Birthing mothers: your body in the first week after birth
The first week after your baby’s birth is a time for you to care for and get to know your new baby.
You’ll have some vaginal bleeding and soreness around your vagina or caesarean wound. You might also have afterpains and nipple or breast tenderness. That’s why the first week or so after birth is also a time for you to rest and recover as much as you can.
Talk to your midwife, child and family health nurse, GP or obstetrician if pain is making it hard for you to rest, sleep or care for yourself or your baby. Your health professional can help you with pain relief medicine. It’s also a good idea to ask any other questions you have about yourself or your baby.
Vaginal bleeding
You’ll have some vaginal bleeding. This starts straight after birth and lasts for 4-6 weeks. The bleeding usually eases off over the first weeks and changes from bright red to red-brown.
You’ll need to use pads rather than tampons. You might prefer to use period-proof underwear or maternity pads at first – maternity pads are larger and longer than regular pads. The bleeding might increase for a short time when you’re breastfeeding or walking.
If your perineum feels hot or becomes more swollen or if your vaginal bleeding has a bad smell, check with your doctor or midwife. These changes can be signs of infection.
Pain and recovery after vaginal birth
You might be sore after a vaginal birth, even if you haven’t had any tearing or stitches. This is because the muscles and nerves around your perineum have been stretched and bruised.
There are several things you can try to help with pain, swelling and bruising of your perineum:
- Put ice packs or cold gel packs on the area for 10-20 minutes every 2 hours.
- Lie on your side and do pelvic floor exercises.
- Take some paracetamol or other mild pain relief. Ask your doctor, midwife or child and family health nurse which pain relievers are best for you, especially if you’re breastfeeding.
- Keep the area clean by showering or bathing daily and changing your pad or period-proof underwear regularly.
- Gently pat the area dry with a clean, soft towel or cloth after each wash.
If it hurts to urinate, tell your doctor, midwife or child and family health nurse. This might be caused by grazes on your perineum. These things can help:
- Pour a cup of warm water over your genitals when you urinate.
- Use a urinary alkaliniser.
- Drink plenty of water.
If you have stitches to repair a tear or an episiotomy, these will dissolve gradually 1-2 weeks after the birth.
Pain and recovery after caesarean birth
After a caesarean birth, you’ll have a surgical wound in the lower part of your tummy. It’s normal for the wound to be sore.
It can help to support your wound with pillows under your knees when lying on your back, or under your tummy when lying on your side. When you sit up from a lying position, roll onto your side and use your arms to raise your upper body from the mattress.
Your midwife or doctor will tell you to limit vigorous exercise and activity after a caesarean birth. It’s best to avoid tasks that involve lifting, carrying and driving in the first few weeks. You can ask your partner, family or friends to help you with these tasks.
A gentle walk each day can help your body heal. You should also get as much sleep and rest as you can.
Loose-fitting clothing and cotton underwear with a high waist will probably be more comfortable on your wound than tight clothes and bikini underwear.
The size of a caesarean scar is different for each birthing mother, but your wound will appear smaller in the first few weeks after birth as the bruising and swelling settle down.
If you see any signs of infection around your wound, see your doctor or midwife straight away. Signs of infection include pain, swelling, smelly discharge, the wound coming apart and skin discolouration – red on light skin, or brown, purple or grey on dark skin.
Afterpains
Afterpains are short cramps caused by your uterus contracting to get smaller and control bleeding. You might get afterpains while you’re breastfeeding because the hormones released when you breastfeed also make the uterus contract. This helps your uterus to get smaller and get back to how it was before you were pregnant.
Afterpains are uncomfortable and can last a couple of days. Warm packs on your tummy or your back can help. You can also take paracetamol or other mild pain relief.
Afterpains are more common in birthing mothers who have given birth before, but you can have them after your first birth too. They generally get stronger with each birth.
Breast and nipple soreness
You can expect sore nipples and tender breasts in the first week as your milk comes in and you and your baby learn to breastfeed.
The most common reason for soreness is your baby not attaching properly to your breast. With good attachment, this will usually settle down. Ask for help from your midwife, child and family health nurse or lactation consultant if you’re not sure or you’re very sore.
If you’ve checked your baby’s attachment and you still have sore nipples, don’t give up just yet. Check out our article on sore nipples for more things you can try. The problem of sore nipples usually doesn’t last.
If your breast and nipple soreness doesn’t get better each day, talk to a midwife or your child and family health nurse. An Australian Breastfeeding Association (ABA) counsellor can also help – phone the National Breastfeeding Helpline on 1800 686 268.
Urinary and bowel incontinence in the first few months after birth
In the early months after birth, you might find that you have incontinence – that is, you might accidentally urinate or have accidental bowel motions, especially when you laugh, cough or sneeze.
This will usually fix itself as your swelling goes down, sensation comes back and muscles get stronger. Pelvic floor exercises to strengthen your muscles can help.
If you’re still having problems with incontinence when your baby is 6 weeks old or older, talk to your doctor, midwife or child and family health nurse. They can help, or they might refer you to a women’s health physiotherapist or continence specialist.
Incontinence after birth is very common, and there are many treatments that can help.
Weight in the first few months after birth
Weight loss usually happens gradually after birth. Healthy eating and gentle exercise like walking can help with losing weight. Breastfeeding can help too.
Weight loss is safest when you take it slowly. If your goal is to return to your pre-pregnancy weight, you can expect this to take several months.
If you were overweight before you got pregnant and you’d like to lose weight, talk with your GP, dietitian or child and family health nurse. If you’re losing too much weight and are underweight, it’s also a good idea to talk with your health professional.
Hair in the first few months after birth
You might lose some hair from your head in the months after giving birth. This won’t last and should settle down when your baby is about 6 months old.
It happens because of changing hormone levels in your body.
Stretch marks
You might have stretch marks on your tummy, hips and breasts during pregnancy. After the birth, the marks usually change, fading from a dark colour to a silvery colour. The marks usually get smaller too.
Your health and your baby’s health will be reviewed at a 6-week check-up with your midwife, child and family health nurse, obstetrician or GP. This is a chance for you to ask about any physical or emotional changes that are worrying you.
Your relationship in the early months of parenthood
If you have a partner, becoming parents is a big change for both of you. Some couples find a deeper connection, but others need time to nurture their relationship as parents.
Your feelings about sex and intimacy can depend on many things – your birth experience, pain, tiredness, the demands of caring for your baby and your feelings about your body after pregnancy and birth.