Caring For Your Postpartum Body

In the excitement of preparing for a new baby, especially the first one, pregnant people are often busy researching, learning, and getting ready for this new chapter in the life of their family: Nesting is very real. It can be a crazy, fun, and sometimes stressful time. 

In the months leading up to and directly after birth, it’s easy to overlook your needs. It helps to invest time into learning about the changes your body might experience in the weeks following birth, regardless of your delivery method. Postpartum recovery is different for every new mama, but prioritizing your physical and mental health is paramount!  

In this Ultimate Guide, we cover the common postpartum recovery stages and potential complications that can arise. We’ll share best practices for caring for yourself during each stage, and you’ll learn when it’s important to reach out to your doctor.

Lactation consultants are also available in many hospitals and birthing centers. They can help you and your baby establish an effective latch, answer your initial questions about breastfeeding, and help you feel prepared to head home with your new little one. Many new parents tell us how helpful these consultations are as they are establishing their breastfeeding and lactation goals.

During pregnancy, your growing baby inevitably pushes on your muscles, organs, and supportive tissues. The hormonal changes of pregnancy and postpartum are also challenging for the body. Regardless of how you delivered your baby, the early weeks postpartum are a critical recovery period. 

Remember that you’re not missing out on anything if you don’t feel ready to jump back into your pre-pregnancy lifestyle! It’s wisest to allow your body to rest and do what it needs to do to heal. This can and should be “me time” for you, your baby, and your family as you all ease into this new chapter together. Don’t be shy about asking friends and family to help you ahead of your delivery and before you arrive home, especially if you have older kids at home. 

First, it is super important for new mamas (and their partners) to be aware of specific postpartum symptoms that can signal a serious medical concern that requires urgent care.  

The Centers for Disease Control (CDC) has outlined a list of postpartum warning signs that signal a serious medical problem. If you are experiencing any of the following signs or symptoms, call your healthcare provider right away:

• Severe Headaches
• Dizziness or Fainting
• Changes in Vision
• Fever
• Trouble Breathing
• Overwhelming Tiredness
• Chest Pain
• Severe Belly Pain
• Severe Nausea & Vomiting
• Severe Swelling
• Thoughts on Harming Yourself or Baby

As you adjust to breastfeeding your baby, you may experience breast engorgement, sore nipples, and mild leakage. To be prepared, keep nursing pads, nipple care products (such as lanolin), and even a nursing pillow on hand. This will save you time and prevent discomfort in the early days of breastfeeding.

New parents who are breastfeeding may also experience mastitis, an infection in your milk duct. Mastitis can cause breast redness and heat, chapped nipples or painful breasts, as well as flu-like symptoms of infection such as fever, chills, or body aches. Mastitis requires urgent medical attention—do not wait to contact your healthcare provider if you notice these symptoms. 

In the United States, up to 20% of birthing people will experience significant postpartum depression in the first 6 weeks postpartum.

The hormonal shifts that occur after birth can cause the “baby blues” for a few days or weeks. Prenatal and postpartum depression are generally more severe and longer-lasting than the baby blues.

Symptoms of postpartum depression include the following: 

• Feelings of anger or irritability
• Crying and sadness
• Appetite disturbance
• Sleep disturbance
• Loss of interest in things you used to enjoy
• Lack of interest in your baby
• Thoughts of harming yourself or your baby]
• Feelings of guilt, shame, or hopelessness

Perinatal mood disorders can develop at any time, including during pregnancy, the early postpartum period, or even months after birth. These conditions include depression, anxiety, obsessive symptoms, and psychosis. If you, a family member, or a trusted friend notice a change in your mood or behavior, don’t hesitate to seek professional support. Contact your healthcare provider as soon as possible for advice on where to start. Remember, you don’t have to wait until you reach your lowest point to ask for help.

Postpartum Support International is an excellent resource for new parents seeking mental health support. Find a list of providers in your area who have completed postpartum-specific training for mental health concerns. If you think you may have postpartum depression (PPD) and anxiety, even if it feels “mild,” don’t hesitate to discuss your symptoms with your healthcare team. You deserve to feel well and enjoy your time as a new parent as much as possible.

Your first postpartum poop might seem daunting. To make it a smoother experience, drink plenty of water, eat foods that are high in soluble fiber, and ask your physician if you can take over-the-counter stool softeners to reduce constipation. 

When it’s time for that first poop, elevate your feet on a stool or a stack of books. This positioning places your colon in a better position for emptying. Gentle breathing strategies can make that first bowel movement easier, too.

