The postpartum period begins immediately after a woman gives birth and lasts about six weeks. During this time, big changes occur as the body adjusts to being "not pregnant" and the uterus returns to its normal size. Many other changes occur during this time, including the decline in pregnancy hormones, the onset of lactation, and the gradual recovery from pregnancy and the trauma of a vaginal or cesarean delivery. Certain problems can arise during the postpartum period and need prompt attention.
The uterus is designed to expand during pregnancy and return to a normal size once it can no longer accommodate the fetus. In the first few weeks of the postpartum period, women may experience cramping, and most have bleeding comparable to a very heavy menstrual period. The bleeding tends to continue if women are very active during this time, but it also lightens. Extremely heavy, bright red bleeding is not normal and could indicate uterine bleeding; A doctor should be informed immediately. Generally, within the first six weeks, the bleeding will lighten and then stop completely.
A big change occurs during the postpartum period as breastfeeding begins. In the early days, women have a thin secretion called colostrum from the breasts that is full of immune properties that the baby can benefit from. About three to four days after the birth of a baby or earlier, the milk comes in, which can be a very uncomfortable feeling at first, with the breasts prone to sudden leaks or spraying. This feeling happens when supply and demand are resolved between mother and child, or if a woman is not breastfeeding.
Another bodily change in the postpartum period is the decline in pregnancy hormones, which tends to cause some mood disorders. Most women will experience a few days of low spirits, depression, or moodiness, often called the blues. For some women, this condition becomes more severe and their mood does not improve, which is called postpartum depression. Because it can be potentially serious, women should get help right away. A very rare complication is postpartum psychosis, and anyone with a severe mood disorder who has thoughts of harming themselves or the child needs medical attention.
In the first few weeks of the postpartum period, women experience pain, especially if they are recovering from episiotomies or perineal tissue tears. Constipation is common, which can cause additional discomfort, and is best managed by drinking plenty of fluids and eating high-fiber foods. Recovery from surgery takes even longer, and most women must refrain from most physical activity for several weeks if they had a C-section. Doctors also ask women to refrain from sexual activity until the postpartum period is over.
Doctors usually schedule an appointment with new moms for six weeks after birth. This gives them the opportunity to screen mothers for additional problems and determine uterine size. In most cases, the body has recovered from the pregnancy and the postpartum period is considered over.