What to expect during Postpartum Recovery
So what’s in store for your vagina after birth? The condition of your no-longer-very-private parts postdelivery depends a lot on your particular birth experience—so if you pushed for three hours or tore while birthing an 11-pound baby, you’re going to have a tougher postpartum recovery than if you pushed for 30 minutes and your perineum stayed intact. But regardless of how your your labor and delivery went, “the postpartum period can be pretty rough,” Jaime Knopman, MD, an ob-gyn in New York City and co-founder of Truly-MD.com, says. “Pain, bleeding and no sleep are not the best combo. Even if you didn’t tear, you still pushed, and something pretty big came out of your vagina (a baby!), so simple things like sitting and urinating can be sort of a big deal.” Here’s what you can generally expect during your postpartum recovery.
Bleeding and discharge
You’ll have vaginal discharge, called lochia, for up to six weeks after delivery. It’s normal to spot a heavy flow of bright red blood in the beginning as your body works to get rid of the blood and tissue that was inside the uterus. Postpartum bleeding can be compared to a heavy period, Susan Bliss, MD, an ob-gyn at Carolinas Medical Center in Charlotte, North Carolina, says, which is why super-absorbent maxi pads (yes, like the kind you wore in junior high) will become your new best friend. Let your doctor know if you’re soaking through more than a pad an hour or passing blood clots bigger than the size of a plum tomato.
The discharge will gradually taper off and can vary in color, from red, pink, brown, yellow, white to even green. You might detect an odor, but it shouldn’t be foul-smelling, says William Schweizer, MD, OB medical director for the department of obstetrics and gynecology at NYU Langone Medical Center in New York City. Call your doctor if you pick up a pungent scent or come down with a fever, as these may be signs of an infection.
Soreness and swelling
General soreness and swelling around the vagina after birth are a standard part of postpartum recovery—after all, “the area saw a huge increase in blood flow and fluid,” Knopman explains, and childbirth is pretty rough on your vaginal tissue. Tears can also lead to greater blood flow and swelling. Discomfort usually lessens within four to six weeks, Knopman says, although that timeline can be longer if you experienced severe tearing. Stitches from vaginal tearing or an episiotomy can be sore at first and then a little itchy, and they usually dissolve within 7 to 10 days.
Trouble going to the bathroom
It’s not uncommon to have constipation or trouble urinating shortly after giving birth. The tissue around your bladder and urethra may be swollen or bruised, which can make peeing difficult for the next few weeks. And if you received pain-relieving narcotics (like an epidural) in the hospital, they could slow down your bowel movements, Schweizer says. Constipation can also be caused by iron supplements prescribed to get your blood count up to normal, he adds, or if you’re not drinking enough fluids while breastfeeding and become dehydrated. It’ll pass (pun intended), but in the meantime be sure to drink plenty of water and eat high-fiber foods, and let your doctor know if you haven’t had a bowel movement in two to three days.
Trouble making it to the bathroom
On the flip side, many women struggle with urinary incontinence during their postpartum recovery. Childbirth can compress the pelvic nerves and weaken the pelvic floor muscles, which help control the bladder. Plus, “the pressure from the uterus can change the angle of the urethra and cause loss of urine,” Knopman explains. So as embarrassing as it may seem, a little leakage when you cough, sneeze, laugh or lift heavy objects isn’t out of the ordinary. As your body heals, urinary incontinence should resolve itself, usually by the six-week mark.
Even if you managed to avoid hemorrhoids during pregnancy, the strain of pushing during delivery may lead to a swollen vein in or around the anus. Hemorrhoids can be itchy and painful but should shrink within six weeks after birth (although they may never completely go away).
Thought those contractions were behind you? Not quite—you may experience small contractions, called afterpains, for several days after delivery, particularly when you breastfeed (nursing releases a natural chemical that causes your uterus to tighten). Don’t let that freak you out. “This is a good thing,” Bliss says; what you’re feeling is your uterus shrinking back to its normal size and shape. Incredibly, your uterus weighs about 2.5 pounds right after birth, but just six weeks later it’ll weigh a mere 2 ounces.
Postpartum Recovery Tips
1. Stock up on hospital handouts
You’ll definitely want to cop some freebies from your postpartum recovery room before checking out of the hospital. “Get as many of the hospital pads as possible,” Bumpie Princessn6 urges. “They’re better than anything you can get in the store.” Consider stocking up on the hospital’s mesh panties too. (Don’t be shy—ask your nurse for extras.) No, they’re not sexy, but when you’re bleeding for weeks on end, disposable panties rock. And don’t forget your peri bottle (a squirt bottle for rinsing): It’ll keep you feeling clean and help ease any stinging sensation you experience around your stitches when you pee.
2. Put swelling on iceYour vagina after birth will likely suffer some swelling, but applying ice to the region is an easy, effective way to get relief in the first 24 hours after birth, Dr. Schweizer says. And moms agree: “The nurses at the hospital brought me newborn diapers that they had packed with ice. It helped a lot!” Bumpie Kat28655 says.
3. Soak your bottomAfter those first 24 hours, ice ceases to be the best way to reduce swelling, Schweizer says. Instead, he recommends making a sitz bath part of your postpartum care routine: Just fill the tub with a few inches of tepid water and hang out there for about 20 minutes, three to four times a day. “It decreases swelling, cleans the area so there’s less risk of infection and generally soothes discomfort,” he says. Sitz baths are also a great remedy for painful, itchy hemorrhoids.
4. Witch hazel it upAnother way to find sweet relief from uncomfortable hemorrhoids? Witch hazel, an herbal remedy with tannins and oils that can help reduce inflammation. “I’ve been rolling up those witch hazel pads and sticking them between my [butt] cheeks,” Bumpie Taprehoda says. “It gives me hours of relief.” You can also line your pad with them for maximum coverage.
5. Don't be scared to poopSince blood is diverted from your digestive system during labor, it can take a couple of days for you to get back into a normal rhythm. But when your body is ready, don’t hold back: Yes, your first postpartum bowel movement might hurt a bit, but not as much as you might think. “Like I tell my 4-year-old if you hold it in, it just gets bigger,” Bliss says. If you need a little help to get things going, try eating prunes, doing some gentle yoga stretches and taking laxatives. “Mamas, take the stool softener that the hospital offers!” Bumpie jwoods6056 urges.
6. Do your Kegels
Struggling with bladder control postbaby? Doing Kegel exercises can help strengthen your pelvic floor muscles. “This helps maintain urinary continence and function of your anal sphincter,” Bliss says. Bonus—Kegels can also increase vaginal muscle tone to enhance sexual pleasure.
7. Invest in some lube
No, your vagina after birth will never be exactly the same as before. (There. We said it.) Sex is on the horizon, though—good sex, even. Still, it’ll take some time for things to feel “normal” again after delivering baby. When you’re ready for sex after baby—and you’ve held off for the recommended six weeks—go for it. Just don’t forget lubrication! You’re low on estrogen after delivery (and while you’re breastfeeding), causing a thinning of your vaginal mucosa, which can lead to dryness. All this can make sex a little less than comfortable, but investing in some lube can be a lifesaver.