What to expect after the birth

Having a baby changes you both inside and out. Your clothing size, body shape, and even your shoe size might change! Not to mention what goes on inside as your body returns to its pre-pregnancy state. As you start to adjust to your new life with your baby, it’s vital to know about the changes your body is still going through. How you feel after birth, and how quickly you recover, depends partly on what your pregnancy and delivery was like. Here are some things most people can expect after they give birth.

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

Giving birth is a huge achievement, and every new parent responds in their own way. You may feel alert and happy. Or you may feel bruised and battered, exhausted, disappointed, and even depressed. There are huge hormonal changes going on that can trigger all kinds of feelings. You may be bedridden after a c-section or in pain if you've had a tear or cut (episiotomy).

No matter what you feel, try to remind yourself that you are recovering from a huge physical upheaval. If you had a caesarean, you will have had major 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 (SOGC nd(a)).

What changes in my body will I notice?

Your body has spent months 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 after birth, 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 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 (Region of Peel nd). The more you rest, the lighter your postpartum bleeding 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 can range from quite mild to feeling like labour contractions (Region of Peel nd).

They often happen while you are breastfeeding. This is because the hormone oxytocin, which gets your uterus to contract, is released while you're feeding (Walter et al 2021). It also can cause redder or heavier blood loss.

Your vagina will slowly 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 (MCoT nd).

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 quickly. An episiotomy may take longer to heal. And stitches may be painful for a few days or even weeks (Andrews et al 2008).

Doing your pelvic floor exercises may help to reduce swelling and speed up healing around your perineum, as well as helping you regain bladder control. If you're at all worried about how you are healing, ask your doctor or 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 referred to as your ‘milk coming in’ (LLLC 2022), 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 health care provider or a lactation consultant for support.

Your tummy may be soft and wrinkly, and your waistline will still be non-existent. You won't have lost all the weight you gained in pregnancy yet, although simply delivering your baby and the afterbirth will give you a head start. You can start gently exercising your tummy muscles as soon as you feel up to it.

Other changes to your body after pregnancy

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

• You may have hemorrhoids, but they should gradually disappear.
• You may be left with stretch marks on your breasts, tummy and thighs, especially if you gained a lot of weight quickly during pregnancy.
• Your ankles may be swollen for a week or so, 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 off, you may start to lose the hair that you held onto during pregnancy. Don't worry, your hair will return to what it was (AADA nd).
• If you have had a caesarean birth, you're bound to be sore. You'll find it hard to move much at first. But it's a good idea to get mobile as soon as you can, to speed your recovery.

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 (Vance 2009: 135). 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 expect your body to snap back to its pre-pregnancy shape as soon as you've had your baby. This just doesn't happen. Your body has been through the major process of pregnancy and labour, and will need time..

Try not to let it get you down. Don't forget, it took you around nine months to get to where you are. So, it's only fair to allow your body at least the same amount of time to recover its shape. Healthy eating, combined with exercise if you can, will help you shed the weight (Amorim et al 2013). In time, you should be able to get to a place where you’re more comfy in your own skin.

How will I feel in few months' time?

You'll be offered a few postnatal check-ups with your doctor or midwife in the days and weeks after you've had your baby. They will talk to you about how you are feeling in mind and body, and will make sure you're healing well (SOGC nd(b)). If you have any problems, such as soreness from stitches or when going to the bathroom, or discomfort during sex, don't suffer in silence. Ask your healthcare provider for help.

With 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 breastfeed your baby for at least six months (PHAC 2022), to give them the best start in life. Once you stop breastfeeding, your breasts will return to almost their previous shape and size. Except that 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 a few 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 softer shape. Be proud of your body. It brought your baby into the world.