What to expect when healing from birth

by Brood

 

Healing from birth looks different for every parent, but there are common experiences many share in the postpartum period, also known as the fourth trimester. This period, encompassing the first 12 weeks post-birth, is a critical time for recovery and adjustment. As doulas and caregivers, we see all too often that people don’t take the time needed to properly rest and heal after birth. Whether it’s due to our productivity culture, having other children already, pressures to be mobile and out in the world too early—whatever the reason, and whether you can control them or not, if you don’t spend the time to heal and take care of yourself in these first 40+ days, it will only take longer to heal from birth.

Here we breakdown some of the most common things you can expect, and hope you can give yourself as much grace and patience as possible. These are tender times in your new life as a parent, and tuning into your body and mind (and asking for help!), will go a long way to ensuring you’re set up for the long run. It’s not a sprint, as they say!

MOVEMENT:

Difficulty walking in the first week is common, as you feel the effects of labor and birth. Your body will feel sore and exhausted even without the specified birth healing that is taking place. If you gave birth vaginally, your vulva and perineum will be inflamed and swollen. Any repairs you had done will be extra sensitive; padsicles, sitz baths, and donut pillows will be your companions for this. 

POSTPARTUM BELLY:

As your body adjusts to not having a baby inside of it, remember that it took 9+ months to get to this point – and the adjustment tends to be slow moving, meaning you may still look pregnant for a few weeks after giving birth. Your abdominal muscles and connective tissue were stretched for so long, and gradually your muscles will regain their memory and strength. Healing from birth usually takes around 6 weeks, but healing from pregnancy is more like nine to 18+ months. Remember, your body is pregnancy healing, not birth healing. Folks who were pregnant with multiples, or who experienced significant body changes, will experience this over a longer period of time as their muscles and connective tissue stretched even further. Wraps for your abdomen can feel supportive, especially for c-section parents. These can help your organs settle back to place, give your core some support, and help with any back and hip pain you may be experiencing.

YOUR FIRST POOP:

Your first bowel movement(s) after birth can be daunting, triggering, and potentially painful. It may be a part of your hospital release protocol. Be sure to not strain, no matter if you gave birth surgically or vaginally, as this can negatively impact your healing. Your pelvic floor muscles are very fragile after both pregnancy and birth, so use any support you can get, like medical stool softeners, supplements such as magnesium supplements, and/or laxative food sources such as prunes, fiber-rich foods, and plenty of water. It can be helpful to use a warm cloth compressing against your vulva for your first few bowel movements to offer counter pressure on places that are still healing, while also allowing you to pass your stool. Hemorrhoids provide an additional layer of intensity – witch hazel padsicles can provide temporary relief, be sure to focus on frequent and loose stools, daily magnesium can be supportive for this.

WATER RETENTION:

Water retention will occur if you had IV fluids in your labor, an epidural or pitocin – even if you have an unmedicated labor but had IV fluids you will feel the effects of water retention. For most, it lets itself be known through leg and/or foot swelling and intense chest engorgement (before, and as your milk is coming in). Lymphatic drainage via massage, for your chest and legs should be done throughout the day, while you drink plenty of fluids and get some slight movement in (like walking to the kitchen and back, and elevating your legs).

LOCHIA (BLEED):

Lochia, or postpartum bleeding, is caused by the placental separation (afterbirth) and the ensuing healing. This tends to last for around 6 weeks. Regardless of how you give birth, you will bleed, as it is caused by your placenta detaching, not the type of birth you had. The flow is linked to how much you push your body: if you do too much walking/cleaning/doing, it will pick up, which is your cue to rein it in and rest more. From when your placenta is birthed  until your milk comes in (usually anywhere from three to five days), your estrogen is at its lowest it will ever be until menopause. This can affect your mind, body, relationships, and ability to show up in the world. 

