Overview
Congratulations! You had a baby! But now what? There are endless resources about each stage of pregnancy and baby’s development, but when it comes to postpartum, things get harder to navigate. Many new moms feel left in the dark after the baby arrives, and it can be challenging to figure out how to take care of not only a new baby but yourself. Many question what’s normal and what’s not. Many are eager to get back to pre-pregnancy activity while others may be dealing with birth related injuries.
Our postpartum guides aim to go beyond providing information about how to help your recovery postpartum by also simplifying the process. In these first two weeks, we’ll start with the basics. If you read on, you’ll learn ways to take care of yourself and your body to build a foundation for this phase.
Please keep in mind that everyone’s pregnancy, childbirth, and postpartum journeys vary greatly. You may even have experiences that vary greatly from one child to the next. While we try to be as specific as possible, it’s important to remember that it is OK if you’re not perfectly aligned with the timeline. We’ll point out areas that could be of concern and when it may be beneficial or even necessary to reach out to a pelvic PT or your provider.*
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Core
Your whole body, mind, and soul likely just endured a lot over the last 9 months or so. Your core in particular had a big job during pregnancy and is likely taking some time to come back “online.” During pregnancy, the core muscles stretch and separate, and this is normal. Even though it’s normal, it can create some challenges after baby. Since the muscles were stretched, they’re not working optimally, so there isn’t as much support for your back, hips, or pelvis.
Common complaints after baby arrives due to core weakness:
- Pain: in the low back and sometimes even in your abs, but core weakness can also contribute to neck, upper back, and even shoulder and pelvic pain due to changes in posture on top of the physical demands of caring for a newborn
- Activities that may be painful or difficult: getting in and out of bed or on and off the floor, lifting, carrying, sitting for long periods to feed baby
- Muscle separation or diastasis rectus abdominis: While this will continue to improve with time, some women may notice a separation or gap in their belly muscles after baby. This is normal, so don’t be alarmed. However, if you don’t notice any improvement by 3 months or you continue to have issues such as back, pelvic, or abdominal pain, you may need targeted exercises to correct it.
- Feeling “mushy” or even swollen after baby arrives: Your belly and core were stretched to their limits while baby was growing. After baby arrives, you may notice your abdomen feels more squishy or mushy than it used to. This is also a normal feeling to have and should improve as your muscles continue to regain strength postpartum. It is possible to feel swollen especially if you had a c-section or received a lot of fluids during labor and delivery.
If you are wondering what core exercises you can do during this phase of recovery, click here to jump to the exercises section.
Pelvic Floor
Your pelvic floor just went through a lot! To be honest, your pelvic floor is probably sore, fatigued, and not working optimally right after baby. Peeing and pooping can be a challenge after baby in addition to the feeling of pressure. To reduce stress on the pelvic floor and prevent further issues, read the following tips:
Pain
It is common to have some level of vaginal pain after childbirth. This can occur whether you had a c-section or a vaginal delivery. Pain level can vary based on many factors including: number of hours in labor, amount of time pushing, whether an instrument was needed to deliver baby, whether there was an episiotomy, degree of tearing. If you had a cesarean section, it is also common and normal to have some discomfort along the incision. As long as this is not accompanied by new redness, swelling, or discharge from the incision, this is also normal. Here are some things you can do to help with pain*:
- Maxi Pad Padsicles
- Sitz Baths
- Stay hydrated
- Try to sit with weight evenly distributed through your bottom. A cushion or pillow to sit on might help
- Ice packs for 15–20 minutes on the c-section incision
Optimal Pooping
The first poop post baby can be…uncomfortable. We’re just keeping it honest. It’s likely not going to be the most comfortable thing you’ve ever done, BUT you also just birthed a baby. So the bowel movement will likely pale in comparison. Pooping after baby can take a lot of effort, but to help ease the process, consider the following tips:
- Stay well hydrated. Water helps lubricate your bowels and tissues and help things keep moving. Staying hydrated will also decrease the chances of having hard stool, which will also make things more comfortable.
- Stool softeners are often prescribed before you leave the hospital. This helps to also keep the stool soft, making it easier to pass.
