Postpartum Period

Five Things to Expect During Your Postpartum Recovery

As mothers and mothers to be, we typically spend a great deal of time planning and preparing for our child’s birth. We read books, take prenatal classes, write birth plans, pack bags, wash, fold and organize baby laundry and so much more in preparation for the big day. Very few of us however, give much thought to what the postpartum period will be like for OUR bodies. Consumed with the excitement of our baby to be, we may forget that once we bring home our bundle of joy we too will need care, rest and healing as we recover from the amazing feat of giving birth. Here are 5 things to expect from your postpartum recovery.

  1. Heavy bleeding: As your body sheds the uterine lining and also bleeds from where the placenta was attached, you will experience heavy bleeding known as lochia. You may see blood clots in this bleeding and it will likely appear bright red at first. The intensity of the bleeding should subside with time and gradually turn to spotting before it stops. Typically, this should last approximately 2-6 weeks after you give birth. To prepare, stock up on heavy duty overnight strength sanitary pads, mesh panties and even adult diapers can be a great option. This applies whether you had a vaginal delivery or a C-section.
  2. Some pain and discomfort: Take a moment to consider what an incredible thing it is that your body is going to birth a 6-10 pound baby. With this incredible miracle comes hard work and its fair share of aches and pains. Whether you have a natural birth or a C-section, you can expect to experience some cramping, soreness, muscle aches and joint pains. With a vaginal delivery you may also experience some burning and soreness of the perineum and with a C-section, pain at the incision site and abdominal pain as you recover from major surgery.
  3. Hormonal side effects: As your body seeks to adjust hormonally after giving birth, you will likely experience a few unpleasant side effects. These may include fluctuating emotions and weepiness, hot flashes, night sweats and chills, and continued feelings of clumsiness from the production of the hormone relaxin. Give yourself some grace during this period as you may not feel like yourself despite your excitement over your new baby. If you are concerned that the baby blues may be developing into something more serious like postpartum depression, contact your midwife, doctor or a counselor for support. There are many wonderful resources available for women suffering from postpartum depression. Don’t be afraid to ask for help. 
  4. Breast changes: As your milk comes in after baby is born, you may experience some engorgement and sore nipples and breasts as your supply adjusts to meet baby’s needs. You may also notice that your nipples appear darker. If you are recovering from a C-section, breastfeeding can initially be more challenging due to pain from your surgery and having to find a position that is comfortable for you and your newborn while you heal. Fear not though, it will get easier with time and your milk supply will adjust as you and your baby find your rhythm. Consider having nipple pads on hand for leaking breasts, cooling pads or ice packs for sore breasts and a nipple cream for aching and cracking nipples. Be sure to signup for our next Pumptalk 101 class if you have extra questions or would like some more suggestions.
  5. Constipation, incontinence, and frequent trips to the bathroom: Depending on how you delivered and your own personal recovery, you may experience a period of constipation following giving birth and/or urinary or fecal incontinence. A vaginal delivery can cause temporary nerve damage around the bladder making it more difficult to sense when you need to go to the bathroom. You may also have weakened bladder muscles, hemorrhoids and though less common, tears to the anal sphincter causing fecal leakage. Conversely, you may also experience constipation due to the slowing of your metabolism and digestive tract. Talk to your doctor or midwife for effective ways to manage these various side effects.

It’s not uncommon for the postpartum period to be filled with excitement, exhaustion, trepidation and feeling a bit overwhelmed. Make sure that amidst all the emotions and adjustments, you allow time for your own care and recovery. Your body has just undergone the incredible journey of childbirth and needs time to rest and heal so that you can focus on caring for your new, beautiful baby. 

What to Expect from Your First Postpartum Period

Photo by Piotr Marcinski/iStock / Getty Images

One of the many great perks of pregnancy is that you get a minimum of nine months sans menstrual cycle. No pads, tampons, monthly cramping or moodiness (okay, so those last two can happen in pregnancy too). At some point however, after your little one is born and your hormones settle back into a rhythm, your monthly visitor shall return. Many women wonder when this will happen and if it will be the same, worse or better than their pre-pregnancy periods. Here’s all you need to know about your first postpartum period and the factors that may impact how long it stays away.

If you are not breastfeeding your baby, you can anticipate the return of your cycle sometime around two months postpartum. There is a wide range of normal for that first postpartum period that can range from light to heavy, more or less cramping than you previously had, small blood clots and a consistent or inconsistent flow. Your period may be totally different than your pre-pregnancy period or exactly the same and it can differ after each child birth, as well. Whether breastfeeding or not, if your period returns soon after your delivery, avoid using tampons while your body is healing.

