LABOR IS OVER, NOW WHAT? Part 2 Physical Changes
Physical Changes in the First 6–12 Weeks Postpartum
The first 6–12 weeks after giving birth also known as the postpartum period are a time of significant physical healing and adjustment.
Your body is recovering from pregnancy.
Your hormones are shifting rapidly.
And you are learning how to care for a newborn while also needing care yourself.
This season can feel beautiful, overwhelming, exhausting, and transformative and often all at once.
Understanding what changes are normal, what symptoms require attention, and how to properly support your healing at home can make a meaningful difference in your recovery experience.
Preparation does not eliminate every challenge, but it does replace uncertainty with confidence.
And during postpartum, confidence matters.
💛 Nurse’s Note – Postpartum Recovery
Hello again. Thank you for being here. As a doctorate-prepared nurse with extensive experience in perinatal and postpartum care, I can confidently say this: recovery deserves just as much preparation as labor.
Postpartum healing is not “one-size-fits-all.” Whether you’ve had a vaginal delivery or cesarean birth, your body has done something extraordinary, and it requires rest, support, and intentional care. The discomforts you experience are common, but that does not mean they should be minimized.
Recovery is not weakness.
It is healing in progress.
Physical Changes
1. Uterus- It will take a few weeks for your uterus to return to its pre-pregnancy size. Remember during your pregnancy your uterus grows to about 11 times its usual weight, so give it some time. Why your uterus is returning to its normal size you will experience some cramping, which we often call AFTER BIRTH PAINS. This is all normal and you may notice more discomfort during breastfeeding. One thing that can help with the cramping is keeping your bladder empty. If you do not have any allergies and okayed by your provider, you can take OTC medications to help. Normally these cramps go away by the end of the first week on their own.
2. Bladder- For the first few days after giving birth try to keep your bladder empty by going to the bathroom every 3-4 hours. The reason for this, is that when your bladder is full it pushes on your uterus, which can cause more bleeding. Usually during labor, you are getting a lot of fluids, as well after birth your body tries to eliminate extra fluid you took in during the pregnancy, so it is normal to urinate large amounts the first few days. If you had a cesarean birth, you may have a catheter in your bladder during the first day after surgery. This will allow you to rest a little bit so you are not having to get up and use the restroom for awhile.
3. Bowels- Most moms are scared to have that first bowel movement, even more so if you have had any vaginal repairs after birth. Normally you will not have a bowel movement for 2-3 days after delivery because of hormones, medication, dehydration, and the fear of pain influences it. I know this is easier said than done, but try to relax by taking deep breaths. It can help sometimes putting your feet on a stool and rest your elbows on your knees. Try to go when you feel the urge, increase your water intake to at least 6-8 glasses a day, walking if you can, and you may take stool softeners.
4. Hemorrhoids- Do not be alarmed if you developed hemorrhoids during your pregnancy. Hemorrhoids are swollen veins at the opening of your rectum, inside your rectum, or on the anus. Usually these are not serious, but they can be very uncomfortable. A few things to do to help is make sure you eat high fiber foods, increase your water intake avoid straining during bowel movements, and avoid standing or sitting for long periods of time. Topical creams and sprays help for pain as well as using witch hazel pads, ice packs, or using a sitz bath or soaking in a warm tub. We have exactly what you need in our Postpartum Vaginal Recovery Set on our website.
Perineum- The perineum is the area between your vagina and rectum. During a vaginal delivery, it stretches, and you may tear, and it can cause lacerations where you may need some stitches. It is not the norm, but in some instances an episiotomy may be done during birth. This is a cut made by the doctor or midwife at the opening of the vagina to allow for extra room for the baby to come out. Most laceration and all episiotomies need stitches, which will dissolve on their own, no need to get them removed. For the first 24-48 hours applying ice packs can be very helpful. Make sure you keep the area nice and clean by using a peri bottle, handheld shower, or sitz bath as this will help with the healing process. I know some of you can’t wait to get into your nice comfy undies but trust us you do not want anything tight or restricting, the discomfort can last several weeks. (You can find everything you need for comfort at our Boutique with our Postpartum Recovery Kits.
6. Vaginal Discharge- After birth you can expect to have bloody discharge, called lochia as this is part of your natural healing process for your uterus. For the first few days, lochia is bright red, heavy in flow, and you may see small blood clots. Some moms note the smell of this to be fleshy or musty smell. You may also notice after laying or sitting for long periods that when you stand up you may feel a gush or experience a heavier flow. From about day 3-10 you will notice the color going from bright red to pink or brown tinge, medium to light flow, and very few cots. Day 10-14 the discharge will be yellowish white, very light, and no clots. WARNING: Call your health care provider if you soak through more than one pad an hour, have a steady flow that continues over time, pass clots the size of an egg, have bright red bleeding after day four, any foul odor, temperature > 100.4, or any sever pain in lower abdomen. If you had a cesarean birth, you may notice less discharge.
