The postpartum period is the period beginning immediately after delivery and extending for the first 6-8 weeks. You may know this as the postnatal period. This is time of dramatic changes for both the mother and her baby.
In this short period, you will go through as many physical, mental and emotional changes as you did throughout your pregnancy.
Physical recovery
Vaginal birth
Physical recovery following labour and birth takes time. Women will vary significantly in their postpartum recovery however many feel mostly recovered after six to eight weeks.
Caesarean birth
Caesarean section involves abdominal surgery so your recovery will be slower and require more support at home in caring for you and your baby. You will have an incision (cut) that requires wound care. Wound care information should be provided as part of your discharge planning.
While physical activity will be encouraged, there will be restrictions to what you can do until reviewed at your six to eight week check. These may include; not lifting anything heavier than your baby, avoiding heavy housework, jogging or exercises or any activities that make you breathe harder or strain your muscles.
Avoid doing sit ups. You may be advised not to drive for at least two weeks. Do not drive if you are taking strong pain medicine or if you feel weak or dizzy.
Pay attention to unusual discomfort. Pain that gets worse instead of better should not be ignored, call your midwife or obstetrician or go to the Emergency Department at your nearest hospital.
Coping with body changes
The postpartum period refers to the time after childbirth when your body is recovering from pregnancy and delivery. During this time, a woman will experience changing hormones and potential range of physical changes:
Vaginal soreness
The area around your anus and vagina is the perineum. It is not unusual for the perineum to be swollen, bruised or tender following a vaginal delivery. If you have stitches you may have more discomfort. This usually resolves in the first four to six weeks.
If you experience more intense pain or sensations of burning or cutting, it is recommended to follow up with your health care provider. Natural remedies, particularly, salt baths or the use of ice packs can provide short term relief. Over the counter pain relief including ibuprofen or paracetamol are safe to use while breastfeeding.
Vaginal discharge and bleeding (lochia)
Every woman will experience some bleeding post partum, this discharge is known as lochia. It will initially be bright red and may contain a few small clots – similar to a heavy menstrual bleed. By the end of the first week it should change in colour to pinking brown, then cream and reduce in amount.
Vaginal bleeding usually stops in three to six weeks. Be vigilant with cleanliness, wash your hands before touching your perineal area, wipe from front to back after going to the bathroom. It is recommended to use a sanitary pad, rather than tampons, and to wash your hands before and after changing the pads to avoid the risk of introducing bacteria into a healing uterus or vagina.
Consult with a health professional if you have heavy vaginal bleeding at any time (soaking more than one pad each hour), pass large clots- larger than a 50c piece, notice a strong or unusual odour, have unusual abdominal tenderness, feel unwell or have a high temperature over 37.5 deg C.
Varicose veins
Varicose veins are swollen, blue and sometimes painful veins that may appear in pregnancy and after pregnancy. These are commonly found on your legs but may also appear on the vulva and in the vagina. Varicose veins develop because the increased blood flow and the weight of the uterus can soften the lining of some blood vessels and impact blood flow from the lower part of the body.
Walking, avoiding sitting with legs crossed for long period, drinking plenty of water and using support stockings are useful to reduce discomfort and worsening of varicose veins postpartum. Varicose veins usually resolve with six to 12 months however consult with your medical practitioner if pain or discomfort continues beyond birth.
Hemorrhoids and bowel movements
When painful, itchy varicose veins occur around the rectum, we call them hemorrhoids. Hemorrhoids may bleed after a bowel movement. Salt baths or hemorrhoid creams can provide short term relief. Hemorrhoids usually resolve themselves within six to 12 months however consult with your medical practitioner if pain, discomfort or bleeding persists beyond birth.
For some women, the pain of hemorrhoids can contribute to reluctance to have a bowel movement and lead to constipation. Increasing water intake and the amount of fibre in the diet contributes to maintaining regular, soft bowel movements that are less painful to pass.
Constipation
Constipation can occur after birth. For most women, normal bowel movements resume within the first day or two of birth, however if you do not have a bowel movement for several days, you a straining, your bowel movement is hard or dry, you have abdominal bloating or cramping or are passing more wind than usual, you may be constipated.
