timeframe. Again, this is a GRADUAL return to activity. Check out this blog post that will help guide you in returning to your sport.
Again, if you are experiencing any of the symptoms listed above, it is not normal at this point. Reach out to your pelvic floor physical therapist if this is the case for you. No one needs to live with leaking, heaviness, or pain!
Conquer Postpartum Life!
I hope all this information helps you prepare for postpartum life and establish some realistic expectations. While you may go through some difficult times in postpartum life, that cute little baby makes it all worth it. There is really nothing that compares to being a mom! You can do this mama!