Postnatal Care: The First 6 Weeks of Recovery

No words can describe the feelings of being a new parent – bonding and caring for your newborn daily can bring happiness and joy to any parent. However, it can be challenging to adjust to everyday life immediately after childbirth, especially for first-time mothers as this is when their body and emotions experience significant changes. 

In this regard, it’s especially important to receive the proper care in your postpartum period so that you can take care of, not just your baby, but yourself too. 

What is Postnatal Care?

Postnatal care (or postpartum care), is the care given to mothers during the first 6 weeks after childbirth. This period is when you and your newborn will regularly visit your doctor to check that everything is normal and healthy, both physically and emotionally.

It begins within the first 24 hours after delivery and often lasts 6 to 8 weeks after childbirth. The World Health Organisation recommends mothers and babies have at least 4 postnatal check-ups in the first 6 weeks. 

What to expect in your postnatal appointments

With so many changes happening to your body so soon, seeing your doctor or midwife and ensuring everything is going well can be comforting. Here are some things that your doctor or midwife may be checking during your appointments:

• Pelvic exam 
• Breast check for lumps and blocks and nipple damage
• General physical to check your weight, blood pressure & body
• Check on your post-pregnancy body (wounds, uterus position, lochia, etc)
• Nutrition

Besides physical checks, your doctor will also check your emotional state for baby blues, postnatal depression or psychosis. If you are experiencing mood swings or any negative feelings, you should tell your doctor immediately so that you can get the right help to recover. 

5 ways your body changes after birth

It takes a while for your body to prepare for labour, and it will also take a while to recover afterwards. If you delivered via caesarean section (C-section), it usually takes longer to recover as you need to factor in the healing time from the operation. Other physical changes in your body can include:

#1. Breast enlargement

Your breasts will be filled with milk a few days after childbirth. It’s a normal process but can be uncomfortable for some mothers. Fortunately, the pain usually improves with time, but you can apply a warm or cold compress to immediately ease the discomfort. Our highly experienced midwives and lactation consultants can visit you at home and help with numerous breastfeeding problems.

#2. Pelvic changes

During childbirth, the area between your rectum and vagina (the perineum) stretches and can tear during delivery. In the postpartum care period, you should clean the wound frequently to speed up the tear recovery. If the wound opens or is infected, consult your doctor immediately. This can be checked at home during your postnatal home visits.

To help your pelvis, you can ice the area with cold packs, perform Kegel exercises, and ease the pressure by sitting on a pillow.

#3. Vaginal discharge (Lochia)

This happens for around 3 to 6 weeks after delivery. It’s natural for your body to remove excess blood and tissues from the uterus. At this time, you will have to wear sanitary napkins or pads until the discharge stops.

#4. Swelling

This usually occurs on the lower side of the legs, especially the calves, and can be a sign of deep vein thrombosis (DVT); a condition where a blood clot forms deep in the body at the lower legs and thighs. In the case of DVT, urgent medical attention will be required. 

#5. Mood

Although not a physical change, it’s important to understand that the postnatal period is particularly stressful and many mood problems will surface at this time. Partners and family members should be attentive to mood changes after delivery, listen, be empathetic, and supportive. Family members who suspect a new mother has postnatal depression should inform their doctor immediately. 

Contraception & Gynecological Health

After giving birth, your body needs time to revert to a pre-pregnancy state. This can take anywhere from 4 to 8 weeks depending on your situation. Once you start to recover at around 6 weeks, your Lochia will start to clear, your uterus will return to normal size, the uterus lining will recover and wounds heal. You can start to exercise or engage in sex again (but consult with your doctor first!). However, there are several things you are encouraged to pay extra attention to when making this transition.

Cervical smear

All women are advised to have a cervical (“pap”) smear 6 to 8 weeks after their delivery if they are not being screened regularly. You can arrange this with your doctor during the postnatal visit. Any ovarian cysts or uterine abnormalities (e.g. fibroids) noted during your pregnancy can also be addressed at this time to see for resolution. 

Breastfeeding

Breastfeeding can be considered a contraceptive method only if you feed exclusively at least every 4 hours and have not had a period since delivery. It is effective only up to 6 months after delivery. Less than 1 in 100 women will become pregnant using this method correctly. Read our blog to find out more about breastfeeding in Hong Kong. 

Conventional contraception 

An intrauterine device (IUD) can be inserted from 4 weeks after delivery, although many doctors will only insert it later due to a higher risk of perforation when inserted earlier. The device can be left in place for up to 5 to 10 years depending on the type of device inserted. 

Progesterone only injections or pills can also be used by breastfeeding women from 4 weeks after delivery onwards. 

For women who are breastfeeding, they are not advised to use combined oral contraception until after 6 months from delivery. It can be used 6 weeks after delivery if they are not breastfeeding.

Postpartum healing tips

Some things can speed up your recovery process, but understand that recovery differs for every mother as everyone’s body and pregnancy are unique. Here is our advice for postpartum self-care for new moms.

Proper nutrition

Maintaining a healthy diet is the first step to getting better. Try eating more whole grains, protein, fruits and vegetables. If you are breastfeeding, you should drink plenty of fluids too.

Get rest

Try to sleep as much as you can to help ease your tiredness and fatigue. Your baby might not have a routine of waking and sleeping, so you must get as much rest as possible.

Light and moderate exercise

Your doctor will tell you when it is right to start exercising. It shouldn’t be something strenuous, maybe taking a relaxing walk around the block.

Wound care 

If you have had a vaginal delivery you may have had a perineal tear or episiotomy. Keep the wound clean and dry to prevent infection and enhance recovery. Clean the wound with water every time after going to the toilet. Some women find sitting on a donut cushion more comfortable as the area may be sore for several days.

If you have had a cesarean section your doctor will arrange an appointment to remove the stitches. Once the stitches are removed you can bath and shower as usual. Avoid applying soaps to the wound and pat the wound dry after showering.

When should you see a doctor?

Besides your regular appointments, if you are experiencing depression or other symptoms such as long-lasting pains and foul-smelling discharges, swelling or discharge oozing from wounds, you should see your doctor immediately. These could be symptoms of an infection or another underlying issue that should be treated immediately. If you’re unsure, you should still speak to your doctor. 

Help for new parents

Whether this is your first child or fourth, having a baby can be a challenging experience, especially if you’re coping with postnatal symptoms for the first time. If you’re unsure about your postnatal experiences or feel like something isn’t right, don’t hesitate to contact your doctor. They will always be happy to assist you and provide tailored advice.

For these situations, having a midwife can also be highly beneficial to help guide you through the postpartum period. At OT&P, our experienced midwives and obstetricians work together to provide comprehensive care for you and your family from pregnancy, birth and beyond. We can provide the proper support to help you navigate your new experiences.