Constipation is usually managed by drinking eight to ten large glasses of water each day and ensuring there is enough fibre in your diet. Foods such as vegetables, wholegrain cereals and breads, nuts, seeds and legumes provide dietary fibre. Laxatives or stool softeners are not recommended long term so if you have not had a bowel movement for three or four days, speak with your health care provider.
Breast engorgement, tenderness, and possible leakage
While your breasts change in preparation for breastfeeding during pregnancy, this change continues in the postpartum period, whether you decide to breastfeed or not. It is normal for your breasts to increase in size and weight which may feel uncomfortable as your milk supply increases postpartum, particularly in the first week.
For most women your milk will start coming in around day 3 and your breasts will feel very full and may be painful. While your baby gets the hang of feeding, your breastmilk supply will adjust to your babies needs along with you both getting to know each other and establishing your feeding patterns.
The establishment of milk supply usual takes around 6 weeks. In the first couple of weeks you may feel the engorgement of milk in your breast as your milk supply adjusts to your babies needs .
Engorgement happens when milk remains in the breast and your breasts feel hard, warm and painful. Engorgement can happen in both breasts, but you can reduce the likelihood by breastfeeding often (eight to twelve times in 24 hours), ensuring your baby is latched on well at the breast so they can take milk effectively from the breast and taking care of yourself by drinking plenty of fluids, eating well and getting enough sleep. If you need to be apart from your baby for any reason, we recommend expressing milk frequently to avoid engorgement.
Engorgement can be managed by putting a warm cloth on your breast or taking a warm shower ten to twenty minutes prior to breastfeeding, massaging your breasts gently towards the nipple before and during feeding, breastfeeding from the most engorged breast first and hand expressing or pumping your breast a little to soften and make it easier for your baby to latch on.
Between feedings, use cool compresses on your breasts to reduce swelling and pain for a day or so. Some mothers continue to make more milk that their baby needs which may lead to leaking or frequent engorgement. Leaking of milk is common in the first weeks of breastfeeding for some mothers.
Using breast pads is the most efficient way of managing leaking, but you can read more strategies here. If you think you have engorgement or have questions about your milk supply, contact your health care provider or the breastfeeding hotline 1800 686 268.
Uterine contractions and cramping
Some women experience “after pains” – these are contractions of the uterus due to the release of oxytocin during breastfeeding. They happen because your uterus is shrinking in size and weight, going from just over a kilo following birth to around fifty grams at six weeks postpartum.
These contractions are more likely to be intense in women who have had more than one delivery and may be managed with mild analgesia, if required
Urinary incontinence or difficulty emptying the bladder
During pregnancy and childbirth, many women will experience at least some degree of involuntary urination, this is known as urinary incontinence. There are many different risk factors which will influence your likelihood of developing incontinence after pregnancy, however women who deliver vaginally have approximately 50% greater chance of developing incontinence than women who deliver via Caesarian section.
There are several types of urinary incontinence, but most women experience stress incontinence which is brought on by laughing, sneezing, coughing or other activities which put additional stress on the bladder sphincter (muscles) that control urine flow. Urinary incontinence postpartum is common and responds to easy, non-invasive treatments that can greatly improve or eliminate incontinence.
If you have not done them prior to birth, you will be encouraged to begin pelvic floor training or Kegel exercises. Kegel exercises are simple contraction exercises for a women’s pelvic floor that can prevent and cure conditions caused by weak pelvic floor muscles. If urinary incontinence symptoms continue, you feel a urgent need to empty your bladder or bowel, have trouble controlling passing wind or faeces, have a dragging sensation or feel a lump in your vagina, it is recommended you contact your health care provider or physiotherapist.
Hair loss
Postpartum hair loss is a common condition that occurs around three months after childbirth and can last up to six months. Pregnancy hormones interrupt and shorten normal hair growth, but because of the cycle of hair growth this may take a few months to have effect.
There is no treatment for postpartum hair loss however there are things you can do to prevent further loss, including treating your hair with care by gentle washing and combing, using a volumizing shampoo and conditioner and eating a healthy diet. If you continue to lose hair beyond six months postpartum, consult your health care provider.
Tiredness, fatigue and exhaustion
Tiredness and fatigue are the most common challenges identified by new mothers. General strategies to minimise the impact of tiredness and fatigue include ensuring regular fluids and nutritious and balanced meals throughout, regular periods of rest during the day and at night, using social supports to assist with daily activities and to allow some time in the day when the mother does not have to hold the mental load of what needs to be done for the baby and the family.
