Your Postpartum Recovery: What’s Normal and What’s Not?

by
Ashley Gish, NP
Nurse Practitioner
Medically Reviewed
July 21, 2023

Whether it’s your first baby, your fifth, or somewhere in between, at some point after delivery you may find yourself wondering, “Is this normal?!” And you wouldn’t be alone!

As incredible as snuggling with a newborn feels, growing a human is HARD work. There are so many big changes happening in your body, and you’re finding your new normal in many different ways.

To make things even more confusing, there’s so much focus on pregnancy and delivery that what to expect after the baby arrives often remains a mystery, leaving a lot of women to wonder why their hair is falling out, why their nipples are so sore, or why they’re continuing to struggle with fatigue even after their baby is sleeping through the night. But knowing what to expect during this time can help.

With a little information about what’s normal, what’s not, and what can be done to support your healing postpartum, you can feel a little less alone and better-equipped to handle the emotional and hormonal shifts that occur after birth .

Why we call it “the fourth trimester”

The first 12 weeks following birth (AKA the fourth trimester) is an important time for you and your baby. You’re adjusting to fluctuations in hormones and navigating the new challenges that come with motherhood, all while recovering physically from childbirth.

Until recently, maternity care guidelines included just one postpartum checkup, at around six weeks after delivery. This hands-off approach led to the false belief that by six weeks postpartum you should be back to feeling like your pre-pregnancy self again—but that’s not exactly a realistic expectation for most women.

Fortunately, the American College of Obstetricians and Gynecologists (ACOG) now recommends that postpartum care be an ongoing process rather than a single encounter.

At Parsley Health, the medical providers and health coaches are all about this approach, and use a root-cause approach to make sure you feel supported throughout your postpartum journey.

Postpartum recovery: what’s normal and what’s not?

Everyone’s postpartum experience is unique. Although many women may feel somewhat "normal" by 6–8 weeks after delivery, for some it can take 6–18 months for their body to fully recover physically. It’s worth pointing out that it takes over NINE MONTHS to grow a baby, so be patient with yourself!

Some common postpartum concerns that aren’t talked about enough

Fatigue

Sleepless nights and fatigue are common for new moms, with about 64 percent of new moms experiencing postpartum fatigue in the first week or so after delivery. But there’s a difference between normal sleepiness and overwhelming fatigue that leaves you unable to function.How long postpartum fatigue lasts is different for everyone. The amount of support you have at home, how well your baby is sleeping, and how quickly you have to return to working outside of the home can all impact the quality and quantity of sleep you’re getting.

There are so many things that may contribute to feeling tired in the first few weeks with a newborn at home. But just because something is common doesn’t necessarily mean it’s normal. If your fatigue doesn't let up, reach out to your medical provider. There are a lot of things we can do to provide support!

Parsley Health Coach Aly Cassata, NTP , recently shared with me an experience she had working with a Parsley member who was struggling with significant fatigue postpartum. Despite sleeping through the night and being told by her non-Parsley doctor that her labs were all “normal,” she was still struggling to function each day.

Cassata quickly identified that this member wasn’t eating anywhere close to enough calories to support breastfeeding. Together they developed a plan to set up nursing stations around her home equipped with protein bars and packs of nut butter, along with water and electrolyte packets, so she could refuel during her nursing sessions. Within a week, her energy had improved and she felt like a completely different person.

Mood changes

Pregnancy and postpartum are filled with so many emotions, and the massive hormonal shifts that occur postpartum leave many women feeling overwhelmed, exhausted, and struggling with feelings of sadness or worry that just won’t stop.

The “baby blues,” as they are sometimes called, affect 70–80 percent of moms postpartum. Hormonal factors play a role, but other factors such as sleep deprivation, lack of support, difficulty breastfeeding, and normal doubts and worries all contribute to symptoms as well.

These feelings may subside in a few weeks, but if you can’t sleep or are having overwhelming feelings of worry, guilt, or hopelessness, contact your medical provider. These may be symptoms of postpartum depression or anxiety, and the sooner you get help, the better. As a new mama, it can feel difficult to admit that you’re feeling anything other than joy, but you’re not alone, and you don’t have to suffer in silence.

