The postpartum period, also known as the fourth trimester or puerperium, is the window of time after a woman has given birth.
It is a crucial time for healing, rest and recovery.
After going through the harrowing experience of bringing new life into the world, a woman’s body undergoes slow changes in its journey back to its pre-pregnancy state.
This is what every expectant and prospective mother needs to know about puerperium; what happens to your body after childbirth.
How Long Is the Postpartum Period
The postpartum period or puerperium starts as soon as your baby is born.
However, when it ends is entirely dependent on your own physical condition.
That said, experts generally agree on there being three stages of the postpartum period.
The first is the acute phase, which comprises the first 6 to 12 hours after childbirth.
This is the most critical stage, where complications can arise and medical supervision is paramount.
The second stage is the subacute or early postpartum period.
This phase lasts anywhere from 2 to 6 weeks and is less critical.
Any problems do not tend to be serious but may require a visit to the doctor regardless.
The third and final stage is the delayed postpartum period, lasting anywhere between 6 weeks to 6 months, sometimes up to a year.
Complications are rare at this stage and most women are already on their way towards their pre-pregnancy state.
What Happens at Each Stage of the Postpartum Period
First Stage
Immediately after childbirth, the mother will start experiencing increased shivering and sweating in the first 24 hours. Elevated temperature at this point is normal.
The uterus contracts rapidly after childbirth causing abdominal pain and cramps (also often called afterpains).
This is the body’s way of preventing further blood loss.
Postpartum uterine massages are found to be effective in reducing the likelihood of postpartum haemorrhage.
Frequent urination, urinary incontinence, joint aches and perineal or vagina pain are normal.
The mother is most at risk for post childbirth complications at this point.
These include postpartum haemorrhage, uterine inversion, amniotic fluid embolism, eclampsia, and deep vein thrombosis.
You will experience postpartum vaginal discharge (or lochia) between 1 to 4 days.
At this stage, your lochia will contain mostly blood, leftover uterine tissue and mucus and will appear red.
Second Stage
The body is almost close to its pre-pregnancy state but not quite.
The lochia will appear yellowish or brownish in colour at this stage between 5 to 9 days. And then later white between 10 to 14 days.
Lochia can persist up to 5 weeks postpartum.
Mothers who underwent Caesarean may have less lochia than women who deliver via vaginal birth.
If you’re not breastfeeding, the menstrual cycle will return by the 6th or 8th week of your postpartum period.
There is a small chance of getting pregnant again due to the lack of menstruation.
So, non-breastfeeding mums should take contraceptives after three weeks (three months for breastfeeding mums) if sexually active.
Breast engorgement, mastitis, sleep deprivation, hair loss, constipation, flatulence, frequent urination, and weight loss are normal at this stage.
Afterpains, as a result of the uterine involution, is still normal at this stage.
The sensation is similar to menstrual cramps and can be relieved with massage.
Common afflictions during this time can include perineal discomfort, peripartum cardiomyopathy (palpitations, shortness of breath, nocturia) or postpartum depression.
Due to decreased oestrogen levels, mums may experience low libido that may not return for as long as 1 year postpartum (especially if you are breastfeeding).
Third Stage
The body should be back to normal at this stage.
Any discomfort and afterpain should be gone.
Sleep should improve greatly too.
You should no longer experience any lochia.
However, for some women, medical conditions may take time to resolve.
These include urinary and faecal incontinence, painful intercourse, and pelvic prolapse.
Treatment for these may extend beyond the normal postpartum period.
Other benign effects of pregnancy and childbirth may persist such as hyperpigmentation, and stretch marks.
Vaginal dryness is often reported, but may resolve once you stop breastfeeding.
Mums who have stopped breastfeeding should have a fully functioning menstrual cycle again.
However, the first period, or menses, after postpartum tends to be heavy.
It’s important for mums to seek professional help if struggling with mental health issues such as postpartum depression.
Postpartum Period Challenges
There are no shortages of difficulties that a woman can go through after giving birth.
The early stages of the postpartum period as highlighted above is the most critical time.
Complications, and even death, can occur if great care is not taken.
Heavy bleeding, infections, pain and high blood pressure are just some of the risks that doctors tend to watch out for.
Mothers require lots of healing during this time, which includes plenty of rest and sleep.
The challenges do not stop after the acute phase, however.