Paying attention and taking the time to rest is important to be able to recover physically and to learn to respond to your baby’s needs. This rest and recovery, along with realistic expectations about what can be done.
Weight loss or gain
Each of us differ in how our body responds and changes postpartum. The immediate changes in weight following delivery come from the combined weight of the baby, the placenta and amniotic fluid (the fluid around the baby – our “waters”). Early weight loss also comes from the uterus gradually returning to a non pregnancy size and additional fluid loss.
Weight associated with breast tissue will continue while you are breastfeeding however most experts suggest breastfeeding itself uses energy which contributes to weight loss postpartum. The remainder of the weight gained during pregnancy, mostly increased fat stores, are usually lost gradually over the period of six to twelve months postpartum.
Losing weight gained during pregnancy is not different from losing weight at any other point in life, with regular physical exercise and maintaining a healthy diet the key. If you are experiencing persistent weight gain or weight loss of greater than 500 grams per week, it is recommended you speak with your health care provider as it may be a result of an underlying health condition.
Tips for physical postpartum recovery
The weeks following birth are a critical period for you and your newborn child, creating a foundation for long-term health and wellbeing. Postpartum care is an ongoing series of actions and choices for self-care that are particular to your needs.
Your health professionals will have a series of clinical guidelines which determines what they do and when. Similarly there are things you can do to help support your recovery from childbirth, adjust to changing hormones, learning to feed and care for your newborn and adapting to the challenges ahead. While these seem simple, they can make a big difference to how you experience parenting and recover from childbirth.
Rest
You will experience fatigue and disruptions to your usual sleep patterns following the birth. Most new parents can manage with some tiredness however if you are so tired you are feeling low, irritable or unable to enjoy things or feel overwhelmed you will need to find ways to sleep.
Tips which may help include: sleeping when your baby sleeps, going to bed early rather than staying up to have time together or do household tasks, involving your partner more e.g. considering sharing some night time job and asking for extra support from a family member and friends.
While most women are attentive to their physical needs in the early days, they often neglect self-care once they get home. If pain or discomfort is keeping you from sleeping, consider ice-packs for a tender perineum, warm (before) and cool (after) washcloths for sensitive and tender breasts or a warm shower/bath which may help prepare you for sleep.
Simple breathing exercises or relaxation exercises can also help you reset or refresh you. While tiredness, stress and changing feelings are expected postpartum, you and your partner are encouraged to be aware of the signs of when normal “baby blues” can become postpartum depressive symptoms and/or anxiety. If you cannot sleep, even when your baby is sleeping, you feel tired all the time, you do not enjoy the things you used or you have feelings of hopelessness or helplessness, contact your health care provider for support and review.
ForWhen is here to support you during this time, call the helpline on 1300 24 23 22 to start a conversation.
Nutrition
Try to make eating well and regularly a priority – what you eat will positively impact your recovery. A healthy eating balanced diet means eating a wide variety of food – as well as five serves of vegetables and fruit, include carbohydrates like potatoes, bread, rice or pasta, some dairy or dairy alternatives, beans, pulses fish, eggs or meat.
Drinking plenty of water means drinking to thirst or at least six to eight glasses of water per day. If you are cooking, try to make more than you need and freeze extra portions for later meals. Tinned and frozen vegetables are quick to prepare and convenient, as well as snacking on raw vegetables to help increase your daily vegetable count. You may find aiming to only eat healthy meals or five smaller meals per day works better around your baby’s feeding, wake and sleep cycles.
Exercise
When you feeling tired, being active might seem like the last thing you want to do, but regular activity can help you relax and help you feel more energetic. Exercise can also help your body recover and reduce recurrent risk of postnatal depression. Your lower back and core abdominal muscles may be weaker than they were before pregnancy and birth and your ligaments and joints will continue to be more flexible for a few months after birth, so you may be at an increased risk of injury if you stretch or twist too much.
Postpartum pelvic floor training, or Kegel exercises, are strongly recommended as your perineum and pelvic floor have supported the accumulated weight of baby, uterus and amniotic fluids during pregnancy and birth. Seek support from a qualified health professional or a physiotherapist for an individualised exercise program.
