Labor, Delivery, and Postpartum Period

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Physical changes after childbirth

After childbirth (postpartum period), your body goes through numerous changes, some of which continue for several weeks during your postpartum period. Like pregnancy, postpartum changes are different for every woman.

  • Shrinking of the uterus to its prepregnancy size (uterine involution) starts when the placenta is delivered and continues for about 2 months. Within 24 hours, the uterus is about the size it was at 20 weeks of pregnancy, and after 1 week, it is half the size it was when you went into labor. By 6 weeks after delivery, the uterus is nearly as small as it was before pregnancy.9
  • Contractions called afterpains shrink the uterus for several days after childbirth. These sharp pains are usually not as problematic after a first childbirth as they are after later deliveries. Afterpains typically improve during the third day.
  • Sore muscles (especially in the arms, neck, or jaw) are common after childbirth. This is a result of the hard work of labor and should go away in a few days. You may also have bloodshot eyes or facial bruising from vigorous pushing.
  • Difficulty with urination and bowel movements (elimination problems) can occur for several days after childbirth. Drink plenty of fluids and use stool softeners, if needed.
  • Postpartum bleeding (lochia) may last for 2 to 4 weeks and can come and go for about 2 months.
  • Recovery from an episiotomy or perineal tear in the area between the vagina and anus can take several weeks. You can ease the pain with home treatment, including ice, pain medicine, and sitz baths. Pain, discomfort, and numbness around the vagina are common after any vaginal birth.
  • Breast engorgement is common between the third and fourth days after delivery, when the breasts begin to fill with milk. This can cause breast discomfort and swelling. Placing ice packs on your breasts, taking a hot shower, or using warm compresses may relieve the discomfort of engorgement. For more information, see the topic Breast Engorgement.
  • Recovery from pelvic bone problems, such as separated pubic bones (pubic symphysis) or a fractured tailbone (coccyx), can take several months. Treatment includes ice, nonsteroidal anti-inflammatory drugs (NSAIDs), and sometimes physical therapy.

Call your doctor if you are concerned about any of your postpartum symptoms. For more information, see the When to Call a Doctor section of this topic.

Coping during the postpartum period

When you have returned home, you may find it a challenge to meet the increased demands on your limited energy and time. Take it easy on yourself. Pause for a moment, and think of what you need. Tips for coping during the postpartum period include accepting help from others, eating well and drinking plenty of fluids, getting rest whenever you can, limiting visitors, getting some time to yourself, and seeking the company of other women who have new babies.

Click here to view an Actionset.Fitness: Staying active when you have young children

Postpartum depression

If you are having trouble with postpartum blues that last more than a few days or you think you may have signs of postpartum depression, call your doctor right away. For more information, see the topic Postpartum Depression. For tips on how to cope with postpartum depression, see:

Click here to view an Actionset.Depression: Managing postpartum depression.

Even if you have no significant postpartum problems, your doctor will want to see you for a checkup 2 to 6 weeks after delivery. This is a good time to discuss any concerns, including birth control.

Sexuality, fertility, and birth control

Avoid sexual intercourse and putting anything in the vagina (including tampons) until you have stopped bleeding. After you have stopped bleeding, avoid having sexual intercourse if it is still painful or uncomfortable. Your body needs at least 4 to 6 weeks to heal after the trauma of childbirth.

It is common to have little interest in sex for a while after childbirth. During the time when your body is recovering from childbirth and your baby has many needs, you and your partner will need to be patient with one another. Talking together is a good way to deal with the changes in your sexuality after childbirth.

Your menstrual cycle, and thus your ability to become pregnant again, will return at your body's own pace. Remember that you can ovulate and get pregnant during the month before your first menstrual period, as soon as 2 to 3 weeks after childbirth. If you do not want to become pregnant right away, use birth control even if you are breast-feeding.

  • If you do not breast-feed, your menstrual periods may begin within a month or two after delivery.
  • If you breast-feed full-time, your periods will probably not resume for a few months. The average among women who breast-feed exclusively is 8 months. But breast-feeding is not a dependable method of birth control. For more information, see Breast-feeding as birth control.

Most methods of birth control are safe and effective for breast-feeding mothers. Talk to your doctor about which type is best for you. For more information, see the topic Birth Control.

By: Healthwise StaffLast Revised: January 7, 2010
Medical Review: Kathleen Romito, MD - Family Medicine
Sarah Marshall, MD - Family Medicine
Kirtly Jones, MD - Obstetrics and Gynecology

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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