- Use a squatty potty or something under your feet. Having the knees slightly higher than the hips when you’re sitting on the toilet will help relax the pelvic floor muscles and make it easier for stool to pass.
- Do not hold your breath as you poop and try to exhale as you gently bear down. Imagine you are blowing out birthday candles as you bear down.
- Use a wipe or toilet paper to apply gentle pressure to the perineum (the area between the rectum and the vagina) while you bear down. This will help avoid excess pressure on the pelvic floor. This is especially helpful if you had tearing or an episiotomy.
Optimal Peeing
Peeing after birth may not be as uncomfortable as pooping, but there can still be some challenges with it. Consider the following tips to help improve peeing as well as prevent any pelvic floor issues:
- Avoid straining. Peeing should be a passive activity and not require any pushing or bearing down. If you’re finding that you’re having a hard time initiating the urine stream, try taking a few deep breaths and imagine the pelvic floor opening up.
- Use a stool or squatty potty as well to help relax the pelvic floor muscles.
- Wiping could be uncomfortable, so consider using a peri bottle to clean instead of wiping.
- Promote normal time frames for peeing. As soon as possible, work on training your bladder for 3-4 hour intervals between bathroom trips.
- If you continue to have urge or stress incontinence after the second week, it’s important to seek out physical therapy. For some clarification:
- Urge Incontinence: Having a strong urge to urinate and having trouble making it to the bathroom on time or not being able to make it to the bathroom on time and experiencing leakage.
- Stress Incontinence: Leaking urine with activities such as coughing, laughing, sneezing or physical activity.
Optimal Lifting
I was surprised by just how physically demanding caring for a newborn can be! You’ve just given birth and now you have to lift your baby to and from multiple places: bassinet, car seat, swing, stroller, and changing table. On top of that, you are likely carrying your baby in your arms, in some kind of wrap, or in a car seat that’s awkward and heavy! All of that lifting and carrying adds up, so try these tips to optimize your lifting techniques and promote healing rather than causing more pain while your body is still recovering from birth:
- Keep the baby as close to you as possible
- Lift with your legs and bend at your hips (instead of your back) when possible
- If you are feeling the need to hold your breath or bear down to lift something, try and exhale at the hardest part (this helps engage your core) or consider asking someone for help
Adjusting to Motherhood
Your life has just drastically changed. You may be experiencing the highest highs as you admire your new babe or the lowest lows as you are physically recovering from birth while adjusting to life with a newborn. If you are a first time mom, this may be overwhelming, so know that it is normal to take time to adjust to all the physical, relationship, mental, and emotional changes of motherhood.
Not sure what is normal postpartum? I wasn’t either.
In the first two weeks, you may experience postpartum blues. This should typically resolve within the first 2 weeks after birth (“Postpartum Depression Symptoms”, 2020).
If you experienced trauma during birth, feel that you need help now, or are feeling worse and not better over the first 2 weeks, you can learn more about postpartum mood disorders here or see our Maternal Mental Health Resources for additional support.
See the sections below for some ideas to help you adjust to common changes in your life during this time period:
Emotional Changes
Emotional changes do happen during this period even when a mood disorder is not present. Normally, change in our lives happens slowly or at least in one area at a time. As a new parent, many of your normal routines will be disrupted overnight. If you are feeling overwhelmed, take a look at the following list of common areas of change for new parents and choose 1 area of your life to focus on at a time. There will be time to tackle other areas over the first year of your baby’s life, but there is not enough time in each day to master every new skill and routine in the first 2 weeks. Please go easy on yourself mama.
Changes Experienced by New Parents:
- Schedule
- Feeding Baby
- Feeding a Family
- Baby Care
- Work (stay at home parents and those who work outside of home)
- Sleep
- Leisure Time
- Your Relationship with Your Partner
- Your Relationship with Your Extended Family
- Your Relationship with Your Friends
- Your Body (and clothing)
- ________ Fill in the Blank (What areas are unique to you?)
Sleep
Ahh, sleep. This is probably the one that impacts everyone no matter what kind of labor or delivery you had. This can certainly be baby dependent, but there are a few things you can do to TRY to optimize your own sleep when you get it.
