After You Give Birth: What’s Normal and What’s Not

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Woman holding baby
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You’ve just had a front-row seat to a minor miracle: giving birth. While many women say that having a baby is the most amazing experience of their life, it’s also one of the most physically traumatic. Your body will inevitably take some time to heal after a vaginal delivery. But what exactly should you expect? Here’s what’s totally normal—and what should send you back to your Ob/Gyn.

Bleeding

It’s perfectly normal to have heavy bleeding and vaginal discharge (called lochia) after delivery. Lochia often has a foul odor, like some menstrual discharge. It starts off as dark red. Small blood clots, up to the size of a plum, are normal.

After day three, lochia should become lighter in color and consistency. Within two weeks, it should transition to a yellowish color. Within four to six weeks, it should stop entirely.

While you have lochia, wear only pads, not tampons. Nothing should go in your vagina for six weeks after delivery.

If your discharge continues to be heavy after three days—and you still are changing pads several times an hour—check in with your doctor. You should also see your doctor if your bleeding slows down but then increases again.

Cramping

Your uterus, normally about the size of a pear, vastly expands during pregnancy. It’s common to feel cramps as your uterus heals and returns to its normal size, usually over six weeks. Cramps (called after-pains) are a sign that your uterus is working to stop the bleeding from where the placenta was attached.

The cramps can be intense, especially if you’re breastfeeding. Some can feel as strong as contractions during labor. But they should subside in five minutes or less.

When they’re bad, try placing a heating pad on your abdomen or sitting in a warm bath.

If you’re having a lot of pain that persists rather than coming and going quickly, see your Ob/Gyn.

Tears

It is not uncommon to have torn skin or vaginal tissue after delivery. Sometimes it happens naturally. Sometimes your doctor will make a cut (an episiotomy) to help your baby pass through your vagina easier. These cuts usually heal with no problem. If you have stitches, they will dissolve on their own.

In the meantime, clean your sensitive parts gently after using the toilet. Your hospital may have given you a squirt bottle for this very reason. Squirt warm water between your vagina and rectum, from front to back. Then pat yourself dry with toilet paper. Don’t rub.

If your tears are uncomfortable, try sitting in a warm bath. Soak in a few inches of plain water up to four times a day. Don’t use bubble bath or other bath additives.

Keeping torn tissue clean will help it feel better and help prevent infection.

See your doctor if you think you may have an infection. Symptoms include:

  • Fever
  • Discharge with a bad odor
  • Increasing pain

Urine or Bowel Leaks

Childbirth stretches your pelvic muscles. That can cause you to temporarily lose control of your bladder or bowels. This is common and should improve within a few weeks.

Your doctor may recommend you try Kegel exercises to strengthen your muscles and stop the embarrassing leaks. However, Kegels may not help prevent leaking gas or bowel movements. If Kegel exercises cause pain, talk to your doctor before starting an exercise routine.

If bowel or bladder leaking hasn’t gone away by your first postpartum check-up, mention it to your doctor.

Constipation

You may not have regular bowel movements immediately after childbirth. You may feel backed up for a few days. If constipation isn’t going away on its own, ask your doctor for help. Your doctor may recommend:

  • Stool softeners
  • Eating more fruits, vegetables, and whole grains
  • Drinking at least 10-12 glasses of fluid per day

If you have concerns about your healing, reach out to your obstetrician who may offer advice or provide a referral to a urogynecologist. If you feel something isn’t right, you deserve to get help.

Dr. Propst is a women’s health subspecialist at Cleveland Clinic. She is board-certified in obstetrics and gynecology, and in female pelvic medicine and reconstruction.

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Article Sources

  • Physical Changes after Child Birth https://my.clevelandclinic.org/health/articles/9682-pregnancy-physical-changes-after-delivery