UTERINE CONTRACTIONS:

Your uterus is back to pre-pregnancy size in around 9 – 11 days. Your body needs much healing, time and care to allow this incredible feat. A side effect of this shrinking is experiencing uterine contractions, these are triggered by the release of oxytocin (seeing your baby, nursing/pumping, having an orgasm, etc). These cramps should subside as your uterus shrinks back, and your lochia begins to peter out.

LEAKING:


Sweat, blood, milk and tears – postpartum is a time of leaking! Hormonal fluctuations cause intense sweating (usually at night, you may wake to a wet bed), and will fade as your hormones slowly regulate within the first few weeks. In the meantime, make sure you have extra sheets and a good mattress protector. Your chest will be leaking milk, also soaking your clothes and sheets, as your milk comes in and you become engorged. Even folks who don’t plan on using the milk their bodies make go through this experience, called lactogenesis, before being able to wean.

BONUS ROUND:

Baby pee/poop and spit-ups. Blow-out diapers, pee everywhere and spitting-up happens to everyone. Don’t wear your best clothes in the first few weeks postpartum as you get used to this!

C-SECTIONS:

For gestational parents who had a surgical birth, there are extra considerations for healing, as a general abdominal surgery is a large feat for your body and psyche to undergo. When moving around, be sure to use your hands for sitting up, so as not to use your core/body as much; this will be supportive of fundamental healing. Be sure to not lift anything heavier than your newborn, and even then be sure to not hold your newborn for too long unassisted. Before doing any physio/movement/healing work on your body or scar, wait until you are no longer taking any pain medications. It’s a good idea to wait until around six weeks postpartum before introducing rigorous, regular and outside healing care. For the first four to six weeks, your main goal for your incision should be to keep it clean and dry. You can use your hairdryer (on the cool setting) to make sure it’s totally dry after showers/baths. 

Keep up with Tylenol and Advil to reduce inflammation and allow you more range of motion. Make sure to prioritize rest, and limit activity.

Scar desensitization is key for healing, and you can begin taking steps for this yourself, with additional support later on. When your scar is completely healed (no scabbing) and no longer bandaged, around four to six weeks postpartum, you can start using soft fabrics (tissue, silk, flannel, cotton ball) to gently glide over your abdomen and incision. This will help bring awareness back to the site, and bring in different stimuli. Once you can do this comfortably, you can move to using a washcloth, denim or linen. Then, you can begin touching your scar by patting and tapping it. When you can tolerate sustained touch you can begin scar massage.

VULVA CHANGES:

As your body underwent birth, it’s very common for birthers to feel fear, anticipation and nervousness around the physical differences of their vulva – as pregnancy and birth will have undoubtedly altered it. It can be normal for scar tissue to be present in your vulva, as you may have gotten stitches, a tear or an episiotomy. In the first few weeks and months of postpartum healing, your vulva will be altered in ways that will not last forever (inflammation, fresh scars, discoloration and so on all fade). In the first week, you may feel swelling and pain. And by the second week, as inflammation goes down, you may begin to itch as your perineum heals further. You may also  be experiencing incontinence due to pelvic floor weakness, and core instability. This is expected after pregnancy and labor, but should these symptoms persist after six weeks postpartum, you will want to seek guidance from your care provider and pelvic floor physiotherapist. 

Trust yourself in knowing if it’s not feeling or looking “normal” to you. If this is the case, feel free to call your care provider, get your midwife to take a look at your next home visit, or request a follow up with your obstetrician. Your perineum and vulva look very different post-birth due to swelling, meaning repairs can be missed or done poorly. Your other option is also to get a pelvic floor physio or bodyworker to work through healing the scar tissue together, finding out what touch works for you and what is normal, or a variation of that.

There are so many variables in healing and recovery and just know that if you take the time to rest and heal, you’ll set yourself for so much success later on. Many of these physical and emotional changes may take more time than we think to improve, just know that’s normal and that your body has done a LOT of work to get here. You’re doing great.

 

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