Hemorrhoids are veins that become swollen and irritated inside or around the end of the rectum and anus. They can occur internally (inside the anus) or externally (under the skin surrounding the anus). 
Hemorrhoids can cause itching, pain, discomfort, and sometimes, small amounts of bright red bleeding. Hemorrhoids are usually caused by excessive pressure on the pelvic floor, typically from constipation, pregnancy, and delivery. Because of this shift in pressure on the pelvic floor, hemorrhoids are extremely common in pregnant and postpartum women.

If you’re struggling with discomfort from hemorrhoids, here are some tips to temporarily alleviate symptoms: 

• Apply an over-the-counter cream or a hydration lubricant to decrease friction and sensitivity to the area.
• Use a sitz bath once per day or after bowel movements.
• Use medicated wipes that contain witch hazel for gentle relief.

If you’re experiencing extreme discomfort from your hemorrhoids, speak to your OB/GYN or healthcare provider about medications that support faster healing.

Many first-time moms are surprised to find that they experience vaginal bleeding and discharge for several weeks after a vaginal delivery. This combination of blood and discharge is called lochia. 

Even if your postpartum bleeding seems quite significant, it may be perfectly normal: Your uterus was the baby's home for nine months, and suddenly, all that uterine lining isn’t needed anymore. Most providers will explain when to be concerned about bleeding. Don’t be afraid to ask clarifying questions. 

The duration of postpartum bleeding varies. The most commonly reported range is around 24-36 days, but it can last up to 12 weeks postpartum. Usually, postpartum bleeding will gradually decrease over the weeks following delivery; it may even stop for a few days before starting again. A temporary increase in blood loss may be a sign that you’re doing more than your body is ready for, and prioritizing rest for a few days can help your body focus on healing.

Simple supplies like maxi pads, postpartum-specific underwear, or even adult diapers can help you stay clean and dry while your lochia is finishing up. As always, call your healthcare provider if you have any concerns about blood loss or symptoms of low blood pressure.

After delivery, your uterus gradually shrinks back to its pre-pregnancy size (or close to it). This process can take several weeks, especially if you’ve previously been pregnant. You may experience cramping in the lower abdomen as your uterus shrinks; fortunately, many people find that the most intense cramps resolve within 2-3 days. The cramps may be more noticeable during nursing or pumping because breastfeeding causes the uterus to contract. 

Many mamas also experience postpartum leg swelling and find that compression socks can help reduce the swelling and discomfort. Call your healthcare provider immediately if you have questions or concerns about your postpartum swelling, particularly if you notice the following signs:

• Rather than improving, the swelling is worsening over time.
• The swelling is accompanied by headaches, blurred vision, and/or sensitivity to light.
• The swelling occurs only on one side/limb.

When you first arrive home with your baby, your “exercise” program may not feel like traditional exercise–but it still counts! During the first few weeks, focus on moving intentionally during basic baby-care tasks, like picking your baby up from the crib, standing up from the couch or a chair, and rolling over in bed. 

Discomfort at a c-section scar or the perineum can cause you to hold your breath, or“guard” those areas with your whole body. Unfortunately, breath-holding places extra pressure on your still-recovering pelvic floor and abdomen. To reduce this pressure, exhale during large movements and efforts. Avoid overdoing it by progressing quickly into a lot of strenuous activity.

By week four, you’ll likely be feeling a bit more like yourself. If you exercised regularly before or during pregnancy, you might be itching to get back to the gym or lace up those running shoes. Take a deep breath: it’s not time to hit the pavement just yet. Professionals recommend easing back into running and weightlifting between 12-16 weeks postpartum. In the meantime, try basic core reconnection and stability-oriented exercises, like bridges, squats, modified planks, and single-leg balancing. For your cardio fix, stick to low-impact options like walking, stationary cycling, or swimming (if your stitches are fully healed).

Recovering from a C-section? By week three, your incision may begin to look fully closed. Though it might feel more comfortable now, it still needs a few more weeks to heal before you return to strenuous activity. During this time, many moms report lingering sensitivity over their cesarean scar. Nerves and connective tissue take time to heal, but there are some strategies you can use to help the area become less sensitive and more comfortable.

Scar massage is a common strategy to help the scars and tissues underneath move more smoothly with less discomfort.   

Touching the scar and the surrounding area can help remind your nervous system that some types of touch are normal and safe. This seemingly simple touch helps reduce sensitivity at and around the scar. Once your incision is fully healed (often around 6-8 weeks postpartum), you can start gently massaging the scar in all directions. Check out our Ultimate Guide to C-Section Aftercare for tips to get started with scar massage. 