- Limit screen time before bed
- Limit drinking liquids more than 1-2 hours before bed if you can. This is hard if you’re breastfeeding, but try to not to guzzle more than you need so you can limit how much you may need to get up at night to pee
- Get outside during the day. Research has shown that natural light during the day can help with sleep at night.
- Make your room DARK! I love black out curtains to help with this (and also for baby’s room)
- Setting a comfortable room temperature helps improve sleep quality.
- Prioritize sleep. This was a hard one for Alex and I. As two people who are used to being on the move, it’s hard to not want to get everything done while your baby sleeps. But maybe give yourself 20-30 minutes to get things done while baby naps and the rest for sleep or rest.
Hydration & Nutrition
Good nutrition postpartum can go a long way. Staying hydrated will keep fluids normal and prevent things like headache and dehydration. It can also help with energy levels.
One of the best things to do postpartum is to make other people cook good meals for you! Check out these nutritious postpartum meal ideas.
Support: Childcare & Partner Support
As we mentioned previously, there are many factors that go into postpartum recovery. While we can tell you all the things to do for yourself, it’s not easy to act on if you don’t have support at home or in your community. Without going into a diatribe on the lack of postpartum support for moms (in a general, nationwide sense), there are some things to consider to help improve the support around you:
- Open communication with your partner- communicate when you are overwhelmed or when you need help. While we understand not all partners may be receptive, unfortunately, they can’t read our minds. So the first step is communicating when you need something.
- Find a mom group. This was made harder during the pandemic, but finding a group or community to be a part of can be a huge mental support. For example, I (Kristina) did a tummy time class with our daughter and still keep in touch with other moms from the class.
- If possible, have an extra set of hands for those early days or weeks. Think of family or friends who may be willing to stay for a couple of days or nights even if it’s just to sit with baby while you take a walk or shower.
- If finding childcare is a challenge for you, like it is for many modern families, here is a list of some great childcare resources to check out
In my experience, lowering my expectations and prioritizing my sleep and nutrition had the most impact on my mental wellbeing the first 2 weeks postpartum, so don’t underestimate the value of just focusing on the basics right now.
Everyone adjusts at their own pace. If you are feeling ready to tackle more, check out 2-6 weeks.
Common Struggles
The following are common struggles that women experience postpartum. The struggles that follow immediately are not necessarily reasons to seek care from your provider but things to keep in mind. Oftentimes these struggles can be alleviated at home or with time.
Perineal Pain
Perineal pain is pain in and around the vaginal area. This is common especially with a vaginal delivery but also with a C-section as well. If you experienced any tearing during delivery, the use of an instrument (vacuum or forceps) to deliver your baby, or had an episiotomy, your chances of having some amount of pain or discomfort are higher. There are a few things you can do to help decrease perineal pain:
- Padsicles
- Pelvic Floor Relaxation: Inhale and imagine opening and bulging your pelvic area as if you’re trying to have a bowel movement. You don’t want to strain with this exercise but simply imagine gently bulging your pelvic floor or perineal area.
- Try Alex’s favorite Guided Meditation for Pelvic Release.
- Pelvic Rest Posture: See our Exercises Section below for details.
Neck Pain
Neck pain is a common physical complaint for a variety of reasons. You’re likely spending more time sitting and feeding, holding, or looking down at your new baby. While all of these things are great, if you’re not aware of your posture, they can put a lot of strain on your neck.
- Pro Tip: Sit with optimal posture by making sure your ears are in line with your shoulders and your shoulders are stacked over your hips. When you’re feeding baby, bring baby to you with pillows or a boppy rather than hunching forward to feed baby.
Back Pain
Back pain also happens for a combination of reasons like muscle weakness, poor posture, repetitive activities, and poor lifting technique. While it may not be possible to avoid it completely, paying attention to how you’re carrying yourself at various points throughout the day can help prevent or minimize it.
- Pro Tip: When lifting or holding baby, gently engage your deep core muscles by slightly drawing your belly button in or imagine activating your lower abdominal area as you would when blowing out a candle. This will help support the back as you move through your day. (This does not mean suck your belly button in though!)