Breastfeeding your baby can be a game changer in the return of your menstrual cycle and fertility. Breastfeeding releases the hormone prolactin into the body which is necessary to produce breastmilk but consequently suppresses your reproductive hormones. The effect that breastfeeding has on the body will vary from woman to woman with some getting their cycle back a few months postpartum and others needing to ween entirely before their period returns. For women who practice ecological breastfeeding and natural child spacing, the average return of menses is 14.6 months.

Because breastfeeding suppresses fertility hormones and the return of your menstrual cycle, it can be used as a form of birth control for the first six months of baby’s life and possibly beyond. Learn more about maximizing your period of infertility following your baby’s birth and how to use breastfeeding as an effective means of contraception.

Although you can get pregnant before your first period because ovulation may occur, the chances are slim—about 6 percent. Because of this, some women who are eager to grow their family start to feel concerned about when their period will return. If you are breastfeeding around the clock and your body is continuously releasing prolactin and suppressing fertility hormones, it may begin to feel like your fertility will never return. If you are concerned about the return of your fertility because of age or your child spacing plans, there are usually ways to continue breastfeeding and still get your period back. Here are a few tips if your baby is over six months of age and you are concerned that breastfeeding is suppressing your cycle:

  • Start introducing solids: Once your baby is eating more solids, he may not need to nurse as often. Learn more about starting solids with baby.
  • Try cutting out a session and offering a bottle: Sometimes making abrupt changes to your pattern of breastfeeding can bring back your cycle.
  • Work on night weening: Research suggests that reducing time spent suckling at the breast between the hours of 12 and 6 AM may be most effective for bringing back fertility.
  • Be patient. Lactational amenorrhea may be your body’s way of telling you that it’s not ready for the next pregnancy yet and your child’s nursing habits may be indicating the same. In MOST cases, your period and fertility will return eventually despite continuing to breastfeed.

You may feel as though you have PMS symptoms for months preceding the return of your period as your body gears up for ovulation. It’s not uncommon to have some cramping, cervical mucus and other menstrual cycle indicators well before you get your actual period. Then once your cycle returns, it may take a few months for it to regulate back to a reliable schedule (if you’re lucky enough to have one). Although most women will begin to ovulate after their first period, it’s not uncommon to have one or more anovulatory cycle before returning to full fertility.

Whether you are welcoming the extended vacation from your monthly visitor or are anxious for its return, your period will return when your body is ready. If you have not had your first period due to breastfeeding and have concerns about the return of your fertility, talk to your midwife or OB to come up with a plan that works for you and your baby to aid in the return of your cycle. For questions about pregnancy, natural birth or your postpartum period, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Your Six-Week Postpartum Visit - What to Expect

Midwife Postpartum Visit

Whether you give birth at a birth center with midwives or at the hospital with your OBGYN, you will likely have a postpartum follow up appointment about six weeks after you deliver. The purpose of the visit is to check on your physical and emotional well-being as you recover and adjust to your new life post childbirth. Here’s what you can expect to happen at your six-week postpartum check-up. 

NOTE: Health Foundations also provides a postpartum visit at 2 weeks for our families

A thorough assessment of how your body is recovering from childbirth: 

Your midwife or doctor will likely check the size of your uterus to see if it has returned to its pre-pregnancy size. She or he will also want to ensure that any vaginal tearing or C-section incisions are healing well, and assess for any post-birth physical problems like hemorrhoids, incontinence or constipation. Now’s the time to mention any other aches and pains you are experiencing. Your care provider will likely also clear you for sex and exercise at this visit should everything check out okay.

A check-in on your mental health: 

Your care provider may give you a written assessment for postpartum depression or she may just evaluate how you are feeling in discussion. Postpartum mood disorders affect approximately 10-15 percent of all new moms though many feel ashamed or afraid to seek the necessary help. If you are experiencing symptoms of depression such as hopelessness, sadness, anger or thoughts of harming yourself or your baby, please tell your care provider right away so they can support you in finding the appropriate help. There are many options for moms experiencing postpartum depression or anxiety including counseling, support groups and even medication. Your postpartum visit is a great opportunity to share any concerns about your mental well-being with your care provider.

A discussion about birth control:

Since you’ll most likely be cleared to resume having sexual intercourse with your partner at this visit, your care provider will probably want to discuss options for birth control. While exclusive breastfeeding can provide effective protection for the first six months postpartum and sometimes beyond, you may want to consider a back-up plan such as the mini-pill or an IUD if you don’t want to risk your kids being too close in age. Your midwife or OBGYN can discuss the various options for birth control with you and help you come up with a plan that works for you.