Note that a C-section scar can become infected even if you take care to clean it properly. If an infection isn’t near the surface of your skin, it often won’t be visible. If the infection is within a deeper layer of your C-section incision or in the uterus itself, you may notice symptoms such as fever, chills, sweating, increased pain, or just a general sense of “being unwell.” Call your healthcare provider promptly to discuss these symptoms.

Do not delay addressing symptoms of infection because untreated infections can progress and spread to other parts of the body. 

The Motif Medical C-Section Bandage System can be a helpful tool for protection and scar tissue healing. This multi-step system consists of a series of wound care items designed to be used in succession, depending on your stage of wound healing. They may also be covered by your insurance plan!

Perineal stitches from a vaginal tear or episiotomy can make sitting—even on the softest couch—uncomfortable. To reduce pressure on the perineum, sit on a donut pillow or a Boppy pillow. Once the initial inflammation and soreness subside, you can switch back to a regular cushion. 

Here are a few other items that can help perineal healing:

• Tucks pads infused with witch hazel
• Perineal ice packs
• Soothing sitz baths
• Perineal squirt bottles 

Check out Lansinoh’s Birth Recovery Bundle. It includes essential perineal care products!

High blood pressure that is left unchecked can turn into postpartum preeclampsia, a serious pregnancy complication that can damage the kidneys, liver, and other organ systems. If left untreated, preeclampsia may progress into eclampsia or HELLP syndrome, both of which can be life-threatening—these are not problems to ignore! 

Unlike preeclampsia that starts during pregnancy, postpartum preeclampsia begins after birth. It can develop in people who had no signs or symptoms of preeclampsia during pregnancy. 

It’s important to note that the symptoms of postpartum preeclampsia may feel very similar to the normal symptoms of early postpartum recovery. This makes it even more critical for new moms to listen closely to their bodies during this time.

Here are some symptoms of postpartum preeclampsia to watch for: 

• Elevated blood pressure (over 140/90 mmHg)
• Severe headaches (like a clap of thunder or “the worst headache of your life”)
• Blurred vision or light sensitivity
• Pain in your upper belly
• Nausea and vomiting
• Shortness of breath
• Decreased urine output
• Swelling in combination with any of the previous symptoms, and/or swelling that gets worse suddenly

If you’re experiencing any of these symptoms, call your healthcare provider right away.

Pelvic organ prolapse is an umbrella term for the downward descent of the pelvic organs (bladder, rectum, uterus, and/or lower intestines). The pelvic organs can descend like this when their supporting structures (the pelvic floor muscles and connectives tissues) are weakened 

A baby traveling through the vaginal canal will certainly have an impact on the strength of those tissues, as can perineal tears. Perineal tearing is extremely common during childbirth, and often, it can’t be completely prevented. Perineal tears reduce the integrity of your pelvic floor, which may increase the risk of prolapse. Fortunately, some simple techniques that can reduce the odds of prolapse and perineal tearing: 

• Perineal self-massage starting during your third trimester through the end of pregnancy may help reduce the severity of tears.
• Discuss your planned birthing position with your OB/GYN or midwife. Birthing positions like kneeling, squatting, and side-lying allow your pelvis to move more naturally than it does while lying on your back, and they may reduce strain on your perineum.
• Harness your breath. As much as possible, exhale as you push during labor. Holding your breath increases intra-abdominal pressure, which can push your pelvic structures down with the baby.
• Support your body as you recover. Consider using postpartum support garments like compression shorts or leggings that cover your abdomen. Supporting the healing perineum area with compression can reduce feelings of vaginal or pelvic heaviness as you heal during those early weeks.
• Be intentional about how you move your postpartum body. Taking the time to build up your pelvic floor and abdominal strength after birth can make a big difference in how your pelvic floor heals. Support your body now and it will pay off in the decades to come.

Every mom is a candidate for pelvic physical therapy after birth. No matter how you delivered your little one, you can benefit from a consultation with a pelvic physical therapist. Even if you’re feeling pretty good and think you’re recovering well after childbirth, postpartum pelvic rehab can prepare you for all the phases of your life ahead. While we recommend asking about a pelvic physical therapy consultant before you leave the hospital (as noted at the beginning of this guide), you may find that you require one (or another one) further into your recovery. 

