An OBGYN Answers 18 Questions to Help You Prepare for Postpartum
With so much to do when preparing to have and bring home a new baby, expecting moms sometimes feel blindsided by their postpartum experience. Understanding the common physical and emotional transitions a body goes through once baby arrives can help lessen the shock of normal, but challenging, shifts in the body. Dr. Shelby Green, OBGYN, UnityPoint Health, answers some popular postpartum questions and what to expect following childbirth.
1. How Long Does Postpartum Last?
Six weeks after baby is a common milestone for women to get a check-up from their doctor, but the postpartum recovery period is much longer.
“The six-week postpartum mark signifies how long it takes the uterus to shrink back to pre-pregnancy size. Physiologically, it takes the body about a year to fully recover from giving birth,” Dr. Green says.
“Any complication during delivery, and whether you delivered vaginally or by C-section, needs to be factored into your recovery timeline. Chronic, pre-existing conditions like hypertension, diabetes or kidney issues can prolong the postpartum recovery process, too,” Dr. Green says.
With so many new shifts in the body, she also encourages women to contact their doctor with any concerns.
“No one should suffer in silence. We’re more than happy to support you through a phone call or bring you in for a visit. The earlier your doctor knows what you’re experiencing, the earlier we can help.”
2. How Long Does Postpartum Swelling Last?
Vaginal soreness and swelling are normal after giving birth and, unfortunately, hard to avoid (especially with a vaginal delivery).
“Fluid shifts happen right after delivery. You lose water weight quickly and some of that may come from the vulvar area. Once you start urinating, the fluid and swelling get better, but it can take a few days to weeks,” Dr. Green says.
Factors like how long you push, baby’s size, the degree of tear or laceration you might experience and whether you had an assisted delivery with a vacuum or forceps contribute to increased swelling and soreness.
“There’s a range of what level of swelling and soreness after giving birth is normal. If you’re concerned, the best thing to do is ask a nurse to check your bottom while you’re still in the hospital.”
3. How Do You Get Rid of Postpartum Swelling?
Dr. Green suggests the following self-care tips to ease any vaginal pain from soreness and swelling:
- Soak your bottom in warm water 15-20 minutes, several times a day.
- Place an ice pack along a menstrual pad in your underwear 10-20 minutes a day, several times a day.
- Go for small walks each day to help increase blood flow to the area and reduce swelling.
- Gently clean your vagina and bottom after bowel movements by pouring warm water over the area.
- Take Tylenol or ibuprofen to help lessen discomfort.
4. How Long Does Postpartum Vaginal Bleeding Last?
Vaginal bleeding occurs after a vaginal delivery or C-section. It gets better days after delivery and usually resolves within four to five weeks.
“Postpartum vaginal bleeding is called lochia. It’s just normal blood and tissue passing as the uterus shrinks. It starts off bright red and shifts in color, becoming darker brown and eventually pink or white,” Dr. Green says.
Lochia can have a foul odor, and while the smell isn’t great, it’s normal.
5. When Should You Worry about Postpartum Bleeding?
If you’re filling a menstrual pad in an hour or two and continue to do so for multiple hours, that’s too much bleeding. Similarly, if you’re passing blood clots larger than the size of a golf ball, it’s a good idea to check in with your doctor.
“Most postpartum blood clots are very normal. When you’re lying on your back, blood can pool in the vagina. As soon as you stand up, a clot might pass. Nurses are very good about watching for them when you’re in the hospital and making sure you’re safe,” Dr. Green says.
6. How Do You Stop Postpartum Bleeding?
The best way to stop postpartum bleeding is to let it run its course. If you’re breastfeeding, that may help the bleeding slow down or stop sooner.
If you’re still bleeding at your six-week postpartum check-up — tell your doctor. They may order blood work or do an ultrasound to rule out certain health conditions.
7. How Do You Relieve Sore Breasts During Postpartum?
Sore breasts start to happen about three to five days after delivery. An influx of milk comes around then, and breast engorgement can happen. Engorged breasts feel firm, swollen and tender. Dr. Green recommends the following:
- Lay cold cabbage leaves against the breast to help with swelling
- Gently massage breasts between feedings to relieve pressure
- Use gentle heat against the breast before feedings to help with milk production
- Take ibuprofen or Tylenol for pain management (it’s considered safe during breastfeeding)
- Avoid stimulating the breast or wearing bras that are too snug.
If you’re feeding a baby breast milk, sore breasts can sometimes indicate a clogged milk duct or a latch issue. Emptying your breasts regularly is also important to keep engorgement at bay. Skipping feedings or pumping sessions could potentially lead to not only clogged ducts, but mastitis, which is a painful breast infection that requires antibiotics.
If you’re experiencing pain with little relief – despite trying the above at-home remedies – schedule an appointment with your doctor.
8. How Long Do Postpartum Hemorrhoids Last?
Hemorrhoids and painful bowel movements are another unpleasant but common part of the postpartum period. It’s nothing to be embarrassed about — just something to be prepared for, as many women experience both.
“Constipation is more common during pregnancy and after giving birth due to the excess progestin hormone women produce during their pregnancy. So, it’s normal for women to develop hemorrhoids for the first time ever during pregnancy and postpartum from straining during bowel movements,” Dr. Green says.
