Pregnancy changes your body – and often by a lot. But those changes don’t stop once your baby is born. Once bubs arrives, there’s a lot going on; from breastfeeding to healing, it can sometimes be uncomfortable or just plain unexpected. So, what postpartum changes happen in those first few weeks? Let’s have a look.
Week one is when hormones go wild, and your body starts to adjust to sustaining a baby on the outside rather than inside. Something that may come as a surprise to some is that your belly won’t magically spring back into the shape it was before you were pregnant as soon as baby is born – whether you delivered your baby vaginally or via a caesarean section, it takes time for your uterus to shrink back down, and your muscles and skin to follow suit. It’s not uncommon to continue looking pregnant for a wee while after your baby has been delivered. Lochia, the bleeding that occurs after delivery, is usually very heavy in those first few days and can last a number of weeks. It’s good to remember that you’ll need specialised maternity pads to deal with the flow from lochia at first – don’t use tampons or menstrual cups until you’ve been given the all-clear to do so (this might be sometime around your six-week check). This is because the risk of infection from tampons and menstrual cups in those weeks after birth is much higher, so it is recommended to wait until you’re fully healed before moving back to using these (if they are your preference).
After a vaginal birth, you may also find your perineum is in some discomfort or pain – this is incredibly common due to bruising, tearing, or episiotomy cuts and stitches. You can help deal with this in a few ways. Rest as much as possible and take the chance to lie down to keep your perineum (somewhat) elevated to help reduce swelling. It may also help to cool the area – Haakaa’s Reusable Cooling Perineum Compression Pads are a fantastic way to do this. Just pop the pads in the fridge or freezer, then clip them onto your underwear as you would a pad. They even come with sleeves to provide a barrier between the compression pad and your skin (always vital), as well as some non-woven fabric covers to keep things hygienic while they’re being chilled. Just don’t keep them on any longer than needed, and don’t use them without the cotton sleeve, especially if using frozen, as this can cause ice burns.
You’ll begin to notice changes in your breasts, and this is true whether or not you’ve chosen to breastfeed. A couple of days after your baby is born, your breasts will feel a little heavier than usual and probably a little fuller, as well, as they gear up for milk production. It’s also around this time you might get struck by the ‘baby blues’ – also known as ‘postpartum blues’ – a time when your rapidly fluctuating hormones, along with the (rather expected) levels of tiredness and generally feeling overwhelmed, converge to leave a lot of mums feeling tearful around the day three mark. For this reason, you may have also heard it referred to as the ‘day three blues’. This is completely normal and is something that many mums experience – anywhere up to 80%, in fact! However, this time of feeling down and overwhelmed should resolve within a few days. If you find symptoms sticking around longer, speak to your maternity carer, as this may be a sign of postnatal depression beginning to set in.
Once breastfeeding starts, you’ll find your breasts undergoing a whole raft of changes. It’s not uncommon in those first days to develop nipple tenderness – for most, a nipple cream should help. Haakaa’s Nipple Cream is 100% ultra-pure medical-grade lanolin, is made right here in New Zealand, and doesn’t need to be washed off before breastfeeding. Just use it as required to help heal minor damage to your nipples. If this tenderness doesn’t resolve, or if it gets worse (for example, if your nipples become cracked or start bleeding), consulting your midwife or a lactation consultant is highly recommended, as they will be able to determine the cause of the pain or damage and give you advice on how to rectify any issues.
Things start to become quite interconnected, with some aspects and behaviours feeding back into how the rest of your body responds. Remember when we were discussing your uterus returning to its pre-pregnancy size and lochia? How long each of these things last can also be related to whether you breastfeed or not. It’s not unusual to get much stronger tummy cramps while breastfeeding, as this stimulates the release of the hormone oxytocin. This hormone causes the muscles of your uterus to contract, which is what pulls it back to its former size. These uterine contractions can be pretty intense, so it’s good to be aware of them beforehand! Because of these increased contractions, breastfeeding tends to shorten the time lochia occurs compared to bottle feeding, which is also something it’s good to know about, so it won’t come as too much of a surprise. You may also find that when you feed baby, the contractions that occur end up pushing out more blood, so depending on how heavy your bleeding is, you may want to put on a fresh maternity pad before a feed.
There’s a great deal more that happens, of course – this is just the barest scratching of the surface. Your lead maternity carer (LMC), be that midwife, obstetrician or nurse, can fill you in on a lot more details and explain any unexpected changes to you as they occur. Being open with your LMC about what you’re noticing as you go through this immediate postpartum period will help you deal with anything unexpected.