Here are some common postpartum symptoms that a pelvic PT can help you address:  

• Bladder leakage (urinary incontinence)
• Loss of bowel control and/or the ability to hold back gas (anal incontinence)
• Persistent pain at the perineum, upper or lower back, or pelvis
• A sensation of heaviness or downward pressure in the vagina, almost like something is “falling out”
• Pooching or doming at the midline of the belly, especially near the belly button
• Persistent* pain with sexual activity, particularly with vaginal penetration (intercourse)
• Tailbone pain and/or pain with prolonged sitting
• Back, neck, or other pain while breastfeeding
• New wrist and hand pain when gripping and carrying things

Be sure to discuss your concerns with your healthcare provider at your postpartum check-up, too. If a provider tells you any of the aforementioned symptoms are “just a normal part of being a mom” and doesn’t offer you any options to address them, it’s worth seeking a second opinion from a new clinician.

Postpartum intimacy and sex might feel like a source of stress for you and your partner. It‘s important to talk openly about how you’re feeling physically and emotionally so that you’re on the same page with your partner. 

It takes many months for your hormones to normalize after pregnancy and delivery, and these hormonal changes affect all aspects of your physical and mental health, including your interest in and enjoyment of sex. Estrogen levels in nursing parents remain low for longer than in their non-nursing peers. These lower levels of estrogen can reduce the elasticity of vulvar and vaginal tissues, making sex less comfortable.

Here are some tips to ease your journey into postpartum sex:

• Don’t rush it! There is no single “right time” to resume sex after childbirth. Every person and partnership is unique and different. Only you will know when you’re ready to get busy again!
• Remember that sex doesn’t always have to include penetration. If your body isn’t ready for intercourse, you don’t have to give up on sex altogether. Cuddling, kissing, light touch, and other forms of physical intimacy allow couples to stay close even if penetration isn’t on the table.
• Hydrate your healing tissues. A gentle vaginal moisturizer can be a lifesaver if you’re experiencing vaginal dryness. Good Clean Love’s Ultra Moisturizing Gel is gentle on sensitive vaginal tissues, maintains a healthy vaginal pH, and can be safely used with condoms.
• When you and your partner are ready to engage in intercourse, use plenty of additional lubrication. Choose a water-based lubricant to preserve a healthy vaginal environment. If water-based lubes don’t last long enough, consider a well-formulated silicone-based lubricant like Überlube.  

It’s not unusual for the first 1-2 attempts at postpartum sex, particularly sex involving vaginal penetration, to be tender and uncomfortable. This is common for people who delivered vaginally, but it can also happen to those who had a C-section. For many people, this discomfort resolves with time and patience; however, if the discomfort persists beyond your first couple of attempts at sex, it’s time to seek care from a pelvic PT. You do NOT have to live with painful sex!

It may feel like a big transition to get your body and mind back into the routine of the workweek. If you plan to continue breastfeeding, your breast pump will play a major role in this routine. Speak with your child’s caregivers about how you plan to manage your milk stores so your baby has plenty to eat.

Urinary tract infections (UTIs) are fairly common after both vaginal and cesarean births, affecting 2-4% of postpartum women. 

Most new mamas will have some amount of discomfort while urinating after birth. Perineal swelling, stitches at the site of a C-section or perineal tear, and irritation from a catheter placed for C-section deliveries can all cause pain while peeing. This can make it difficult to tell the difference between normal discomfort and painful peeing due to a UTI. 

If you’re feeling discomfort while peeing when you first arrive home, use a peri-bottle to spray warm water over the perineal area when you urinate. You can add a little witch hazel and aloe vera gel to the inside of your pads to help with stinging. This type of discomfort should lessen over the first few days.

If discomfort while peeing doesn’t improve within the first few days, or if your symptoms are worsening, you should be evaluated for a urinary tract infection. Here are some common signs and symptoms of UTI: 

• Pain or burning while peeing
• Pressure or sharp pain in the lower abdomen
• Feeling a need to pee often
• Urine that’s cloudy or smells foul
• Pain with urination that seems to be getting worse. 

If you notice any of the above or have concerns about lingering pain with peeing, don’t hesitate to call your care provider.

Diastasis recti abdominis (DRA) is the widening and thinning of the linea alba, a band of connective tissue between the two sides of the abdominal muscles. Some people refer to DRA as “ab separation”, but don’t be alarmed; DRA is a thinning of the connection tissue, rather than a true “split” or “tear.”

DRA occurs to some extent in all full-term pregnancies. It’s your body’s natural way of adapting to your growing belly during pregnancy. While DRA does improve after delivery, the healing process can take many months. Even if you're doing everything right for your postpartum body, change is slow, and connective tissues take longer to recover than muscle.

