Postpartum Physical Recovery - The First Two Weeks
Hang on to your oversized, mesh undies because this blog is going to get real when it comes to everything you need to know about your postpartum physical recovery. Babies are cute but childbirth is messy and that is true for the immediate postpartum period too. You’re leaking from just about every imaginable place on your body, you’re hurting in places you didn’t know you could hurt, and your hormones are taking you on a wild ride you didn’t sign up for. This is the truth about those first two weeks after having a baby.
If you have no idea what to expect, you are not alone. We spend so much time preparing for birth, but what happens postpartum is often overlooked. Especially when it comes to your postpartum body. What’s normal? What should you be prepared for? How long will this last? These are all super common questions and we have answers. Read on.
Lochia - Vaginal Discharge or Bleeding
There will be blood. Great movie, not so fun part of recovering from childbirth. Whether you have a vaginal or cesarean birth, you will experience lochia, vaginal discharge or bleeding, for several weeks following the birth of your baby. At first, this bleeding will be heavy and the blood will be bright red. You might also pass some blood clots for the first several days. Your uterus is healing from the wound left behind by the placenta, so it will take at least 2-3 weeks for the lochia to really decrease. You will notice the color change from bright red to more pink to brownish and then finally a yellow or white discharge. The flow will also decrease as the weeks pass.
Be prepared by stocking some bathroom stations in your house with various size sanitary pads. You will use a very heavy flow size for the first week and then taper down. Some people even prefer to wear Depends, or some other brand of adult diaper, in the early days. Hey, they’ve gotten very stylish lately and some people find them more comfortable than pads. Do not use a tampon or menstrual cup, as nothing should be inserted into the vagina for the first six weeks.
By the 6 week mark, this bleeding/discharge should have stopped entirely. If you are still bleeding, definitely bring this up with your provider at your six-week checkup. If you are soaking through a pad within an hour, even while lying down, passing blood clots the size of a golf ball or larger, or running a fever, call your provider right away. These can be red flags of a more serious condition.
Vaginal Soreness - Tearing or Swelling at the Perineum
For most people, one of their birth plan goals is not to tear during the pushing stage of labor and delivery. However, the American College of Obsetricians and Gynecologists (ACOG) reports that between 53-79% of vaginal births do involve some degree of tearing at the perineum. A vaginal tear can range in severity from a Type 1, the most moderate that normally only involves minimal repair work, to a Type 4, the most severe that can require surgery to correct.
But even a Type 1 or Type 2 vaginal tear can result in a large amount of discomfort for someone who finds themselves sitting most of the day, as they learn how to feed and take care of a baby. A few things you can do to soothe your perineum include using a chilled sanitary pad right out of the freezer, as the cold sensation can feel very soothing. When you urinate, bring your peri bottle with you! If you don’t know what a peri bottle is, think of this as a handheld bidet. It’s a small, plastic bottle with a spout that you can squeeze and use to direct water against the vulva and perineum to take any discomfort or burning that might occur when using the bathroom. Definitely take the peri bottle (or multiple peri bottles if you have more than one bathroom in your house) from your hospital postpartum room when you are discharged. This little guy will be your friend immediately postpartum.
And if sitting is uncomfortable, do NOT reach for one of those donut-shapped hemorrhoid pillows. Those actually do nothing to support your swollen or healing perineum. Instead, use a pillow, blanket, or rolled up towel to support one side of your bottom. This asymmetrical elevation will help take pressure off the perineum and make it more comfortable to sit down.
Afterpains - Postpartum Uterine Contractions
This one can come as quite a shock! You just went through all the hard work of labor and delivered your baby, so why are you still experiencing contractions?!? In order to slow the flow of bleeding after delivery and aid in shrinking your uterus to its pre-pregnant size, the uterus will continue to contract. And these contractions can be painful. Some people report that they feel similar to period cramps, while others, especially if this is their second, third, or more baby, report them to be very strong and as powerful as labor contractions. Ugh.
If you are taking any over the counter pain medications, continue to do so to help with any afterpains. Using a hot compress or hot water bottle over that area of the abdomen can also provide some relief, especially during breastfeeding sessions when the release of oxytocin can trigger these contractions.
Hemorrhoids
Ahh yes, one of those lovely pregnancy symptoms that can be exacerbated during childbirth. Or perhaps you were lucky enough not to develop hemorrhoids during pregnancy, but a long pushing phase to deliver your baby is how these first developed. Either way, they are a very common, yet uncomfortable, condition postpartum. If hemorrhoid pain is making sitting uncomfortable, try soaking your bottom in a sitz bath with warm water. Using cold, witch hazel pads on the affected area can also help. If they are not improving over a few weeks, you may need to talk with your provider about a topical medication.
Avoiding constipation is also very important if you are dealing with hemorrhoids. You want to lessen any time spent straining on the toilet. If you were given a stool softener, such as Colace, when you were discharged from the hospital, take that. Also remember to drink plenty of water and eat foods high in fiber to also help with more regular bowel movements.
Diaphoresis - Night Sweats
The Night Sweats are a great band, but definitely a not so fun part of postpartum physical recovery. Postpartum sweating, especially at night, is normal and is attributed to your wildly fluctuating hormones. These night sweats usually last for several weeks and then go away. If you find yourself waking at night and drenched in sweat, there’s a few things you can do. Sleep in light and breathable pajamas, keep a fan running in your room, and have a stack of towels handy so that if your sheets end up wet too, you can simply throw down a clean towel and worry about the laundry in the morning.