Physical changes after delivery (postpartum period)
As your body returns to its nonpregnant condition, there are changes you can expect during the days and weeks after delivery (postpartum period). Like pregnancy, postpartum changes are different for every woman.
You may experience shaking chills right after delivery. This is a common reaction in the hours after delivery. A warm blanket may help you feel more comfortable.
As your uterus shrinks back to its nonpregnant size, you may have contractions (afterpains) for the first few postpartum days. The sharpest pains usually subside during the third day. Afterpains are nonexistent to mild following a first childbirth and are more painful with each successive pregnancy. They are especially noticeable during breast-feeding; breast-feeding triggers the release of oxytocin, which in turn causes the uterus to contract.
The uterus takes about 6 weeks to return to its nonpregnant size. If this was your first pregnancy, your uterus will remain slightly larger than it was before you got pregnant.
Immediately after delivery, you will have a bloody discharge (lochia) from the vagina. This will turn pinkish within a week and become white or yellowish after about 10 days. Lochia may last for 2 to 4 weeks and can come and go for about 2 months.
Don't be concerned if you pass occasional blood clots, as long as they are smaller than a golf ball. Use pads, rather than tampons, during this time. If you have a perineal tear or episiotomy that is healing, change the pad at least every 4 hours to help prevent irritation and infection.
You may have some difficulty urinating for a day or two after delivery. You may also have constipation or discomfort with bowel movements for a few days after delivery. Drink plenty of water and juices to ease constipation and help you stay more comfortable.
In the days and sometimes weeks after delivery, it is not unusual to urinate more frequently than usual. Your body is ridding itself of the extra fluid from pregnancy. Some women also sweat heavily as they lose their extra fluid.
It is not unusual to have sore muscles (especially in your arms, neck, or jaw) after delivery. This is from the hard work of labor, and it should go away in a few days. You may also have bloodshot eyes or facial bruising from vigorous pushing.
You may have pain, discomfort, or numbness around your vagina. If you had a cesarean delivery (C-section), an episiotomy, or a tear in your vagina, you may have discomfort when you sit or walk, and your first bowel movement may be quite painful. Taking stool softeners and drinking lots of fluids can help soften stools and ease pain.
Between the third and fourth days after delivery, your breasts begin to fill with milk. This can cause breast discomfort and swelling (engorgement). Placing ice packs on your breasts may relieve the discomfort of engorgement. Some women find a hot shower or warm compresses on the breasts are more comforting. For more information, see the topic Breast Engorgement.
During the first days of breast-feeding, your nipples will probably become tender or sore. However, as breast-feeding becomes more established, the soreness usually goes away. For information about preventing undue soreness or cracking, see the topic Breast-Feeding.
Last Updated: August 6, 2008
Author: Jan Nissl, RN, BS