7. Cesarean Birth Incision Care- Your incision may be closed with staples, stitches, wound closure strips, surgical glue, or a few of them. Your incision will be covered with a sterile dressing that is normally removed before you leave the hospital or at your follow up visit. If you have wound closure strips also known as steri strips they usually start loosening up 7-10 days on their own. You may want to use a clean gauze over your incision especially if the skin on your belly folds over your incision. Main thing you want to do is keep the area clean. Always wash your hands before applying or changing the dressing this well help decrease the chance of it getting infected. WARNING: Call your healthcare provider if you notice your incision to be red, separated, swollen, warm to touch, tender or painful, or if you see drainage. Check out our Deluxe C-Section Recovery Kit!
8. Managing Pain-Everyone reacts differently to postpartum pain and different approaches may need to be tried based on your needs.
9. Comfort Measures: Some ways to help with pain is relaxation with deep breathing, listening to music, ice packs for 24-48 hours, warm pads to abdomen to help with cramps and warm sitz baths/herbal bath.
10. Pain relief Treatments- Topical Creams or sprays, over the counter medication like ibuprofen, or if needed prescription medication from your provider.
11. Cesarean Birth Pain- First thing to remember is that you just had major abdominal surgery, so you need to start slow and gentle. One thing you may experience is gas pains. Walking around, eating food high in fiber, and plenty of fluids is going to be most helpful. When you are in the hospital you will have a variety of medications and you will think the nurses are out to harm you when they are making you get out of bed 8-12 hours after surgery but trust us they are doing you a favor. As much as it hurts just know it will be much worse if you do not move. When you are at home if you still are experiencing the gas pain you can try knees to chest, lie on your left side, drink warm fluid, and avoid carbonated drinks.
12. Rest and Sleep- After the birth of your baby you mostly likely will feel exhausted and there are many logical reasons for this. One of the big ones is that most moms do not sleep well, late in pregnancy, plus they do not call it labor for nothing! It is true hard work and it is exhausting. Trying to get rest when you are in the hospital is almost impossible with the multiple interruptions. Once the baby is home, sleep can become even more of a challenge as you try to balance the need for rest and your babies need to be cared for. Whenever you can, try to sleep when your baby sleeps. You may need to take several short naps during the day. Try to keep things calm by having simple meals, a routine often can help, accept help if someone offers to shop or drop off a meal, avoid caffeine, and reach out for help if you need it.
13. Hair Loss- Pregnancy will change your hair growth cycle. When you are pregnant your hair is in a resting phase, a few weeks after birth you may see that you are losing hair, even some lose in large amounts. This is not unusual in the first 5-6 months after birth. It could take up to a year and half for it to return to a normal growth cycle, so don’t worry.
14. Skin Changes- You may have noticed that during pregnancy you had some skin changes such as discoloring of the skin, dark line down the middle of your belly, or acne due to the rising hormone levels. These changes are usually fade within several months after birth. However, within 30% of women they may persist longer. Eventually tiny red blood vessels on your skin, rashes and stretch marks will fade.
15. Baths/Showers- Often if you had a vaginal delivery you can shower within the first day. Sitz bath can start the second day and warm tub baths are generally safe when you go home. For cesarean births you can shower once the outer dressing over your incision has been removed. Tub baths are not recommended for a few weeks. Always ask your healthcare provider if you have questions about when you can take a bath.
16. Varicose Veins-You may notice some blue-colored soft bulges in your legs called varicose veins that happen during pregnancy. They are caused when your veins get weak and swell up with blood. One thing that can help with these is elevating your legs when sitting or wearing compression socks. Typically, these varicose veins improve within the first 6-weeks after birth without treatment. You can always talk to your doctor if they do not lessen after 6 months.
17. Menstrual Cycle- You will probably have your menstrual cycle sometime within 7-9 weeks after giving birth. If you are breastfeeding it could be 4-6 months, or some moms do not get a period until they stop breastfeeding. Another perk why you should breastfeed. YES! However, it is important to know that just because you are not having a period, your body may begin egg production and you have a chance of becoming pregnant if you are not using some type of birth control. Your doctor should discuss future pregnancies before you resume sexual activities.
18. Sex: Having a new baby pretty much changes your whole world you were living, and sex is not excluded from this change. Babies come with a lot of needs, and it takes a lot of time and energy, which can have a bearing on new parents to recapture their closeness as a couple. Open communication can help minimize the frustration and misunderstanding. Remember if you had a tear or episiotomy or cesarean incision, you may feel a little anxious about having sex again. It takes a good 6-weeks for incisions to heal, so make sure your partner understands this. Vaginal dryness is common as well, because of the hormones. This will improve, but when you are ready a water-based lubricant can help with this. You may experience difficulty with sexual intercourse so open communication is the best with your partner. If after your postpartum period you are still experiencing discomfort or difficulty, reach out to your provider for guidance.
Sex::Re Remember Mama, physical changes can sometimes be overwhelming, and do not be afraid to reach out to a licensed therapist who can help you early on. Click the Picture for a link directly to a therapist who specializes in helping moms during pregnancy, postpartum, and beyond.
Remember, your body has just accomplished something remarkable, and recovery is both complex and completely human. Swelling, night sweats, hair shedding, emotional swings are common physiologic responses as your body recalibrates.
It may feel like everything is changing at once, because in many ways, it is. Give yourself grace. Hydrate, rest when possible, and remember: if your body can grow and deliver a baby, it can absolutely handle postpartum recovery, even if it does so while wearing mesh underwear and asking for snacks. You've got this mama.