The body after birth

Information à laquelle il faut porter une attention particulièreAfter you return home, see a doctor or your midwife right away or go to the emergency room if

  • You show signs of hemorrhaging
    • You soak one regular sanitary pad an hour for two consecutive hours
    • or You lose large blood clots (e.g., more than one egg-sized clot)
  • You have a fever—temperature of 38.0 °C (100.4 °F) or higher
  • You have severe abdominal pain not relieved by analgesics
  • You have difficulty breathing
  • You have a new pain in your leg with swelling
  • You have severe headaches, upper abdominal pain, or a sudden change in vision

Call 9-1-1 if you show signs of shock: agitation, weakness, paleness, cold and damp skin, sweating, confusion, palpitations.

Your body needs time to recover. Be patient—it’s normal. It will take several weeks to get to a good level of energy.

Back home, if you see signs that worry you, don’t hesitate to contact the CLSC nurse or Info-Santé (8-1-1). You can also consult your doctor or midwife.

The following section provide information about the body after childbirth and about post-delivery care for both vaginal and caesarean deliveries.

Contractions

You may feel uterine contractions, especially while you are breastfeeding. If this isn’t your first pregnancy, you may experience more contractions than during previous pregnancies. If you need relief from the pain, contact your health professional.

Blood loss

After giving birth vaginally or by caesarean section, it is normal to experience blood loss, known as lochia. For the first day or two, your blood loss will be heavier than during menstruation and will then diminish. If your bleeding increases instead of diminishing, consult your healthcare provider.

Occasionally you may pass a blood clot. This happens generally in the morning after urinating or breastfeeding. So long as the bleeding lessens after passage of the clot there is no need to worry. Be aware that unusual physical effort may cause redder and more abundant lochia. See the box to know when to see a health professional.

As the days go by, the colour and texture of the lost blood will change. It may be mixed with mucus (a whitish substance). The colour will gradually change from pink to brown, becoming paler, and it could turn yellow.

Lochia discharge usually last three to six weeks. During this time, use sanitary pads. Do not use tampons or a menstrual cup.

Hygiene

Hygiene is very important after giving birth. Here are a few helpful tips:

  • Change your sanitary pad at least every 4 hours.
  • Always wipe from front to back.
  • Wash your hands after using the toilet.
  • Wash yourself once a day or more, but do not use a vaginal douche.

If you had a vaginal birth, you can shower or take a bath in a clean tub at any time, but don’t use oil or bubble bath.

If you had a caesarean delivery, you can shower at any time. You can have a bath starting around five days after the procedure, as long as the incision is healing well.

Stitches

Don’t worry if you have stitches in your perineum: they will not tear when you have a bowel movement. After showering or bathing, gently dry the stitches before you get dressed.

If you had a caesarean delivery, it is important to dry the stitches on your belly thoroughly with a clean towel after taking a shower or bath. After seven days, you can remove any adhesive strips that have not come off by themselves. If you see any signs of possible infection (e.g., redness, discharge), see your healthcare provider.

Bowel movements

It is normal not to have a bowel movement in the first two to three days after vaginal delivery and three to five days after a caesarean.

However, if you still haven’t had a bowel movement after this period, you may be constipated. Constipation is common after both vaginal and caesarean deliveries.

These tips can help:

  • Gradually increase your intake of high fibre foods:
    • Whole grain foods
    • Vegetables and fruits (fresh, dried, frozen, or canned)
    • Legumes and nuts
  • Increase your daily water intake.
  • Go to the bathroom as soon as you feel the need.
  • Gradually resume low-intensity physical activity when you feel able to do so (see below Physical activity).

If these measures aren’t enough, ask a health professional whether a laxative might help.

Urine

After the delivery, you may feel a burning sensation when urinating. If you do, try spraying your vulva with warm water while you urinate.

It’s also normal in the first few days after delivery to have trouble retaining urine. Urine leakage may continue for a few weeks after you give birth. If this annoyance persists, mention it to your doctor during a follow-up visit.

