Overview
After months of anticipation, meeting your baby for the first time will surely be one of the most memorable experiences of your life. In addition to the big adjustment of becoming a parent, you’ll also encounter a new set of physical and emotional symptoms that begin once your baby is born. These symptoms will be unlike any you’ve experienced before.
The most common symptom that women experience after birth is a discharge called “lochia.” This bloody discharge looks similar to a menstrual period and can last up to eight weeks after birth. Women also typically experience strong sensations of uterine cramping as the uterus shrinks back to the size it was before pregnancy.
Other symptoms will vary from person to person, depending on your method of delivery and whether or not you decide to breastfeed. Bleeding, discharge, breast swelling, and uterine pain are all part of what happens after delivering a baby. Many women feel unsure about what to expect and wonder what’s considered normal after delivery. Most women make a full recovery after childbirth. Nevertheless, there are some complications and less common symptoms you should be aware of.
Heading home after giving birth
The length of your stay at the hospital will depend on your birth experience. Some birthing centers allow women who experience natural childbirth to leave on the same day that they deliver. Most hospitals, however, require a stay of at least one night. Women who have cesarean births should expect to stay in the hospital for up to three nights, unless other complications are present.
While you’re at the hospital, you’ll have access to pediatricians, maternity care nurses, and lactation consultants. They will all have plenty of information and advice for you about the physical and emotional journey ahead. Try to use this opportunity to ask questions about postpartum body changes and breastfeeding. Hospitals with labor and delivery units have nurseries where your baby will be supervised and kept clean. Though it’s tempting to keep your baby by your side 24/7, use this resource to try to get a couple of hours of rest, if you can.
Many hospitals will require that you have a bowel movement before you’re able to leave the facility. You’ll be offered a stool softener after delivery to ease the pain of the first bowel movement after birth. If you show any signs of infection, such as a fever, you may have to stay at the facility until those symptoms resolve. Your midwife or delivery doctor may perform a brief exam before you leave, just to make sure that you’ve started the healing process.
If you opt for a home birth, your midwife will be the primary overseer of your care after delivery. Your midwife will examine you and your baby to make sure everyone is healthy before periodically checking in during the weeks after your delivery.
Your baby’s health
The first medical test that your baby will have at the hospital is called the APGAR test, and it takes place as soon as the baby is born. APGAR tests taken 5 to 10 minutes after birth are the most accurate. However, most physicians also regularly record the one-minute APGAR score. The APGAR score is based on five factors:
Appearance
Pulse
Grimace
Activity
Respiration
The maximum score is 10, and any score between 7 and 10 is considered normal. A low APGAR score could indicate that the baby may have been stressed during the end of the birth process.
While in the hospital, your baby’s hearing and eyesight will also be tested. Your baby will also be tested for their blood type. Some states have laws or recommendations that mandate babies receive certain vaccines or medications before they leave the hospital.
The rest of your baby’s experience in the hospital will depend on their birth weight and how they’re doing after birth. Some babies that aren’t considered full-term (born before 37 weeks) or are born with a low birth weight are kept for observation in a neonatal intensive care unit (NICU) to ensure that they can adjust to life after the womb.
Newborn jaundice, which involves a yellowing of the skin, is fairly common. Around 60 percent of newborn babies experience jaundice, according to the March of Dimes. Babies with jaundice will need to be treated in an incubator. In their first few weeks of life, they might also need to have formula as a dietary supplement to breastfeeding.
Before you leave the hospital, you’ll need to make an appointment with a pediatrician outside the hospital to weigh and examine the baby. This one-week appointment is standard practice.
Feeding your baby
The American Academy of Pediatrics recommends that children be breastfed exclusively through their first six months of life. Breastfeeding is an intensely physical experience for both mother and child. During your pregnancy, you may notice your areolae darkening and your nipples growing in size. Babies can’t see well when they’re first born, so this will help your baby find your breast and eat for the first time. The first milk that enters your breast is called “colostrum.” This milk is thin and has a cloudy color. The liquid contains valuable antibodies that will help establish your baby’s immune system.
Within the first four days of your baby’s life, the rest of your milk will “come in,” causing your breasts to swell. Sometimes milk ducts can become clogged, causing a painful condition called mastitis.
