Postpartum

THE FIRST SIX WEEKS

The postpartum period deserves just as much preparation as delivery. Recovery looks different for everyone, and having support in place can make a big difference. Use the planning outline below to think through your support system and recovery needs.

Postpartum Planning Worksheet

Postpartum Service

Physical Recovery

Bleeding: Postpartum bleeding (lochia) changes from bright red to pink/brown, then light yellow-white over several weeks. Passing small clots can be normal. Call if you pass a clot larger than a tennis ball or have heavy bleeding.

Cramping: After-birth cramping is normal and helps the uterus return to its normal size. It may be stronger during breastfeeding and typically improves within a few days. Warm compresses and ibuprofen can help.

Breasts: Breast engorgement is common when milk comes in.

If breastfeeding: feed frequently for relief
Not breastfeeding: use a supportive bra and ice packs, and avoid stimulation

Swelling: Swelling in the hands, feet, and legs is common after delivery. It will gradually go away as your body gets rid of excess fluid. As this happens, you may be urinating and sweating more than usual. Please call our office if the swelling is in the face, associated with persistent headaches unrelieved by Tylenol or ibuprofen, or if the swelling in the legs is associated with pain, particularly behind the knee.

Constipation: One of the great miseries of life is constipation. You don’t appreciate the simple pleasure of a good bowel movement until you can’t have one. Many people fear the first bowel movement. If, however, you try not to poop, you will find you get constipated, and that will be uncomfortable whether you have stitches or not! We recommend using stool softeners until regular bowel movements are reestablished. You can use colace or Miralax. Once your bowel movements are normal, wean yourself off. If you have constipation that requires more than a stool softener, try milk of magnesia. If you have not had a bowel movement within two days of going home, call us for guidance.

Vaginal tears or episiotomy: Many women tear naturally when delivering, and occasionally, we have to make a small incision to help the baby delivery. These are repaired with dissolvable stitches. They will dissolve over 3-6 weeks. To care for these, try using cold packs immediately, then dry heat, sitz baths, or a spray bottle. A stiz bath is a clear, comfortable hot bath that can be done 2-3 times a day for 15 minutes at a time. Afterward, dry completely by blotting with a towel or blow drying. Periwash is a spray bottle used to rinse after using the restroom for the first week. Pat or blow dry after.

Hemorrhoids: They are no fun but are common. Try Preparation H, Tucks pads, dry heat and sitz baths for comfort.

Hair loss: Thinning hair is normal postpartum, often occurring months after delivery. It usually takes a year for hair growth patterns to correct themselves.

Intimacy: We encourage you to wait to have intercourse until we have seen you back in the office. Most women are physically healed enough for sex after 6 weeks. Many women who breastfeed struggle with vaginal dryness so we recommend having a lubricant available.

Bladder function: Many women will have trouble controlling their urine after delivery. This is from pressure to the bladder and the nerves to the bladder during labor. Doing Kegel exercises (link) and emptying your bladder before it becomes overfull helps.

Emotional Health

Mood changes are common after delivery. Postpartum blues may include tearfulness, irritability, or anxiety in the first 1–2 weeks and usually resolve on their own. Postpartum depression can occur anytime within the first year and may include persistent sadness, overwhelm, difficulty bonding, or changes in sleep or appetite. If you’re struggling emotionally, please call us. You are not alone, and support is available.

Call us if you experience: