Looking after your body after having a baby

Every person will have a unique recovery after having a baby. The type of labour and birth you had will influence how you adjust and how your body recovers in the postpartum period.

In general, it takes about 6 weeks for your body to recover after giving birth. If there were pregnancy or birth complications, recovery may take longer.

Vaginal Bleeding

You may experience vaginal bleeding after having a baby, which may at first be heavy. After the first few days, this often becomes a pinkish-brown colour. The flow will get lighter and can last up to 6 weeks.

You may prefer to use pads rather than tampons and it's important to change your pads regularly. It's also a good idea to observe the colour, volume and smell of your blood loss.

Contact your pregnancy care provider or GP straight away if:

• your bleeding becomes heavier
• your discharge becomes a brighter red colour
• you are passing clots
• the bleeding is smelly

Uterine cramps

Uterine cramps, are also called 'after birth' pains and can cause pain in your lower abdomen (tummy). This is more common for second or subsequent births. It is caused by the release of a hormone called oxytocin and may be more noticeable when your baby breastfeeds.

You can take simple pain relief medicines such as paracetamol or ibuprofen and use warm packs on your tummy to help ease discomfort.

Vaginal pain or discomfort

If you have had a vaginal birth, you may be sore for a few days. You may be especially sore if you have stitches due to a tear or episiotomy.

In the first few days after birth, putting an ice pack on the area can help to reduce pain and swelling. Simple pain relief medicines may also help.

To bathe the area, use warm water and pat it dry softly. In the first few days, remember to sit down gently and lie down whenever possible.

It's a good idea to keep an eye on your perineum (skin between your vagina and bottom), particularly if you have had stitches. If you're not sure if the area is healing well, call your pregnancy care provider or GP.

Caesarean section

If you have had a caesarean section (C-section), it may take a little longer for you to heal. It's likely that your doctor may give you a prescription for stronger pain medicines.

It's best not to drive or lift anything heavier than your baby for the first 6 weeks. This may mean you will need to ask for extra support from family and friends.

Usually, your caesarean cut will have dissolvable stitches, but not always. Follow the advice from your care provider. Unless your doctor or midwife says otherwise, it is generally fine to bathe the area in warm water and gently pat dry.

It is common for your scar to be tender for a few weeks. But if the area becomes more painful, inflamed (red) or oozing, or if the stitches look like they are coming apart, call your pregnancy care provider or GP.

Backache

Your posture may have changed as a result of your heavy uterus stretching your abdominal muscles during pregnancy. It will take some time for you to return to a normal posture.

You can protect your back by lifting and bending safely.

Longer term, strengthening your core muscles will help to support your back. See your doctor or a women's health physiotherapist for more advice.

Abdominal muscle separation

It's normal for your stomach muscles to weaken and separate during pregnancy. This is known as abdominal separation or 'diastasis recti'. It is common for your muscles to stay separated after having your baby.

Here are some things you can do to help your abdominal muscles recover in the first weeks:

• Avoid lifting anything heavier than your baby.
• Roll onto your side when getting out of bed or sitting up.
• Do gentle exercises that strengthen the deeper stomach muscles (don't do sit-ups.)
• Wear a supportive brace or compression underwear.

If your muscle separation is not improving, see your doctor or a women's health physiotherapist.

Breast discomfort

It's common to have heavy, full breasts, especially a few days after birth when your milk comes in. You can also expect some nipple tenderness if you're breastfeeding, but pain or bleeding and cracked nipples is a sign that your baby may not be attaching well to the breast.

Breastfeeding is a skill you can learn, and it can take time to get it right. If you have trouble breastfeeding or if breastfeeding is uncomfortable, speak to your midwife or a lactation consultant to get support.

Many people find that cold compresses on their breasts can help before and after a breastfeed, particularly if your breast becomes engorged.

If you choose to formula feed or need to stop breastfeeding suddenly, you may find that your breasts become full and feel uncomfortable. The best thing to do is to wear a supportive bra and only express what you need to for comfort. Your milk supply will gradually decrease. Using cold packs and taking paracetamol can also help to relieve pain.

Breasts leaking

You may find that your breasts leak milk at times, especially as the breasts become fuller. You may choose to wear absorbent breast pads in your bra.

You may also notice that your breasts leak during sex. If this makes you or your partner feel uncomfortable you can try feeding your baby or expressing before having sex to decrease the amount of milk in your breasts.

Sexual health

There is no rule on when you can start having sex again, it really comes down to personal preference.

Fatigue, lack of sleep, mood and lack of time are common reasons people avoid sex after birth.

The general advice is to wait for vaginal bleeding to settle and for any stitches to dissolve. These usually happen about l 4 to 6 weeks after having your baby and this time will allow your body time to heal.

It is important to feel secure and comfortable about having sex again post birth. Regular and honest communication is important between you and your partner. Remember, body changes and breastfeeding hormones can affect your sex drive.

Hormonal changes may mean that your vagina isn't as lubricated as usual. Here are some tips to help manage this:

• Understand it can take up to 3 months to improve, but may take longer if you are breastfeeding.
• Use lubricant and take it slow in the meantime.
• If sex is painful, see your doctor.