Continuing to feed your baby and massaging your breast with a hot compress can unclog the duct and reduce the risk of it becoming infected. Newborn babies tend to “cluster feed.” This means that at times it may feel that they’re eating almost constantly. You may choose to pump your breastmilk and feed it to your baby from a bottle or to feed your baby formula.
Not every woman is able to breastfeed. Some women have breast or nipple abnormalities that prevent adequate lactation or proper latching on. Sometimes certain chronic medical conditions prohibit breastfeeding. Many times, there are social factors such as jobs and family situations that prevent breastfeeding. Each mother needs to make what she feels to be the best decision for her infant and herself.
Feeding your baby from a bottle will require keeping a close eye on how much the baby eats and how often. If you’re unable to breastfeed, or if you choose to formula feed your baby for another reason, discuss this decision with your pediatrician. Make sure that you know how much and what kind of formula is best to use for your infant.
Postpartum diet
The La Leche League, an organization devoted to the promotion of breastfeeding, points out that the best diet for a breastfeeding mother is a diet that would be healthy for any human being. Fresh vegetables, a variety of grains, and low-fat proteins are the ideal staples in your diet as you recover from delivery. If you’re breastfeeding, you may find yourself feeling hungry often. This indicates that you need to consume extra calories to make up for the calories lost to making milk for your baby. Continue taking your prenatal vitamins while you breastfeed. Drinking plenty of water will increase your milk supply.
You should also continue to restrict the substances you limited or avoided during pregnancy, in particular:
alcohol
caffeine
fish that contains mercury, such as tuna and swordfish
While you don’t have to avoid alcohol or caffeine completely, the Mayo Clinic advises being mindful of the amount that you consume and the timing of your consumption. This will help keep your baby from being exposed to too much of these potentially harmful substances.
You may want to jump right into a dietary regimen that will restore your “pre-baby body.” But the most important thing you can do for the first few weeks after childbirth is to heal and restore the vitamins and minerals you may have lost during delivery.
Physical activities
During the healing process, make sure your body is ready to resume certain physical activities. If you had an episiotomy, vaginal tear, or cesarean delivery during birth, the time before you can resume certain activities may vary. Speak to your midwife or OB-GYN at your follow-up appointment about the following topics.
Exercise
The American Congress of Obstetricians and Gynecologists states that most women can resume exercise within a few days of giving birth. Moderate aerobic activity, such as jogging and swimming, can even decrease your chances of developing postpartum depression. But if you had any complications during delivery, speak to your medical practitioner and get cleared before you resume any exercise routine. Don’t pressure yourself to exercise before you feel like your body is ready.
Sex
Doctors generally advise women to wait at least six weeks after a vaginal birth, and eight weeks after a cesarean birth, before having sexual intercourse. Hormone changes during pregnancy and the act of giving birth itself might make sex uncomfortable at first. You should also be aware that immediately following childbirth and before your menstrual cycle resumes, you’re especially likely to get pregnant again. Make sure you’ve chosen a method of birth control before having sex with a partner of the male sex.
Mental health after baby
One symptom of postpartum life that many women may not anticipate is mood swings. Hormones from giving birth and breastfeeding can combine with the exhaustion and responsibility of parenting to make for a difficult psychological experience. While the “baby blues” and clinical postpartum depression share many symptoms, they’re not the same thing.
It’s normal to feel tearful, emotionally fragile, and tired during the first few weeks after your baby is born. Eventually, you really will begin to feel like yourself again.
If you begin to have suicidal thoughts or thoughts of harming your new baby, you may be suffering from postpartum depression (PPD). Anxiety that keeps you awake or makes your heart race, or overwhelming feelings of guilt or worthlessness, could also indicate that you need to seek help. Give yourself permission to reach out to others. Around one in seven women experience postpartum depression, according to the American Psychological Association. You are not alone.
Rarely, postpartum depression can accompany a condition called postpartum psychosis. This is an emergency situation and is characterized by delusions and paranoia. If you feel at any time like you’re experiencing symptoms of postpartum depression or postpartum psychosis, you should ask for help.
Outlook
By the time you’re ready for your post-birth exam six to eight weeks after delivery, you may start to feel more like yourself physically. But if at any time after leaving the hospital your bleeding becomes heavier, you experience a fever over 100.4°F (15°C), or you see a pus-like discharge coming from one of your incisions, you should contact your doctor.