Bleeding and Contractions After Childbirth: Lochia and Afterpains
Vaginal bleeding, known as lochia, is common after childbirth, whether the delivery was vaginal or by cesarean section. It is generally heaviest in the first few days and then gradually decreases. Its appearance and color change over the course of several weeks: red blood gives way to a more watery discharge (known as serous lochia), which starts out pinkish, then turns brownish, and finally whitish.
It may seem heavier after you resume physical activity, after lying down, or after a feeding if you’re breastfeeding. This doesn’t necessarily mean there’s a problem, but you should keep an eye on how it evolves.
It’s recommended that you use sanitary pads and avoid vaginal tampons or menstrual cups. It’s also recommended that you avoid baths and swimming pools for the first 4 weeks: stick to showers instead.
After birth, the uterus gradually contracts to return to its normal size. These contractions, also known as afterpains, can cause pain in the lower abdomen. They may be more frequent and more painful while breastfeeding, but they generally subside over the first few days.
Perineum and C-section Scar: Healing After Childbirth
After a vaginal delivery, the perineum (the area between the vagina and the anus) may be tender, swollen, or painful. A tear or an episiotomy (an incision made in the perineum during delivery) may take several weeks to heal, and the dissolvable stitches will disappear in about two weeks.
Careful daily cleansing of the perineum with water or mild soap is recommended; avoid douching. Keep the area as dry as possible by changing sanitary pads regularly.
You may also experience a feeling of heaviness or temporary difficulty controlling urine or gas. Perineal recovery is gradual, and pelvic floor rehabilitation is recommended starting 6 weeks after delivery.
After a cesarean section, the scar may be painful, tender, or feel tight, or there may be an area of reduced sensation for several weeks. Its appearance changes gradually over the following months. Once healing is complete, massage your scar with small circular motions to promote better healing and prevent adhesions (areas where tissue sticks together). Recovery time after a cesarean section is longer than after a vaginal delivery.
Breasts, Stomach, and Weight: How the Body Changes After Childbirth
In the first few days, the breasts change as lactation begins. They may become larger, taut, or tender when your milk comes in. These changes can also occur if you are not breastfeeding: milk production then gradually stops. The nipples may also be sensitive or painful at the start of breastfeeding.
The abdomen does not immediately return to its pre-pregnancy appearance. It takes several weeks for the uterus to return to its normal size, and the abdominal muscles as well as the pelvic floor (the group of muscles located at the base of the pelvis that extends from the pubis to the coccyx) gradually recover. Dedicated programs helps you progressively strengthen your abdominal wall. Your weight and body shape also change at their own pace.
Other Postpartum Physical Changes
Bowel Movements
Constipation is common after childbirth. It can be caused by hormonal changes, reduced physical activity, or fear of perineal pain. You may feel anxious about having a bowel movement: find the time that works best for you and take your time. You can place your feet on a stool to adopt a more natural position. Don’t be afraid to push. Staying well-hydrated, eating a balanced diet, and gradually resuming physical activity can help
Hemorrhoids
Hemorrhoids may develop or worsen during pregnancy or after childbirth. They cause discomfort, itching, pain, or sometimes bleeding around the anus. They are often caused by straining during childbirth or by constipation, and generally improve gradually.
Sweating
It is common to sweat more, especially at night, during the first few weeks. This sweating is related to hormonal changes and the gradual elimination of fluids accumulated during pregnancy.
Fatigue
Fatigue is very common after childbirth. Physical recovery, hormonal changes, and frequent awakenings due to the newborn’s schedule can disrupt sleep. The need for rest may remain significant for several weeks: listen to your body and accept help from those around you whenever possible.
Back pain
Back pain, particularly in the lower back, may persist after childbirth. It may be related to changes that occurred during pregnancy, the delivery itself, or new postures adopted while holding, breastfeeding, or caring for the baby. It will gradually improve as your body recovers and you resume your normal activities. Be mindful of your posture and consider an osteopathic follow-up care.
When should you seek medical attention after childbirth?
Certain symptoms require immediate medical attention:
- Heavy bleeding or bleeding that increases suddenly;
- Fever, chills;
- Severe, unusual pain that is getting worse;
- Headaches, blurred vision;
- A scar that is very red, swollen, painful, or oozing;
- Unusual pain, redness, or swelling in a leg;
- Sudden shortness of breath or chest pain;
- Significant difficulty urinating or persistent pain when urinating;
- A hard lump in a breast accompanied by pain, redness, warmth, and fever.
Key Points
Every postpartum experience is different: the body does not instantly return to its pre-pregnancy state, and recovery occurs gradually, at a pace that varies from person to person.
Some changes may seem dramatic or uncomfortable without being abnormal.
If a symptom concerns you, becomes more severe, or does not improve as expected, do not hesitate to seek advice from your doctor, midwife, maternity ward, or the emergency department. When in doubt, it’s best to seek advice. If you have any questions, the maternity department at Hôpital de La Tour can be reached at 022 719 64 77
It is possible to take medication even while breastfeeding, but it is recommended that you always consult your doctor, midwife, or pharmacist before taking any medication.