What To Expect When You’re Done Expecting: Normal Postpartum Symptoms During The Road To Recovery

Mom Crew caught up with Dr. Taraneh Shirazian, a board-certified OB/GYN in New York City and founder of Mommy Matters. Here she discusses common medical issues that women can face in the postpartum period and warning signs to look out for.

Article by Dr. Taraneh Shirazian, OB/GYN

Normal Postpartum Symptoms

The postpartum period, defined as the time it takes for all organ systems to return to their pre-pregnancy state, begins after delivering a baby and usually ends 6 to 8 weeks after delivery. Common postpartum symptoms include vaginal soreness, bleeding/discharge, abdominal contractions, hemorrhoids, incontinence, and the baby blues.

Vaginal Soreness

If you delivered vaginally and had an episiotomy or tearing, you may have vaginal and perineal soreness for a few weeks (the perineum is the area between the vagina and the rectum). Recovery time may be longer if the tearing was extensive. The Mayo Clinic recommends using special pillows, sitz bath products, and over-the-counter pain medication to manage this symptom. Emily at Mom Crew has also shared some products that were helpful for her during this time. 

Note: Mommy Matters’ Postpartum Underwear was developed with this condition in mind, and features a cooling gel crotch insert for vaginal pain and an absorbable lining for postpartum bleeding.

Abdominal Contractions

Sometimes called afterpains, these contractions feel like menstrual cramps and occur in the first few days post-delivery as your uterus shrinks back to its normal size (from 2½ lbs immediately before birth to 2 oz just six weeks later). Oxytocin released by breastfeeding may also stimulate afterpains. The Mayo Clinic suggests discussing the use of an over-the-counter pain reliever with your provider if these are especially painful. 

Vaginal Bleeding and Discharge

Just as the function of your regular menstrual period is to shed the unused lining of the uterus, the uterus also has to shed its lining after pregnancy. This post-delivery vaginal discharge (called lochia) will happen for weeks, so you should use pads or padded postpartum underwear (Mommy Matters recommends our reusable, rewashable Postpartu Underwear) to absorb it. For the first few days, discharge will be heavy and red, and it will eventually grow pale and watery in color. However, extremely heavy bleeding (soaking a pad in less than an hour) can be concerning – if you experience this, you should call your physician immediately. 

Incontinence

Due to pelvic floor weakening during pregnancy, labor, and vaginal delivery, some urine leakage may happen when you sneeze, cough, or laugh after giving birth. Typically this improves in a few weeks, but it could also last longer. Wearing sanitary pads and doing Kegels to strengthen the pelvic floor muscles are the current medical recommendations.

Hemorrhoids

Due to the pressure of labor, hemorrhoids (swollen veins in the anus or lower rectum) may develop and cause you to have painful bowel movements. Stool softeners and topical over-the-counter medications may help with this symptom.

Baby Blues

Up to 70% of women experience the baby blues, which are non-clinical sad or stressed feelings in the first 1 to 3 days after giving birth. The baby blues may last up to 2 weeks, but you should consult your provider about the possibility of postpartum depression or anxiety if these feelings persist after two weeks.

Diastasis Recti

This is a relatively common condition in which the abdominal “six-pack” muscles (rectus abdomini) separate during pregnancy. One study estimated that up to 60% of women experience diastasis recti to some degree during pregnancy. Mommy Matters hosts an ongoing series on diastasis recti written by Marianne Ryan, a licensed physical therapist, if you are interested in more information about this condition. 

Postpartum Complications

Take these seriously! If you have been diagnosed with a chronic condition including cardiac disease, obesity, or high blood pressure, you are at higher risk of postpartum complications. For women with these conditions, it is especially important to monitor your postpartum health and prioritize seeing your provider for regular postpartum care.

You should call your health provider immediately if you experience any of the following:

• Bleeding and soaking through more than one pad an hour or blood clots the size of an egg or bigger

• An incision that isn’t healing

• A red or swollen leg that’s painful or warm to the touch

• A temperature of 100.4 F (38 C) or higher

• A headache that doesn’t get better, even after taking medication, or a bad headache with vision changes

The Mayo Clinic advises seeking emergency help if you experience chest pain, difficulty breathing or shortness of breath, seizures, or thoughts of hurting yourself or your baby.

You can read more about postpartum complications here:

• Mayo Clinic, “Postpartum complications: What you need to know”

• March of Dimes, “Warning signs of health problems after birth”

Overall Postpartum Care Tips

Go to all of your postpartum checkups, even if you feel normal and fine. 

Although many physical changes after birth are normal, they are sometimes warning signs or symptoms of other health conditions that need treatment. Seeing your provider regularly will help them diagnose any potential issues and get you prompt treatment. 

The Mayo Clinic also advises, “Any time you see a health care provider in the year after childbirth, be sure to share the date that you gave birth. This can help your provider know that your symptoms might be related to your recent pregnancy.”

The American College of Gynecologists (ACOG) has new recommendations for postpartum care. Replacing the former model of a single postpartum visit, postpartum care is now considered an ongoing process. ACOG recommends that you:

• Contact your physician or healthcare provider within 3 weeks of giving birth. 

• Get ongoing medical care during the postpartum period as needed (i.e., as symptoms emerge).

• Have a complete postpartum checkup no later than 12 months after giving birth.

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About Dr. Shirazian

Board certified OB/GYN Dr. Taraneh Shirazian (@drshirazian) is the founder of Mommy Matters, a platform for women’s health education and quality pregnancy and postpartum products that give back to maternal health globally via the nonprofit Saving Mothers (@savingmothers). You can find the answers to all your maternal health questions at MommyMatters.com and on Instagram at @becausemommymatters.