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What to Expect After Giving Birth

Answers to your most frequently asked postpartum questions

by Bridgette Holmes, MSN, CNM

A person looking away from the camera pushes a stroller on the beach.
It’s important to know what is normal when it comes to healing after birth. From bleeding to stitches to mood changes – and even to the first poop! – we will break down exactly what you might experience during the fourth trimester.

You’ve taken your birthing, lactation, and newborn care classes and are feeling ready to rock the transition to parenthood. Amazing! Or maybe you’ve just given birth, and you’re wondering what’s next. Let’s talk about how to prepare for the postpartum period.

The first twelve weeks after welcoming a baby are commonly called the fourth trimester. This time period comes with many physical and emotional changes as you adjust to your new normal. Many new parents are unsure of what to expect in these early days. Your body has been through a huge transformation and may not feel familiar to you. Your routine gets turned upside down, and you may find yourself wondering what the healing process looks like as you start to build this new life with your baby.

How long will I bleed after birth?

Vaginal bleeding and discharge after birth is called lochia (pronounced low-key-uh), and it follows a usual pattern. It starts out bright red and heavy, almost like a period, and gets lighter over time. Eventually lochia becomes light pink, brown, or yellow before fully stopping.

It’s normal to bleed for up to six weeks after delivery. Every person is totally different and will have a unique experience.

However, it’s never normal to bleed through more than one pad per hour. Especially if you pass large clots, have a fever, or feel worsening pain, seek medical attention. Some complications, like infections or retained pieces of placenta, can cause your bleeding to increase. It’s important to check in with your provider if you feel like your bleeding is too heavy. 

When will my period come back? 

For chest/breastfeeding parents, your period may not return for more than six months after birth! The hormones that support lactation also block ovulation for many people who are exclusively breastfeeding during the first six months. Most parents who nurse find that their periods return when they introduce solid foods or begin to wean, usually between 9 and 18 months postpartum.

For formula-feeding parents, your period may return as early as 5-6 weeks after giving birth. 

For your information

Did you know? You can still get pregnant while nursing.

What about my stitches?

Some studies say that more than 80% of people will experience tearing during birth. There are four different types of tears. The most common tears are called first degree (just involving the surface skin) or second degree (involving the skin and some of the underlying muscle).

It’s normal to bleed for up to six weeks after delivery. Every person is totally different and will have a unique experience.

A very small percentage of people will experience more significant tearing that involves the muscles around the anus. These are called third or fourth degree tears, depending on how severe they are. 

Your provider will place stitches that dissolve on their own. For first, second, and many third degree tears, healing usually takes around 4 to 6 weeks. Fourth degree and more severe third degree tears can take several months to fully heal. 

The best thing you can do for your stitches is to rest. “Resting” might include avoiding stairs or not doing tasks like laundry, dishes, or cooking. You don’t need to try to clean your stitches or remove them yourself. Some people find that stitches are itchy or uncomfortable as they heal. Witch hazel pads and sitz baths in warm water can provide some relief.

When can I have sex again, and what can I do for birth control? 

Most providers recommend waiting four to six weeks after delivery to have sex. This allows time for bleeding to slow and stitches to heal. However, there isn’t really any strict waiting period. What is most important is taking your time, listening to your body, and communicating your needs with your partner. 

When you do feel ready, there are several options for birth control. Options may depend on whether or not you are lactating, as well as your personal health history and goals.

When can I start exercising?

You can return to exercise fairly quickly after having a baby, but it’s best to start out gently. Your body has been through a lot, and it’s important to take care of yourself.

Your body will let you know if you are doing too much. The placenta leaves a dinner plate-sized wound inside the uterus, and it needs time to heal!

Walking is a great exercise for your whole body, and can help you get outside for some fresh air and vitamin D. You can begin walking short distances immediately postpartum and work up in distance as you feel comfortable. If you’ve had stitches, you might want to wait until after the first week to start exercising.

Your body will let you know if you are doing too much. The placenta leaves a dinner plate-sized wound inside the uterus, and it needs time to heal! If you begin bleeding more heavily or experiencing more pain, try to rest for a few days. Twisting, lifting, or bending can all cause an increase in bleeding.

I don’t know how else to say it — I’m scared to poop! Any advice? 

Several things can make it more difficult to poop after having a baby. Hormones at the end of pregnancy may cause constipation before the baby even arrives. Certain pain and anti-nausea medications during labor and delivery can make you even more constipated. Dehydration from your hard work during labor can worsen things. And as your milk comes in, your body’s fluid needs increase even more! 

Especially if you have stitches, you’ll want to try to keep your first poop soft so you don’t have to strain. Increasing your water and fiber intake can help. Foods like fruits, vegetables, and whole grains are great sources of dietary fiber. If necessary, you can take medications like stool softeners or gentle laxatives (like Miralax). A daily magnesium supplement can also help support regular bowel movements. It may also ease some muscle aches from all your hard work during the birth. 

Getting out of bed and walking can also help to get your bowels moving, but make sure you are also getting plenty of rest. And don’t stress too much – the first poop is usually not as bad as you’d think! If you want a little extra support for stitches while on the toilet, apply a warm washcloth with gentle pressure to your stitches as you ease out a bowel movement.

A tired-looking person sitting on the ground holds their sleeping baby.

I’m tearful, irritable, and disconnected from my baby — is this normal?

Postpartum depression is incredibly common, affecting 1 in 7 birthing people. It can be brought on by a perfect storm of factors, including hormone shifts in your body, lack of sleep, limited community support, and total emotional upheaval and adjustment. Postpartum anxiety is also common. But while common, postpartum depression and anxiety aren’t normal, and they aren’t things that you have to suffer through alone. 

Postpartum doulas can be a great option to help with household tasks or baby care. They can help give you a chance to rest more. Some have specialized training in lactation, baby care, sleep schedules, herbal remedies, cultural postpartum practices, and more! 

Mental health therapy can be really helpful for people struggling with postpartum depression or anxiety. Some people benefit from individual therapy, while others may benefit from new parent support groups alongside others going through similar life experiences. 

There are also safe medications that can be taken postpartum, even while nursing, to help treat postpartum depression. These are often most effective when used in combination with therapy.

Healing after birth is a journey 

Remember – through all the ups and downs, you’re doing a great job. Lean on your support network, including your provider, family, and friends. Don’t be afraid or ashamed to ask for help when you need it. Recovering after birth can be tough, but you’ve got this!

This article was reviewed by Quilted Health midwife Michele Augur.

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Bridgette Holmes MSN, CNM
(she/her)

Bridgette enjoys supporting people through collaborative, person-centered reproductive healthcare. As a new mom herself, she appreciates how powerful and transformative pregnancy and birth can be.

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