9. How Do You Heal Postpartum Hemorrhoids and Painful Bowel Movements?
Your first bowel movement after giving birth can be especially uncomfortable, but there are things you can do to help. Dr. Green suggests these tried-and-true ways to make postpartum bowel movements easier:
- Drinking a lot of water
- Eating more fiber
- Taking an over-the-counter stool softener, like Senna or MiraLAX
- Placing your bottom in warm water
- Applying Preparation H to your bottom
“If we can prevent constipation and straining, then we can prevent hemorrhoids. But sometimes they develop after pushing during labor, especially if it was long,” she says.
10. How to Recover from Postpartum Urinary and Fecal Incontinence?
There are two kinds of incontinence women can experience after giving birth — urinary and fecal. This is when urine or stool involuntarily escapes, although urinary incontinence tends to be more common.
Incontinence happens for a few reasons. “The first is caused by the pressure of a fetus positioned on the pelvic floor for many months. The second is from the excess pressure and trauma that impacts the pelvic floor during birth,” Dr. Green says.
You might experience some urine leaking after activities like walking and running or even coughing and sneezing, because of the pressure placed on weak pelvic floor muscles.
11. How Long Does Urinary Incontinence Last After Giving Birth?
Urinary incontinence can last from weeks to months after a vaginal delivery or C-section. It’s more common if you’ve delivered a large baby, multiple babies or had an assisted delivery. If you’re having symptoms after 12 weeks, try Kegel exercises to help strengthen the pelvic floor muscles.
“Wait a few months before you start Kegel exercises. Beginning them too soon can cause more harm than good. We really want everything to heal first, especially if you have a laceration from your delivery. If you’re experiencing incontinence, bring it up with your doctor at your six-week check-up,” Dr. Green says.
Your doctor can refer you to a pelvic floor therapist who specializes in helping women with both urinary and fecal incontinence.
Dr. Green says not to feel embarrassed talking to your doctor about incontinence issues.
“It’s quite common and resolves with time. The exam room is a safe space for bringing up any postpartum issues you need support with or feel like they’re lasting longer than they should.”
12. How Long Does Postpartum Hair Loss Last?
Postpartum hair loss has to do with an immediate drop in hormones. It can happen right after your baby is born to several months later. It’s more prominent in women who breastfeed.
While there’s not much you can do to avoid shedding some postpartum strands, taking your prenatal vitamin, staying hydrated and trying a hair, skin and nail vitamin with biotin are prevention methods Dr. Green recommends.
13. How Long Do Postpartum Night Sweats Last?
Postpartum night sweats come in hot the first few weeks after giving birth. If you breastfeed, you might have them longer, because the ovaries are suppressed from releasing normal amounts of estrogen.
Dr. Green says night sweats are something women usually have to wait out, but cool sheets and staying hydrated can make you more comfortable until they go away.
14. What Causes Postpartum Preeclampsia?
Postpartum preeclampsia is rare. It happens when your blood pressure is too high, and there’s excess protein in your urine. Most cases happen within one to two weeks after giving birth.
“It’s more concerning than simple blood pressure issues and tends to happen more in women who have chronic or pregnancy-induced high blood pressure. We see symptoms like headaches that don't go away, blurry vision or vision changes, abdominal pain or shortness of breath in severe cases,” Dr. Green says.
If you notice any of these symptoms, always call your doctor.
15. What are the Signs of Postpartum Depression?
Mood changes are common in pregnancy and after giving birth. Your body goes through hormonal fluctuations that can trigger feelings of anxiety and depression. In fact, around one in seven women suffer from postpartum depression. While lack of sleep and caring for your newborn around the clock can intensify feelings, women who’ve previously struggled with their mental health are more likely to experience postpartum anxiety and depression.
Before baby arrives, Dr. Green encourages women to round up a support system. Ask friends and family you’re comfortable being vulnerable with to check in on you. If possible, lean on that support system to give you breaks from taking care of baby.
“If you can, it’s a good idea to get outside and work in some gentle exercise once you’re healed. It can help relieve stress, promote better sleep and be a mood booster,” she says.
If you do find yourself struggling with anxiety and depression after baby, the most important thing you can do is tell someone.
“Whether it’s a partner or trusted friend or family member—don’t try to go through it alone. You can always talk to your doctor about it, too. It won’t last forever, and it’s treatable. And if you do end up needing life-long treatment, that’s OK, too. The important thing is you’re getting the support you need,” Dr. Green adds.
16. What is Postpartum Psychosis?
Postpartum psychosis (PPP) is considered a mental health emergency. It’s rare and typically occurs within the first few weeks after giving birth.
“If you’re hallucinating, hearing voices, feeling confused or paranoid, or don’t feel safe taking care of your baby, tell your doctor right away. PPP is treatable. but dangerous for both mom and baby,” Dr. Green says.
17. What Clothes Should You Wear Postpartum?
Comfort is key when it comes to clothing during your postpartum period. Dr. Green recommends adding the following items to your wardrobe:
- Leggings, particularly those that extend higher on the abdomen to avoid any irritation on an incision site from a C-section
- Loose fitting pajamas
- Nursing bras if you choose to breastfeed
- Full coverage underwear or mesh panties from the hospital
- Belly band for extra support after a C-section