Key Highlight
An extensive postpartum evaluation serves as a valuable occasion to revisit and thoroughly discuss your childbirth experience. This reflective process enables you to comprehend the experience and offers insight into any differences from your initial plans or expectations.
The postpartum checkup
A routine six to eight week check is recommended for both the mother and the baby. This postpartum health check is important for reviewing your general health and wellbeing, assessing your recovery from birth and checking that conditions you may have had during pregnancy have resolved – this includes; high blood pressure of gestational diabetes, bleeding and vaginal loss, recovery from episiotomy or tear, healthy and functioning bladder and bowel, and to assess any pain or discomfort.
Usually your doctor will check your cervix has returned to pre-pregnant state, check your perineum and vagina to ensure repair and discuss future pregnancy planning, contraception and resuming sexual activity. They may also take a pap smear at this time and take blood tests to assess your iron levels and thyroid function.
A comprehensive postpartum check will also be an opportunity to review your birth experience, to debrief and understand what happened and how this may have differed with what you had planned or expected. This is an opportunity to discuss breast health and feeding options, as well as how you are adapting to the many changes relating to having a new baby. If you have experienced “baby blues” or if you/ your partner are concerned about your mood or postpartum depression, this is a good opportunity to discuss.
If you have also booked a newborn baby postpartum check at the same time, your doctor will do a physical examination of your baby that includes checking their skin, eyes, hips, mouth, head and listening to their heart and lungs. This check is an early opportunity to ensure both mother and child have recovered from labour and delivery and to ensure that baby is growing and developing well.
Establishing early positive relationships with health care providers is an opportunity to develop a partnership with the people who will monitor and promote your child’s physical developmental and emotional wellbeing across childhood.
Mental health
Pregnancy, birth and parenting are emotional times for everyone. The period after birth is a time when women are more likely to develop mental health conditions than at any other time in their lives. Men are also at increased risk, especially if their partner or child is unwell.
Mood swings and baby blues
During the first week you may experience mood swings known as the “baby blues”. This is linked to the sudden hormonal and chemical changes that take place in your body. Common baby blues symptoms may include: irritability, anxiety, feeling emotional or tearful or feeling low or “flat” with decreased energy or motivation. These feelings are normal and only last a week or two.
A more recent term, postnatal depletion describes the physical, hormonal and emotional resources used in giving birth, breastfeeding as well as the stresses and strains of modern parenthood. This involves a range of accumulated issues including deep fatigue, poor immune function, poor gut health and a feeling of being overwhelmed. While postnatal depletion is not the same as postpartum depression, these are signs you may need to consider more support and a discussion with your health care provider.
Key Highlight
Postpartum depression and anxiety are common mental health conditions affecting new mothers, impacting daily life and childcare. Symptoms include mood changes, sleep disturbances, appetite shifts, and intrusive worries. Seeking professional help, building a support system, and maintaining physical health are crucial coping strategies.
Postpartum depressive or anxiety symptoms
Postpartum depression (postnatal depression) is a common mental health condition that interferes with your daily life, including caring for your baby. Common symptoms include: feeling numb or low, lack of energy, lack of interest in things you previously found pleasurable (this may include your baby, yourself, your partner or sex), changes in sleep pattern (sleeping more or having difficulty sleeping or staying asleep), changes in appetite, feeling alone or isolated, difficulties concentrating or making decisions, loss of confidence, feelings of worthlessness, irritability, crying spells, feeling highly sensitive or feeling exhausted and having no energy.
Some women may also have thought of harming themselves or their baby. Postnatal anxiety is a common mental health condition that involves feelings of worry or disturbing thoughts which impact on your experience of daily life and capacity to get things done. Common symptoms include: intrusive fears or worries, irritability or feeling “on edge”, palpitations or a racing heart rate, negative thoughts about yourself “not being able to do anything right” or concern that “something terrible will happen”, difficulty sleeping, concerns something will happen to your baby.
Some women will experience intense feelings of anxiety that feel impossible to control, known as panic attacks. It is common to experience postpartum depression and postpartum anxiety at the same time. There are a number of things you can do but the most important ones are; tell someone how you are feeling – seek professional help from a health professional, use parenting lines or mental health crisis lines when professional help is not available, accept you can not do this alone – you will need a support system of health professional, family, friends, take care of your physical health – diet, exercise, relaxation and sleep, and involve your partner and other in appointments and information so they can best support you.