Here’s how you can check to see if you have DRA:

• Start lying on your back with your knees bent and feet on the floor or bed.
• Place two fingers on the middle of your belly, right under the center of your ribcage. This usually feels the closest to your "normal."
• Keep your belly relaxed. Using two fingers, work your way down the midline of your abdomen. Notice the width of the space between your muscles.
• Exhale and gently engage your belly muscles, like you’re blowing out a hundred birthday candles. Did the space under your fingers change? Notice how deep your fingers can sink down before you feel tension under them.
• Now, lift your head and shoulders off the floor. Feel your way down your entire abdomen again, noticing both width and depth under your fingers. Does the space change when you do this?

If you notice a large gap between the muscle bellies, don’t panic! Consult with a pelvic physical therapist to assess the area more fully. If you do have DRA, a pelvic PT or corrective exercise specialist can teach you how to manage it and help it heal.

DRA recovery starts by building a strong and functional core. Your postpartum rehab specialist can help you learn to generate tension at the midline of your belly as you rebuild control and strength of your deep core muscles. 

All-Fours Draw-In

Description: Start on all-fours with hands under shoulders and knees under hips. Exhale and gently draw your belly button in towards your spine. Hold this draw-in as you take 2 breaths. Release and repeat 10x.

• To increase the challenge, combine this draw-in with a pelvic floor contraction, as though you’re squeezing your vaginal muscles around an imaginary tampon.

All-Fours Opposite Arm & Leg Lifts (Single-Leg)

Description: Start with the All-Fours Draw-In (above). Maintaining the draw-in, inhale to reach your right arm forward and your left leg straight back. Exhale to lower arm and leg. Repeat 10x, then switch sides.

Side Plank

Description: Lie on your right side and prop up on your right forearm (elbow under shoulder). Bend your right knee so your lower leg rests on the ground. Straighten your left leg and place your left foot on the floor for balance. Exhale to lift your hips off the floor, pushing through your legs and right arm. Hold this position and take 5 steady breaths. Lower and repeat on the opposite side.

Lying Draw-In

Description: Lie on your back with knees bent and feet flat on the floor. Exhale and gently draw your belly button in towards your spine. Hold this draw-in as you take 2 breaths. Release and repeat 10x. 

• To increase the challenge, combine this draw-in with a pelvic floor contraction, as though you’re squeezing your vaginal muscles around an imaginary tampon.

Lying Hands & Knees Press

Description: Begin with the Lying Draw-In (above). Exhale to lift your thighs over your hips, one at a time. Place your palms against your thighs and inhale. As you exhale, press hands into thighs and thighs back into hands, keeping your lower back flat on the ground. Inhale to release. Repeat up to 10x.

Elevated Plank

Description: Stand in front of a sturdy, knee-high surface. Place your hands on the surface and walk your feet back to create a plank shape. Draw your belly button towards your spine to maintain the position; hold for 3-5 breaths.

Elevated Plank with Mini-Mountain Climbers

Description: Begin in Elevated Plank (above). Maintaining the belly draw-in, exhale to draw one towards the elevated surface. Inhale to replace that foot in plank. Repeat on the opposite side to complete 1 repetition. Do 10 reps.

Seated Draw-In

Description: Begin seated with knees bent and feet flat on the floor. Place your hands on your shins. Exhale to gently draw your belly button in towards your spine. Hold this draw-in as you tilt your torso back until your arms are straight. Maintain this position as you take 1-2 breaths. Release and repeat 5-10x. 

• To increase the challenge, combine this hold with a pelvic floor contraction, as though you’re squeezing your vaginal muscles around an imaginary tampon.

Boat Pose

Description: Begin in Seated Draw-In (above). If you feel stable there, release your hold on your shins and reach your arms forward in line with your thighs. Keep your spine long and straight. Maintain this position as you take 2 or more breaths. Release and repeat 5x.

Dead Bug

Description: Begin in Lying Hands & Knees Press (previous section). Maintain pressure between left hand and thigh. Inhale and reach your right arm and right leg in opposite directions. Exhale to return to start. Repeat with the left arm and leg to complete 1 rep. Do 5-10 reps.

Rotational Chop

Description: Begin standing with feet hip width apart, holding a light weight (5-10 lbs). Step the right foot back 3 feet and lightly bend both knees. Inhale and reach the weight up and across the left shoulder (photo #1). Exhale to bring the weight down on a diagonal in front of your right hip in a “wood chopping” motion (photo #2). Repeat 10x, then switch sides.

And there you have it! Feeling prepared for the postpartum period? Remember that your body changes tremendously during and after pregnancy, and this is something to celebrate! You worked hard to carry your little one for many months. Now it’s time to extend yourself the same patient care you gave your growing baby. Change takes time! 

References

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