Some of the more common issues that arise include: haemorrhoids, breast engorgement, faecal and urinary incontinence, and depression.
Strict medical supervision is provided during the first 24 to 48 hours. After that, the mother is allowed to discharge.
However, continued support at home is crucial.
Physical, emotional, maternal and even oftentimes, financial factors, make up the major challenges for women going through their postpartum period.
A strong and solid social support system of family members and friends are needed during this time.
How to Know If Your Postpartum Period Has Ended
There is no universal consensus about when the postpartum period ends.
The general rule of thumb is to see if your body has fully returned to its pre-pregnancy state (more or less).
However, there is no way to properly tell on your own when you’ve reached this phase.
Some will say it’s after you’ve gotten your first postpartum menses, or once you’ve stopped breastfeeding, or after you’ve gone through the entire six weeks (or six months).
It is different for each woman.
The only reliable way of knowing is by going to the doctor.
A healthcare professional can do a proper examination of your body to determine once and for all if your body has properly recovered.
They will usually check if you’ve undergone complete uterine involution.
As previously mentioned, this is a process whereby your reproductive organs have returned to their pre-pregnancy state.
Complications during labour may prolong the postpartum period.
Caesarean births, for instance, may result in slow involution.
But there are other good signs for you to look forward to that your body is telling you when things are getting back to normal:
- improvement of sleep, mood and appetite
- cessation of lochia/spotting
- healing of episiotomy/perineal wound (or c-section wound)
- resolution of other postpartum symptoms (e.g., backache)
Is It Possible to Prepare for the Postpartum Period?
Just like with pregnancy and labour, preparing for the postpartum period requires more mental preparation than anything.
Taking care of your diet and exercise is important as well.
Educating yourself on what you can expect during this time is also helpful.
But on the more practical side, you will definitely need maternity pads to deal with urinary incontinence and lochia.
Your doctor may prescribe you stool softeners and haemorrhoid creams to deal with those kinds of bowel issues.
Additionally, heating or cooling pads can help deal with discomfort that may arise as a result of breast engorgement or abdominal pains.
As a result of learning the difficulties of postpartum healing, many mothers opt for confinement centres.
These are special facilities that provide complete postpartum care including medical and traditional treatments.
However, not everyone may have the financial means to do this.
So, at-home confinement care will require the assistance of family members or confinement ladies.
Finally, always be vigilant about your body and pay attention to any warning signs.
Pain or heavy bleeding (which can still occur at the later stage of the postpartum period) can be a sign of unresolved post childbirth trauma.
Also look out for any shortness of breath, headaches, fainting, dizziness, swollen legs or blurry vision.
Any seemingly small thing may require an immediate trip to the hospital. So, don’t delay or ignore them.
Are There Any Long-Lasting Changes from the Postpartum Period?
Some changes you go through during pregnancy are temporary, but others may last a long time if not your entire life.
These changes can affect you both physically and mentally.
Hyperpigmentation is the most commonly reported skin change during pregnancy, affecting over 80% of women.
Stretch marks, a form of scarring as well as hyperpigmentation, is the most well-known condition associated with post-pregnancy physical changes.
Permanent breast changes will occur.
Hyperpigmentation of the areolas and ptosis (sagging of the breasts) are the most common ones.
Diastasis recti is another common change reported in pregnant women.
This is where there is a weakening of the abdominal muscles.
While harmless, it can manifest as a belly or ‘pooch’ and may cause difficulty moving heavy objects.
It may resolve with exercise, or it may not.
Other changes, however, are invisible.
For example, childbirth triggers permanent changes in a mother’s brain. Particularly the part of the brain called the hippocampus, linked to depression.
On a more serious note, childbirth can also cause some permanent medical conditions that may be difficult or take a long time to address.
These include uterine prolapse, prolapse, faecal incontinence, urinary incontinence and others.
Getting Your Post-Baby Body Back
The time after childbirth can be fraught with uncertainty. Especially the second after your baby comes.
Medical supervision is paramount at this point.
You may want to throw your entire self into your maternal duties.
But remember that your body needs plenty of healing too, even after you’ve gone home.
Sufficient diet and rest can do wonders to speed recovery.
However, a healthy emotional support system ensures that you’ll also be mentally prepared to take on your new role as a new mother, and whatever challenges it may bring.
You’ve got this, mummies!
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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