For support, you can also call the ForWhen care navigation line 1300 24 23 22 or talk to your child and family health nurse or your Doctor
Lifestyle Changes
Parenting brings big changes as adjust to your new normal, get to know your new baby and learn new skills.
Feeding
In the beginning you may feel like your baby is constantly feeding and that feeding takes a long time. Gradually you and your baby will get into a pattern and the amount of milk you produce will settle. Feeding your baby on demand is known as baby-led feeding. If you follow your baby’s lead they will let you know when they have had enough. You may wonder if your baby is getting enough milk and it may take some time for you to feel confident that they are getting what they need.
If your baby latches on and seems calm and relaxed during feeds, they appear content and satisfied after feeds, your breasts feel softer after feeds and your baby has periods of being alert and active and then sleepy and relaxed – your baby is probably getting enough milk. Most new babies will need around ten to twelve breastfeeds per day. From midway during the first week your baby will do yellow poos every day In the first couple of days your baby may have two to three wet nappies however by the end of the first week your baby will have at least six wet nappies each day.
Wet and dirty nappies are another sign your baby is getting enough milk. You can boost your own breast milk’ supply by offering both breasts at each feed and alternating which breast you offer first, feed your baby as often and for as long as they need. Avoid offering formula or a dummy until breastfeeding is well established. If you are concerned about your milk supply, and are wondering whether to offer additional milk speak with your midwife or child health nurse.
Benefits of breastfeeding
Breastmilk is designed specifically for babies. It is easily available, contains all the elements they require to meet their nutritional needs and can protect them from infections and diseases.
Sleeping
Babies vary tremendously in the amount and duration of their sleep – some sleep for long periods, other in short bursts. Your baby will have their own pattern of waking and sleeping, in the early weeks this may follow their pattern of activity during the late stages of pregnancy.
Most newborns are asleep more than they are awake however their daily sleep can vary from as little as ten to twelve hours, up to sixteen to eighteen hours. Babies will continue to wake during the night for much of their first year because they need regular feeds. Most babies do not need silence during sleep and it can be useful for them to become accustomed to routine household noises.
Babies are not born with a daily sleep cycle (or circadian rhythm), they sleep when they are tired. It takes around four months for their brain to develop the circadian rhythm, however exposing your baby to natural light in the morning and creating a darkened environment at night or sleep time is a useful pattern to indicate sleep time.
There are six evidence based safe sleeping recommendations; always place your baby on their back for sleep, keep your baby’s face and head uncovered during sleep, keep your baby smoke-free during and after birth, have a safe sleeping environment night and day, sleep your baby in your room for the first six month and breastfeed your baby if possible.
Changing a nappy
The purpose of a nappy is to catch the wee and poo your baby produces and to protect their skin. Babies have delicate skin so your baby may need ten to twelve changes in the early weeks, reducing to six to eight changes in older babies. The most important thing to consider is safety – ensuring your baby is not left unsupervised during nappy changes- you might be surprised at how early and how much they can move. Each parent may develop their own style and routine for a gentle nappy change that prevents redness, soreness or infection.
Resuming sexual activity
A woman’s sex drive is impacted by changing estrogen levels postpartum. For some women, a reduced sex drive can linger for up to 12 months. If a couple is not aware of this, there can be a disconnect between expectations of sexual activity and what is “normal” following the birth of a baby. Some women are fearful of resuming sexual activity following birth.
It is encouraged you speak with your health care provider if you are concerned about resuming sexual activity after you have had your medical clearance.
Key Highlight
Transitioning back to work after childbirth requires balancing new parental responsibilities, identity shifts, and schedules. Consider a gradual return, practice childcare routines, set realistic expectations with employers, and utilise support networks to manage challenges and adapt plans as needed.
Returning to work and normal activities
Transitioning back to work after childbirth and parental leave can be difficult. You are not just returning to work, you are negotiating your new responsibilities as a parent, your identity and how you now see yourself as well as managing new day-to-day schedule and the impact of lack of sleep. For many families this requires a huge psychological adjustment. Consider whether a gradual return or a full-time return to work is better for you and your family.