The perineum and pelvic floor

Seen from the exterior, the perineum is the part of the body located between the vulva and the anus (see Female anatomy). Inside, the muscles of the perineum form a “hammock”—the pelvic floor. The muscles of the pelvic floor support your internal organs, including the uterus, bladder, and rectum. Among other things, the perineum helps prevent leakage of urine and feces.

During pregnancy and childbirth, the perineum adapts to facilitate the birth. After the baby is born, the pelvic floor muscles are stretched. It is also normal that the vulva looks different, e.g., the labia are more open.

After a vaginal birth, the perineum may remain sensitive for a while. In some cases, it may also be sensitive after a caesarean.

It can take several weeks or months before the pelvic floor muscles regain their muscle tone. Exercises such as Kegel exercises can help. It’s advisable to talk to your healthcare provider to find out when to start doing these exercises and how to do them properly.

If you have urine leakage, pain during sexual relations, or any other concerns, don’t hesitate to talk to your healthcare provider. If necessary, he or she can give you advice about specialized perineal rehabilitation resources (e.g., physiotherapists).

Fatigue

Information to comfort you and boost your confidenceAll new mothers need rest and a helping hand to recover from the demands of childbirth.

It’s normal to be tired after a vaginal or caesarean delivery. It takes a few weeks to get to a good level of energy. Be patient—your body needs time to recover.

Recovery speed and energy levels vary from day to day and from one woman to another depending on things like the baby’s demands, the mother’s quality of sleep, and the help she has available. Despite your newborn’s needs, try to take care of yourself. If possible, try to sleep when your baby does.

Don’t hesitate to ask for help when you need it.

Physical activity

Pregnancy and childbirth bring about major physical changes that can last for months after your baby is born.

Resuming physical activity little by little can help improve your energy level and physical fitness. It can also contribute to your psychological well-being.

When your pain is gone and you feel up to it, you can gradually resume low intensity activities such as walking. For example, you could start with one daily walk and gradually work up to a few short walks per day. You can increase their frequency and length bit by bit, depending on your energy and tolerance level.

Around four to six weeks after giving birth, you can gradually start increasing the intensity of your activities (e.g., take brisk walks). Choose activities you enjoy while paying attention to how your body has recovered since giving birth.

Information to comfort you and boost your confidenceListen to your body and its limits. They may not be the same as they were before your pregnancy.

It’s usually recommended that you wait until your perineum has regained its muscle tone (see above The perineum and pelvic floor) before you move on to high intensity or high impact exercise like running. This can take from a few weeks to several months after childbirth.

As for swimming, you can usually start again once your lochia discharge (see above Blood loss) becomes less abundant. It is advisable to talk to your healthcare provider before you resume swimming.

If you had any complications during your delivery, it may also be wise to check with your healthcare provider before you start exercising again.

Weight

Some of the weight gained during pregnancy is lost with the delivery of the baby and placenta and the release of amniotic fluid. In the six weeks that follow, the uterus returns to its normal size. Blood volume and swelling also decrease, leading to further loss of weight.

After that, your body will gradually use up the fat reserves it accumulated during pregnancy. The pace of weight loss can differ from one woman and one pregnancy to the next. Be patient! It takes time to shed the weight you gained over nine months.

With a balanced diet (see Eating well) and an active lifestyle (see above Physical activity), losing 1 to 2 kg (2 to 4 lb.) a month is reasonable.

Information to comfort you and boost your confidenceGive yourself time to accept these changes and don’t hesitate to talk about them with people you trust.

Going on a weight-loss diet is not recommended, especially if you breastfeed. A low-calorie diet can diminish your milk production and energy level.

Pregnancy transforms a woman’s body. Even if the weight gained can be lost within a few months, you may not get your pre-pregnancy silhouette back.

Hemorrhage: Heavy bleeding.

Perineum: The part of the body between the vagina and the anus.