There’s a lot of pressure after having a baby to “snap back”, especially if you have a vaginal birth rather than a c-section. Celebrities often seem to be back on their feet quickly, with tennis player Naomi Osaka headed back to practice at 2 weeks postpartum being a recent example. And maybe she was ready! I certainly have never been in professional athlete shape.
But the reality is that even she is not back at peak form immediately, because healing takes time. Pregnancy is completely transformative, and happens over the course of nine months, so no one’s body truly snaps back by two weeks postpartum.
Learning more about the work that your body needs to do in order to recover can set you up for better health long-term. This is especially important for Black women, given that our health is more vulnerable during pregnancy, birth and postpartum. And the more of us that take this time, the more our culture and society may shift to seeing it as normal.
Your Placenta and Your Uterus’ Healing
While you’re growing your baby, your placenta grows too. It filters whatever you eat and drink, and through the connected umbilical cord, allows you to feed your baby. Soon after your baby is born, your placenta will detach from the uterus, and you’ll “give birth” to it as well.
The placenta is an organ with lots of blood vessels, about the size of a dinner plate. So when it detaches from the uterine wall, your uterus has to heal, and this is the source of postpartum bleeding, called lochia.
I find that once we understand that there’s a large internal wound, it’s easier to understand the value of taking it easy. It can take up to 6 weeks for your postpartum bleeding to come to an end.
Here’s what to expect:
- Your heaviest bleeding normally happens in the first few days
- The initial blood should be bright red, and if you’re in the hospital it will be monitored closely in the first hour after birth
- Over time, you should notice your bleeding lessen, and the colors will change- maroon or brown blood is older, then you’ll notice pink and maybe yellow creamy discharge
If your bleeding becomes heavier and bright red again at any point, it may be a sign that you’ve recently become more active, and you should consider slowing down.
If you ever soak a pad per hour (or more) or pass blood clots the size of a golf ball, you should seek medical care quickly. This is a warning sign that you may be bleeding too much.
Your Hormonal Shifts
The delivery of the placenta is also a sign to your body that you need different hormones than during pregnancy. Your estrogen and progesterone levels were high during your pregnancy (and allowed you to stay pregnant and grow your baby). These hormones will drop significantly, and as a result lots of postpartum women experience:
- Mood swings
- Changes in temperature
- Night sweats and changes in body odor
Whether you plan to breastfeed or not, your body will produce oxytocin and prolactin in preparation to make milk. This may lead to breast tenderness and leaking.
Listen to this episode of Musings of a Black Doula for more information about healing after vaginal birth.
Tearing After Vaginal Birth
Many pregnant women are concerned about tearing after a vaginal birth, and make birth plans to do their best to prevent it. First or second degree tears are common, and typically heal well with a little bit of attention. For worse tears, you will absolutely need to follow your doctor’s recommendations and give yourself more time. At home remedies include:
- Taking sitz baths with warm water (you can add Epsom salt, but this is optional)
- Using padsicles to help with swelling (this is a pad soaked with water and/or witch hazel and frozen)
- Using a peri bottle to dilute urine
- Staying hydrated and getting lots of fiber so that bowel movements do not require straining
- If you’re having a lot of soreness in your vulva, you can sit on a pillow (putting a pillow under just one butt cheek can be especially helpful).
Seeking the care of a pelvic floor therapist is especially helpful after a vaginal birth. Having a baby should absolutely not mean a lifetime of “tinkling” when you laugh or sneeze.
Rest is Key to Recovery
It can be hard to take the time you need to heal if you’re used to being a go-getter. And of course, newborns demand attention and care. But prioritizing rest will go a long way towards healing. Make sure that you:
- Take the time you are able to off of work
- Ask for the help of friends and family (or a postpartum doula) with household chores and responsibilities
- Eat nourishing foods and hydrate
- Instead of to-do lists, praise yourself for things you got done. Keeping a baby alive and taking a shower count!
Red Flags: When to Seek Medical Attention After Vaginal Birth
You should absolutely get medical attention if you experience the following after a vaginal birth:
- Heavy bleeding that soaks more than a pad per hour or has clots the size of a golf ball
- A fever of 100.4 or higher
- Foul odor in vaginal discharge
- Chest pain
- Headache that won’t go away
- Dizziness or feeling faint
You can call the nurse advice line that your OB or midwife may have, or call back to labor and delivery.
When we consider that having a baby is a huge transition, not just in your lifestyle, but physically, it makes sense that six weeks is the bare minimum time for healing. While you’ll see your medical provider for the last time regarding this pregnancy at 6 weeks, your healing is ongoing.
Be gentle with yourself if you’re not back up to pre-pregnancy strength and speed. That just means you’re a normal person who just had a baby.
Want help creating a postpartum plan? Click Here.