If you are using child care, try a few practice runs and work out how you are going to communicate with you child’s carers to make this transition less difficult for you and for your child. Discuss realistic expectations of what is possible with your employer and communicate this with your colleagues so they know what to expect.
Continue to use friend and family supports when you are at home to manage the tiredness and feelings that arise as you return to work. Be willing to re-negotiate and make changes to your plans if you or your child need that. Consider breastfeeding and expressing options in your workplace on return to work.
Coping with pregnancy loss
Pregnancy loss, particularly in the first 12 weeks of pregnancy, is common. Many women and men are surprised at the intensity of their feelings of loss and grief. Each women and man will have their own unique feelings following a pregnancy loss. It is important to seek professional support (both individually and as a couple), give yourself permission to grieve – alone, together and as part of a support group, and seek further support if your loss and grief becomes overwhelming or you think you may be experiencing depression or anxiety.
It is common to have fears about a future pregnancy loss. Speak with your health professional about future pregnancy planning – this will include considering when your body is ready physically and emotionally for another pregnancy and whether there needs to be any investigation into the reasons for the pregnancy loss.
The first menstrual cycle may occur as early as four to six weeks after a pregnancy loss so it is worthwhile considering contraception if you are not ready for a possible pregnancy at that time. If you would like to talk to someone about what support is available to you, you can call ForWhen care navigation line on 1300 24 23 22.
Seek Help & Support As Needed
This is a time of great change and many parents will need to develop new networks for information and support. lt is recommended to schedule a comprehensive postpartum visit with your GP within the first 6-8 weeks after delivery in-person or by phone.
Importance of support during the postpartum transition period
Transitioning to parenthood is an exciting and a curious time. Finding good support can help you in this transition as you learn about becoming a parent. Strong, effective support networks are a protective factor against postnatal depression. Social and emotional support reduces stressors and improves our emotional and physical wellbeing
Types of support including partners, family, and professionals
Supports can focus on emotional or physical support and be provided by in many forms, this includes; professional health care provider services, support groups, parenting and support lines, websites, apps telephone support or social media groups, family members, friends or volunteer or peer group supports. Many families find they use a range of services across the early postpartum period.
ForWhen is a free national helpline here to help navigate you to the right mental health support you need, at the right time. Call 1300 24 23 22 to speak to a qualified specialist who will listen to your needs and connect you to support
Frequently Asked Questions
See our most commonly asked questions we receive about postpartum care.
Birth is a major life and health experience, so recovery will take more than a few hours or days. While many women feel a sense of recovery after six to eight weeks, full recovery may take considerably longer. Your health prior to pregnancy, your experience of pregnancy and labour, as well as the expectations and supports you have postpartum, will influence your recovery. Recovery cannot be sped up – you and your body will have a unique timeframe during which you recover. There are a number of things you can do to help the recovery and healing process along, including eating regular, nutritious meals, drinking plenty of water, resuming gentle exercise (start slowly and gradually increase) and get plenty of sleep and rest.
Postpartum health checks are usually recommended six to eight weeks following delivery however if you are have any concerns about yourself or your baby, you can make an appointment with a health care professional at any time postpartum.
Postpartum depression and anxiety are common conditions in Australia affecting up to one in five women and one in ten men. Postnatal depression or anxiety can be debilitating and does not usually go away without help. If you think you have postnatal depression or anxiety, the best thing you can do is ask for help and speak with a healthcare professional. Women are more likely to experience anxiety or depression in the first year postpartum and there are specialised services particularly for this time in your life. Call the ForWhen helpline on 1300 24 23 22 to get connected to local support services.
During pregnancy your body experiences significant changes. Many of the symptoms are a result of changes in pelvic floor and abdominal muscles. The most effective and safe exercises you can do postpartum, are ones that help to rebuild those muscles. This includes Pelvic floor or Kegel exercises and gentle, low intensity abdominal exercises. It is recommended you delay beginning abdominal and pelvic muscles’ exercises until after your six to eight week medical check. then you may begin exercises like pelvic tilts, heel slides or balance exercises. If you have to strain or hold your breath to do an exercise, it is too intense and it may worsen symptoms or cause damage.
If you have any concerns, speak with your health professional – your doctor, your child health nurse or your community nurse. All states in Australia have parenting support lines and you can also call HealthDirect on 1800 022 222 for health concerns.