The return of your period after birth is different for everyone. Even if you are exclusively breastfeeding, you can start ovulating and fall pregnant. Tips to avoid becoming pregnant:

• It's important to make sure you have contraception before you start having sex again.
• Talk to your doctor about contraceptive options.
• Together with your care provider, you can choose the best option for you, considering your general health and if you are breastfeeding.

Urinary discomfort and leakage

Urine can sting or burn if it touches a sore perineum. Tips to help avoid this feeling include:

• stay well-hydrated
• lean forward when using the toilet

You may leak some urine when you laugh or cough; this is called stress incontinence. To help with this:

• understand that it may take time to regain full muscle control after pregnancy and birth.
• start doing pelvic floor exercises when you feel comfortable to strengthen these muscles.

If you are still leaking urine after 3 months, it's important to speak to your doctor or a women's health physiotherapist.

Constipation

Constipation is quite common after giving birth, but there are simple things you can do to soften your bowel motions:

• Increase your fibre and water intake.
• Walk each day.

If this doesn't help, speak to your doctor or pharmacist about gentle laxatives that may help.

Haemorrhoids

Haemorrhoids are common, especially during the third trimester or after giving birth.

It's very important to avoid straining when you go to the toilet to prevent and support recovery of haemorrhoids.

A warm bath can sooth the area.

Ask your doctor or pharmacist for a cream to help reduce the discomfort and support healing.

Pain medicine can also help with the pain of haemorrhoids.

Baby blues

Don't be surprised if you're easily brought to tears or your mood changes suddenly. This may be because of changes in your hormones. Crying is common in the first few weeks after birth, and your mood changes are sometimes known as the 'baby blues'. Usually, the baby blues will pass within 2 weeks.

If you're still feeling overwhelmed, anxious or depressed after 2 weeks it may be a sign of postnatal depression. If this is the case, it's important to seek help early. Speak to your GP or call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse.

Once you go home from hospital, it's important to try and rest when you can. It may take some time before you are ready to take on your usual activities at home. Focus on getting to know your new baby and letting your body rest.

It takes time to recover from pregnancy, labour and childbirth. It's important you don't expect yourself to just 'bounce' back. Be patient as your body heals and you adjust to your new life with a baby.

Looking after your physical health

Take care of your physical health. Avoid skipping meals and prioritise yourself and your baby. Simple care tips include:

• Try to rest and sleep when your baby sleeps.
• Eat healthy, nourishing food.
• Drink plenty of water.
• Go for a gentle walk each day or do some other low-impact exercise.

Looking after your emotional health

Your emotional health is as important as your physical health.

It can take some time to adjust to parenting. Sometimes it is hard to admit that you are struggling. Help is available from a range of support people, for example:

• your partner
• other family members or friends
• a child health nurse
• a midwife
• your doctor

Many people experience disappointment or trauma relating to their baby's birth — help is available through your GP or pregnancy care provider.

Make some time for yourself when you can, by doing something you like and that gives some space for your emotional wellbeing.

Ask for help

Accept all reasonable offers of support from family and friends, including help with:

• housework
• meal preparation
• caring for your baby

It's a good idea to ask your partner or support person to bathe and change your baby — it gives you a break and helps the baby get to know both parents or other carers.

Everyone is different, but many people find their body never quite returns to its pre-pregnancy state. You may have stretch marks and changes in weight after birth.

Your breasts will also change. In the first few weeks they will get bigger and your nipples will be darker. Hormonal influences during pregnancy will have prepared your breasts for breastfeeding. Even if you are bottle feeding, expect your breasts to produce some milk in the first few days after your baby's birth.

The general recommendation is to have a postnatal check 6 weeks after giving birth, but you don't have to wait 6 weeks. See your doctor earlier if you have any concerns about yourself or your baby.

It's important to see your doctor straight away if you experience:

• fever
• heavier or smelly vaginal bleeding
• problems with your stitches or scar
• pain or a lump in your breast
• pain in your leg
• difficulty passing or holding in your urine
• low mood or difficulty coping

At your routine postnatal check, your doctor or midwife can check your tummy and your perineum, or your scar if you had a caesarean. They may also order blood tests, depending on your circumstances.

They will also ask how you're feeling, if you're having any problems feeding and how you're adjusting after having your baby. It's important to share how you are really feeling and any discomfort or pain you may be experiencing. In many cases, addressing things early can help resolve the issue.

At this check-up, your care provider will also discuss contraceptive options with you. If you choose hormone-based contraception, they will arrange a prescription. They may also examine your baby or refer you to a paediatrician.

The SA Women's and Children's Hospital has physiotherapy advice for after the birth of your baby.

The NSW Government has information on caring for yourself and your baby after birth.

Visit the Lactation Consultants of Australia and New Zealand to get support for a positive breastfeeding experience.

There are several organisations that you can talk to for advice and support after having a baby:

• Birth Trauma Australia
• ForWhen — Perinatal Depression & Anxiety Helpline — 1300 24 23 22
• PANDA for depression, anxiety and other mental health difficulties — 1300 726 306
• National Continence Helpline — 1800 33 00 66
• COPE — Emotional health for new parents

Looking for information for Aboriginal and/or Torres Strait Islander people?

Read more about postnatal physiotherapy information for Aboriginal women from King Edward Memorial Hospital.