No one talks about the bleeding!
The unhealed stitches!
The cramping!
The tears!
The sleepy nights!
The exhaustion that is deeper than what is seen!
While there is a new life that has come into the world, there is also a person who has taken a rebirth- a mother.
When everyone is celebrating the baby-the mother’s body is quietly recovering from one of the most intense events of her life. The uterus begins to shrink to its original size. Hormones begin to go up and down dramatically. Milk comes in. Physical strain is coming in with emotional imbalance. Sleep disappears.
This period is known as the post-partum and fourth trimester which is the most powerful time of transformation for a mother as well as the newborn. Understanding what truly happens in these 40 days can make the difference between feeling lost… and feeling prepared.
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What is Post-partum?
Post-partum starts immediately after childbirth and usually lasts 6-8 weeks. It is usually known as the postnatal period. There are three distinct phases of the post-partum period:
- Acute phase-6 to 12 hours after birth
- Subacute phase-Lasting up to 6 weeks
- Delayed phase- Lasting 6 months
According to WHO, New mom care is the most critical and yet the most neglected phase in the lives of new mothers.
Why are the first 40 days Pivotal?
Across many cultures the first 40 days of post-partum are considered to be sacred. Medically this period is called puerperium. During this time:
- The uterus shrinks backs to normal size
- Breastfeeding is established
- Sleep issues
- Hormonal imbalance
- Body begins to heal from vaginal or C-section delivery
- Emotional sensitivity
- Breast begins to sore
- Healing from vaginal tear
This is a time to recover and not bounce back. Give yourself and your body time to adjust to the new changes. New mom care during these times should focus on prioritizing sleep, nourishment and emotional support from family.
Physical Healing after Delivery
- Uterine Involution
This is the condition where the uterus begins to shrink to the original size. The uterus shrinks back down to its non-pregnant size and weight. This process starts soon after childbirth and continues over 6 weeks. This causes mild to strong cramps that are called afterpains and heavy cramps due to breastfeeding that is due to the release of oxytocin.
- Vaginal bleeding
Lochia rubra is a condition where bloody vaginal discharge is observed and is heavy for the first 3-4 days and slowly it becomes watery in consistency and changes the colour to pinkish-brown which is known as Lochia serosa. Lochia alba is a condition where the vaginal discharge changes the colour to yellowish-white which usually is seen after 10-12 days. Seek medical help if the pad is soaked within an hour, there is a foul smell, there is passing of large clots and you might get fever over 100.4℉. Monitoring bleeding is an integral part of post-partum recovery.
- Breast engorgement
Women may experience full, firm, and tender breasts after the delivery. Frequent breastfeeding on both breasts is recommended to avoid engorgement. Women should use warm washcloths or warm showers or place cold washcloths between feedings to relieve the pain. Proper new mom care includes addressing breast discomfort early to prevent complications.
- Vaginal pain
Vaginal pain is very common and is seen in around 90% of the women. Mild vaginal tears occur during delivery and take a few weeks to heal, whereas extensive tears might take longer to heal. Pain management, hygiene and proper rest are part of postpartum recovery.
- Haemorrhoids
Haemorrhoids are swollen veins inside your rectum or in the skin surrounding the anus. They are caused due to the extra pressure on the rectum. When you are pregnant, the baby puts extra pressure on the lower rectum. Thus, haemorrhoids are seen in the post-partum period. Symptoms include:
- Swelling
- Itching
- Irritability
- Bleeding during bowel movements
Hormonal Changes
Hormones play a crucial role in the pattern of new mom care. After delivery, estrogen and progesterone levels drop drastically. This causes:
- Mood changes
- Irritability
- Crying over small things
- Hair loss
- Skin changes
- Weight loss
- Increased sensitivity to pain
- Fatigue
- Intolerance to cold or hot conditions
Many women experience emotional ups and downs during and after the pregnancy which are called “baby blues”. Mental health is very important when it comes to handling a new-born. If sadness, anxiety or hopelessness still continues after 2 weeks of time, it causes post-partum depression and anxiety, both of which are common and treatable.
Pain, Discomfort and medication
Postpartum medications play an important role in new mom care. Some level of discomfort is normal after birth. Healthcare providers typically recommend:
- Pain management options that are safe during breastfeeding
- Iron supplementation if blood loss occurred
- Omega 3 supplements
- Multivitamins for strength
- Stool softeners to prevent straining
- Antibiotics if infection risk is present
- Haemorrhoid treatment
- Laxatives
Postpartum medications are prescribed based on your individual recovery needs. Always follow your provider’s instructions and attend postpartum check-ups.
Warning signs that shouldn’t be ignored
Post-partum is a busy period of time and most mothers usually ignore themselves for the care of their child. There are few signs that shouldn’t be ignored as they can lead to severe conditions in the future:
- Severe headache
- Vision changes
- Difficulty in breathing
- Extreme vaginal pain
- Vaginal discharge that soaks a pad in an hour
- Suicidal thoughts
- Fever that rises above 100.4℉
- Inflammation in one leg
- Lack of bonding with the baby
- Complications with sutures or incisions
- Incontinence
- Frequent urination or burning
- Breast pain and soreness
Final Thoughts
The first 40 days after delivery are not about perfection or productivity. They are about stabilization.
Your organs are shifting back.
Your hormones are recalibrating.
Your sleep is disrupted.
Your heart is expanding in ways you didn’t know possible.
Healing is not a weakness.
Rest is not laziness.
Asking for support is not failure.
The fourth trimester deserves as much attention as pregnancy itself.
FAQ's
1. Is it normal to still have bleeding after 4-6 weeks?
Yes. Light bleeding or discharge usually lasts up to 6 weeks. But if you observe heavy bleeding along with clotting seek medical help.
2. Why do I feel night sweats after delivery?
Night sweats are usually common during the first few weeks. Hormonal shifts cause your body to release excess pregnancy fluids, leading to night sweats.
3. What are the signs of postpartum depression?
The common signs of postpartum depression are severe anxiety, sadness, suicidal thoughts, feeling disconnected from your baby, etc.
4. Is it common to lose hair in postpartum?
After almost 3 months of giving birth, estrogen levels drop and that causes extreme hair fall.
5. How can I prevent Postpartum complications?
Postpartum complications can be prevented by following a balanced diet, ensuring adequate rest, postpartum check-ups, etc.