Vaginal bleeding

In addition to stocking up on cute baby clothes, there are a few postpartum essentials you’ll want to keep on hand. Maxi pads are one of those things.Regardless of whether you delivered vaginally or via C-section, bleeding and discharge for a few weeks after delivery is normal. Initially, postpartum bleeding may feel similar to a period, but it should lighten up within a few days. By 2–4 days postpartum, the discharge (known as lochia) should turn pinkish, and typically will resolve in another 2–4 weeks.

If you have bright red, heavy bleeding that lasts more than a few days after delivery and is soaking through more than one sanitary pad in an hour; are passing blood clots larger than a golf ball; or develop new heavy bleeding after your initial bleeding slowed down, call your obstetric provider right away, as these may be signs of postpartum hemorrhage.

Breast and nipple soreness

Breastfeeding can be an amazing bonding experience and an incredible way to support your baby’s health. But that doesn’t mean it always comes easy.

While it’s true that it shouldn’t be a painful experience, it’s not exactly comfortable, at least in the beginning. Mild nipple soreness is common in the first week or two of breastfeeding as your body is getting used to it. For most babies, it takes a little bit of practice, too. They’re learning how to latch on properly, and you may need to experiment with a few different positions before you both find your groove.

Warm compresses and all-natural nipple butter can help to ease the discomfort early on. Most breast and nipple pain related to breastfeeding can be easily resolved, so be sure to seek support from a lactation consultant early on.

If one or both breasts become red, warm, and painful to touch, or if you develop a fever or flu-like symptoms, follow up with your obstetric provider right away, as these are signs of infection.

Perineal pain

During a vaginal delivery, the perineum (the area between your vagina and anus) must stretch to accommodate your baby’s head, so understandably swelling and discomfort are common. For some, the initial pain resolves quickly, but depending on whether you had perineal tearing or an episiotomy, it may take several months to heal completely.

Warm sitz baths, ice packs or “padsicles,” and keeping the area dry are all simple ways to support healing. If you have any pain or swelling that’s not going away, pain that is getting worse, or any signs or symptoms of infection including fever, swelling, or foul odor, please call your obstetric provider.

Hair loss

During pregnancy, high levels of estrogen and progesterone keep your hair in a state of growth, preventing it from falling out at its normal rate. However, once your hormone levels start dropping back to normal, you may notice what feels like an excessive amount of hair loss.

No need to panic. Not all women will experience postpartum hair loss, but for those that do, hair growth patterns typically return to normal within 6–12 months.f your hair loss doesn’t seem to be slowing down or is accompanied by other symptoms, such as fatigue, cold intolerance, brain fog, or constipation, it could be a sign that your thyroid is out of whack, you’re lacking certain nutrients, that you have postpartum stress, or that your blood sugar is imbalanced—all of which are fairly common after pregnancy.

What to do to support postpartum healing

Caring for a new baby is a lot of work, but your needs still matter.

Quality sleep, staying hydrated , and eating a nourishing diet are important foundational elements of your postpartum recovery. At Parsley Health, our medical providers and health coaches evaluate your hormones and nutrient status, use food as medicine to support breastfeeding and recovery, explore ways to support a healthy mood and quality sleep with a newborn, and help you to keep your expectations realistic throughout your postpartum journey.

Wherever you’re at hormonally, physically, and emotionally, we’re here to support you through it all so you can transition confidently into your motherhood role and feel like the best version of yourself.

Most importantly, we’re here to remind you that you’re doing a great job! Even when it doesn’t feel like it…you’re doing so much better than you think.

Want to become a Parsley Health member? Schedule a free call  to learn more about Parsley’s virtual primary care, how to use insurance  to pay for your Parsley medical fees, and more.

by
Ashley Gish, NP
Nurse Practitioner

Ashley Gish is a board-certified Women’s Health Nurse Practitioner. She completed her functional medicine training through the Institute of Functional Medicine and has additional training in nurse midwifery, holistic nutrition, and women’s herbal medicine.

After spending several years working in conventional gynecology and seeing so many women struggle with the one-size-fits-all approach being offered, she began training in functional medicine and has found it to be the perfect mix of science and the art of individualized patient care. She particularly enjoys working with women on their fertility and postpartum journeys, and loves helping women demystify hormone health!

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