C-Section Incision Pain
If you had a c-section, it’s normal to have some incisional pain for a period of time. Even some numbness, tingling, or pins/ needles sensations are normal. However, sharp, stabbing pain should be minimal or non-existent and the pain should not keep you from being able to do basic activities during the day like sit comfortably or get in and out of bed without too much help. In order to help improve the sensitivity of your incision, try this technique:
- C-Section Scar desensitization: With a cotton ball or your fingertips, very gently move around your incision (not on it) for a couple of minutes in order to help that area get used to touch. This will help the nerves as they heal to not be as sensitive.
Over-Activity
Overdoing it after baby is a common struggle. Especially if you have another little one at home, it can be very hard to balance getting things done with your own recovery. There are a lot of factors that can go into doing too much, too soon, but here are a few signs that you may have overdone it in those first couple of weeks:
- Pain that increases significantly (i.e. if you start with 2/10 pain and do an activity and your pain goes up to 5-6/10 pain, that is too high)
- Significant increase in vaginal bleeding after or during an activity is a sign of too much. While you’ll have some bleeding in the early weeks postpartum, a large increase in bleeding is a sign of too much activity.
- Not being able to easily carry on a conversation while walking or moving can be a sign of doing an activity with too much intensity. For example, if you go for a walk (which we encourage) but are walking so fast that you cannot carry on a conversation, this is too much in the early days.
Gas Pain
Gas pain can be a common complaint during the early postpartum days. Gently massaging your belly can help stimulate gas as well as bowel movements. Start with small circles on the bottom right hand side of your belly. Slowly move up towards your ribcage, across your abdomen, and down the left side of your belly to help stimulate gas. I often used this same exercise to help my daughter with gas pains!
Breastfeeding
If you choose or are able to breastfeed your baby, this can be a struggle. We have listed a few of our favorite resources below:
Red Flags after Birth
While most women recover without any serious complications after birth, there is always the risk of developing more serious complications. While these are rare, it’s important to be aware of signs that are considered “red flags.” These red flags, if present, would be a reason to reach out to your provider or visit the ER. According to March of Dimes, do not ignore the following red flags:
- A headache that does not get better with over-the-counter medication
- A fever higher than 100.4 degrees
- Increased vaginal bleeding or foul smelling vaginal discharge or incisional discharge
- Pain in one area of your breast
- Pain in your lower leg
- Seizures, fainting, increasing abdominal pain
- Persistent cough, chest pain, or shortness of breath
- Having thoughts of hurting self or the baby
- An incision or episiotomy that is not healing or is red (“Warning Signs”, 2022)
Exercises for 0-2 Weeks Postpartum
This early phase is all about self care and recovery. For those who are used to exercising or maybe worked out through the majority of your pregnancy, you may find it difficult to slow down. For others, it may be hard to even find the energy or time to do these exercises that are suggested. That is OK. These exercises are suggestions to help optimize posture, breathing, recovery, and to set a foundation that you can build on during your postpartum journey. For more general guidance on exercise postpartum, see our Guidelines for Postpartum Exercise.
The following exercises are generally safe to start after baby arrives:
- Pelvic Rest Posture- Laying on your back on the floor or your bed, place your legs on the couch or with pillows supporting them to have hips and knees at a 90 degree angle. Stay here and practice deep breathing for 3-5 minutes.
- Walking
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CREDITS
Sources
Postpartum depression symptoms & definition: Perinatal mood disorders. Postpartum Depression Alliance of Illinois. (2020, June 23). Retrieved August 27, 2022, from https://ppdil.org/symptoms-of-ppmds/
Warning signs of health problems after birth. March of Dimes. (2022). Retrieved August 27, 2022, from https://www.marchofdimes.org/pregnancy/warning-signs-of-health-problems-after-birth.aspx#:~:text=Life%2Dthreatening%20conditions%20that%20can,severe%20headache%20and%20extreme%20pain
*Note: We provide information on postpartum recovery not healthcare advice. We encourage you to discuss any content with your healthcare provider – we value their role in your recovery and this site is not a replacement for healthcare services like obstetricians, gynecologists, midwives, primary care providers, physical and occupational therapists, and mental health providers. See our Terms & Disclaimer and our Resources for more information.