The uterus is the largest muscle in the female body at full capacity. Following birth, the uterus has to contract and clamp down to return to a non-pregnant state. Directly following birthing your baby the uterus contracts significantly and encourages the release and birth of the placenta. Once effectively emptied the uterine fibres contract further and over the course of the next 7-10 days, your uterus will return to a clenched fist sized muscle. During your postnatal visits, your midwife will ask if she can touch your tummy and feel where the uterus is and check that it is indeed returning back to where it sat pre-pregnancy.
Post birth you will have vaginal blood loss. This occurs no matter how you birthed your baby as it comes from the area where your placenta has been released from, which is now open and starting to heal. It will last for around 4 - 6 weeks. At first, directly after the placenta is born, there is likely to be a heavy loss. If you are concerned by how much is coming out do ask for the midwife’s advice. As the weeks continue you will notice the loss diminishes and starts to change from heavy red to pale pink and then nothing.
Caesarean sections now account for approximately a quarter of all births in the UK. Whatever the reason may have been, the recovery period needs to be honored as your body has been through significant abdominal surgery. We appreciate that this is easier said than done when you also have a newborn to care for. Just consider for a moment how you would nurture and care for your body if you had been through ANY other form of operation? It is so important to be gentle with yourself and accept as much support as possible in the days and weeks that follow. As your muscles knit back together and your wound heals be very careful about the weight of items that you carry. As a guide we generally suggest you hold nothing heavier than your baby. Remember, even if you have not birthed vaginally, you still need to be very mindful of your pelvic floor and perineum, as you will not initially have the core strength to support them fully.
Following your birth, a combination of hormonal changes, extra blood and fluid can cause swelling and this is called oedema. IV fluids are also a significant cause of postpartum swelling. Most women who experience a C-section receive medications and anaesthesia through IV and those who give birth vaginally may receive medications and certain fluids. These extra fluids tend to accumulate in your body and take several days to leave. You will find you feel the need to wee frequently as your body attempts to get rid of the excess.
When you think about your pelvic floor, it is useful to think of it being a muscular hammock that runs from the front of your pelvis right across to your tail bone. However you have birthed, your pelvic floor will need some TLC in the postnatal period as it regains the tone that has been strained during your pregnancy by the weight of your growing baby.
The perineum is the area between the vagina and the anus. It is common to experience a tear or grazing in this area during birth, especially if this is your first vaginal delivery. Whether you need stitches or not, you are likely to feel tender, swollen and bruised initially after birth. Your perineal area will be checked by your midwife or doctor following birth and they will advise as to whether you will need stitches. You may have had a little cut to your perineum to help make some extra room for baby to birth. If so you will have had stitches and you will be advised to take pain relief to keep you as comfortable as possible. If you have experienced a more advanced tear you may also be taking a course of antibiotics to help avoid an infection occurring and laxatives to stop you becoming constipated.
If you are experiencing a sore and itchy bottom, little hanging lumps around the anus or bleeding when have a bowel movement it is likely that you are suffering with hemorrhoids (piles). These swollen veins can be found around the anus or lower rectum can be inside or outside the anus.
Many women notice changes happen in their breasts prior to birthing. The breast tissue may become fuller, the areola and nipple may appear darker and it is possible that you have been expressing small amounts of milk during the last few weeks of pregnancy. Following birth, with a baby that is encouraged to breast feed and with the added postnatal surge of the hormones oxytocin and prolactin you will find that your breasts will produce colostrum in the first few days after birth and then around day three to five following birth you will notice your breast feeling fuller, heavier and maybe even start to drip a lighter and more watery milk.
Our hormones are incredible before, during and following birth. They create the perfect environment for conception, support our baby as they grow and our bodies as we change shape to accommodate a growing baby. They also play the key ingredient in triggering and supporting labour and birth and they then adapt to make our bodies into milk machines. However, they can leave us feeling very emotionally wobbly. High as a kite one minute, feeling completely loved up and euphoric, then tumbling down with a crash to a tearful postnatal heap. Add the joy of severe night sweats and leaking breasts and you may find you don’t quite know what to do with yourself. FEAR NOT! This is absolutely normal and your hormone system will balance out and re-settle during the postnatal period.
We have always had an expectation that physical changes will occur during the postnatal period, but what about what your mind experiences as you pivot into motherhood. It is hardly surprising that you may feel anxious, low, high or indifferent as you navigate through this huge period of change and your mind needs to be nurtured just as much as the rest of your physical postnatal body.