Your body after the birth

How will I feel as soon as my baby's born?

Giving birth is an amazing achievement, and every mum responds in her own way. You may feel alert and happy - physically, mentally, and emotionally satisfied. Or you may feel bruised and battered, exhausted, disappointed and even depressed. You may be in pain if you've had a tear or cut (episiotomy). You may experience any of these feelings and emotions, or none of them.

However you feel, remember that you are recovering from a huge physical upheaval. If you had a caesarean, you will have had major abdominal surgery. Be kind to yourself and your body, and allow yourself time to get your strength back. With plenty of rest and support, you should recover quickly.

What changes in my body will I notice?

Your body has spent months nurturing and growing your baby. All the changes that helped to bring your baby into the world are now abruptly reversed.

You will have a bloody discharge from your vagina called lochia. This will be the case whether you've had a vaginal or a caesarean birth.

At first, the lochia is red, then it becomes pink, then brownish and, finally, yellowish white. For about 10 days it will be like a heavy period, and it can continue for up to six weeks in dribs and drabs. The more you rest, the lighter the lochia will be.

All the while, your uterus (womb) is shrinking back to its normal size and position. You may have afterpains as it contracts down. Afterpains feel rather like mild labour contractions.

They often happen while you are breastfeeding. This is because the hormone oxytocin, which encourages your uterus to contract, is released while you're feeding. It also can cause redder or heavier blood loss.

Your vagina will gradually regain much of its former tone. And your pelvic floor, although stretched, will return to near its usual position. You can help speed up this process by doing regular pelvic floor exercises as soon as possible after your baby's birth (Lee and Thomas 2009, Guy's & St Thomas's 2006).

If you feel bruised and battered, don't worry, you will feel better. Grazes and small tears to your vagina and the area between your vagina and back passage (perineum) heal quite quickly. An episiotomy may take longer to heal. And stitches may be painful for a few days or even weeks (Andrews et al 2008, Macarthur and Macarthur 2004).

Doing your pelvic floor exercises may help to reduce swelling and speed up healing around your perineum. If you're at all worried about how you are healing, ask your midwife for advice.

After birth your breasts will be soft, as they only contain a little colostrum. This is the rich, creamy first milk full of antibodies that help to protect your baby from infection. After a few days your breasts will begin to make milk. This is often called your milk ‘coming in’, and your breasts may feel hot, swollen and tender.

At first, your nipples may feel very sensitive, and the first 10 to 20 seconds of each feed may be uncomfortable. This usually begins to ease off after about the fifth day. If it doesn't, you may need some help with latching your baby on to your breast. Talk to your midwife or a breastfeeding counsellor.

Your tummy may be flabby and wrinkly, and your waistline will still be non-existent. You won't have lost all the weight you gained in pregnancy yet. You can start gently exercising your tummy muscles as soon as you feel up to it. Starting these exercises soon after your baby's birth will help you to get back into shape and lower your chances of developing back pain (DH 2009a, Lee and Thomas 2009).

You may have a few issues that take a little longer to fade:

• You may have piles, but they should gradually disappear.
• You may be left with stretchmarks on your breasts, tummy and thighs, especially if you gained a lot of weight quickly during pregnancy. These fade to silver lines in a couple of months.
• Your ankles may be swollen for a few days following the birth, as your body starts to move and lose the extra fluid you retained.
• Some of your hair may start falling out. During pregnancy, your hair became thicker and more luxuriant, because hormones prevented normal hair loss. Once those hormones drop, you may start to lose the hair that you held onto during pregnancy. Don't worry, your hair will return to what it was.
• If you have had a caesarean birth, you're bound to be sore. You'll find it uncomfortable to move much at first. However, it's a good idea to get mobile as soon as possible, to speed your recovery.

The good news is that as the level of the hormone progesterone in your body drops, the tone of smooth muscle throughout your body improves.

How long will it take to lose weight?

In the first few days after you give birth, you will lose weight quickly as you shed fluid. The extra water you carried during late pregnancy is passed out in your urine and sweat. You will lose more weight as the amount of circulating blood returns to normal levels and your uterus gets smaller. But after this the weight loss tends to slow down.

Don't be disappointed if your body doesn't snap back to its pre-pregnancy shape as soon as you've had your baby. Unfortunately, this just doesn't happen. Your body has been through the major process of pregnancy and labour, and will need time to recover. Extra fat may linger, as nature intends this to be a store of energy for breastfeeding.

Try not to let it get you down. Don't forget, it took you nine months of pregnancy to get to where you are. So it's only fair to allow your body the same amount of time to recover its shape. Healthy eating, particularly if it's combined with exercise, can help you shed the weight (Amorim et al 2007). In time, you should be able to get your fitness back!

How will I feel in few months' time?

You should have a postnatal check-up with your midwife or doctor about six to eight weeks after you've had your baby. Your midwife or doctor will talk to you about how you are feeling in mind and body, and will make sure you're recovering well (DH 2009a, NICE 2006). If you have any problems, such as soreness from stitches, or discomfort during sex, don't suffer in silence. Ask for help.

With a bit of attention to your posture and some gentle exercise, stretched tummy muscles should regain their tone. It's a good idea to keep doing exercises to strengthen your tummy muscles for at least three months after you've given birth (Lee and Thomas 2009).

It's recommended you exclusively breastfeed your baby for at least six months and give your baby some breastmilk for at least a year or two, to give her the best start in life. Once you stop breastfeeding, your breasts will return to almost their pre-pregnancy shape and size. However, larger breasts may not be as self-supporting as they were before and smaller breasts may not be as perky. It's pregnancy changes, rather than breastfeeding, that make this happen.

If you choose not to breastfeed, the levels of the milk production hormone, prolactin, will fall. Your breasts will stop making milk and will, over several months, go more or less back to their pre-pregnancy size.

Your body will have changed after pregnancy and childbirth and may have matured into a more womanly shape. Be proud of your body. It's done a wonderful job of bringing your baby into the world.