Your annual gynecological exam:

Many practitioners will go ahead and perform your annual exam at your six-week postpartum visit. She may conduct a pelvic exam, Pap smear and breast exam in addition to the usual physical exam measures such as weight and blood pressure. It’s a good time to discuss any other health concerns you have so be sure to bring a list of questions with you to the appointment. 

A breastfeeding consultation:

Your midwife or OBGYN will check in with you to see how breastfeeding is going with your new babe. They can help you troubleshoot any difficulties, address issues with engorgement or clogged ducts and refer you to a lactation consultant if you need additional guidance or support. 

Your postpartum visit is a great time to address any questions or concerns that you are having about your recovery, physical or mental health or adjustment to caring for a newborn. Be sure to come prepared with your questions written down so that you can make the most of the time with your care provider. At Health Foundations, our care doesn’t end in the birthing room. We are here for you during your postpartum period and beyond to support you and your new family as you adjust to motherhood. For questions about natural birth or postpartum care, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.

Is Breastfeeding An Effective Form of Birth Control?

Breastfeeding Baby

If you’re a new mommy and have passed your postpartum period of pelvic rest, you may be wondering how effective breastfeeding is as birth control. While you and your partner may be eager to be intimate once again, you are likely not looking to add another baby to the family anytime soon. Fortunately, exclusive breastfeeding is actually a highly effective method of birth control during the first six months postpartum and sometimes even beyond. Here’s how to make the most of your lactational amenorrhea.

What is the Lactational Amenorrhea Method?

Lactational amenorrhea is the term used to refer to the natural period of infertility that occurs after giving birth when a woman is breastfeeding her baby and is not menstruating. This period of infertility occurs because the hormones necessary for milk production actually suppress the hormones necessary for ovulation. Consequently, the Lactational Amenorrhea Method refers to when a couple uses exclusive breastfeeding as a form of birth control. You may be wondering just how effective simply breastfeeding your baby can possibly be at preventing pregnancy. The answer to that question is very effective, if a few important criteria are met. 

In order for the Lactational Amenorrhea Method to be as much as 98-99.5 percent effective, the following factors must be present:

  • Your baby must be 6 months or younger
  • You must be breastfeeding on demand during both day and nighttime
  • Your menstrual cycle has not yet returned
  • Your baby must be exclusively breastfed with no formula supplementation or introduction of solid foods to his diet

Even after six months of age, moms who frequently breastfeed their babies and who have not had the return of their menstrual cycle are only 6 percent likely to become pregnant.

What Factors will Affect the Return of My Fertility?

Although the average time for nursing mothers to experience a return of their menses is 14.6 months, there are a number of factors that may cause you to become fertile before then. These factors known to impact fertility include:

  • The introduction of solids to baby’s diet
  • A reduction in the number or duration of nursing sessions per day
  • Your baby beginning to sleep through the night
  • Regularly pumping in lieu of breastfeeding

Every woman is different and experiences sensitivity to hormones to varying degrees. Overall, the amount of time your baby spends at the breast each day will be the biggest factor contributing to the duration of your lactational amenorrhea. If your period has returned, breastfeeding is no longer impacting your fertility and you should not rely on this method for birth control. 

Can I Increase the Length of my Lactational Amenorrhea to Prevent Pregnancy?

Yes! There are several simple ways that you can attempt to maximize your lactational amenorrhea while breastfeeding. These include:

  • Continuing to breastfeed on demand past six months. Aim to put your baby to the breast at least every 4-6 hours, day and night.
  • Cosleeping to increase night nursing. Fertility hormone production is highest during the nighttime hours making night nursing a primary factor in preventing the return of fertility.
  • Delaying solids until 6 months and offering the breast before each meal.
  • Using nursing to comfort your baby.
  • Offering breastmilk exclusively. Do not supplement with formula.
  • Skipping pacifiers and postponing the introduction of bottles until necessary.
  • Keeping your baby close to encourage frequent nursing by babywearing.
  • Nursing lying down for naps and at night.

Using breastfeeding as birth control is a safe and effective way to prevent pregnancy during the first six months postpartum and even beyond under certain circumstances. Most importantly, your baby will enjoy the limitless health and emotional benefits of exclusive breastfeeding during this critical time in her development. For questions about lactational amenorrhea or for anything related to pregnancy and natural birth, contact Health Foundations for a free consultation with a midwife and for a tour of our Birth Center.