The postpartum period for many is both exciting and overwhelming. As a new mom, understanding the changes your body undergoes may help you feel more prepared and empowered during that time.

This blog post addresses the key aspects of postpartum physiology, what to expect, and tips on how to care for yourself as you approach that phase.

Postpartum Physiology 101: What New Moms Need to Know

The Postpartum Period: What to Expect

The postpartum period, often referred to as the “fourth trimester,” starts immediately after childbirth and continues for about six weeks. The immediate postpartum period is a critical time frame following childbirth, typically occurring in a hospital setting where healthcare providers monitor the mother’s recovery and provide essential education on newborn care.

In that period, your body undergoes physiological changes as it transitions from pregnancy back to a non-pregnant state. Those changes include the recovery of the uterus and adjustments in hormone levels, blood volume, and milk production.

Uterine Involution and Postpartum Recovery

One of the most notable changes is uterine involution. The process involves the uterus shrinking back to its pre-pregnancy size. Immediately postpartum, the uterine fundus, or the top of the uterus, is high in the abdomen.

Over the weeks postpartum, it gradually moves down to its normal position. Uterine contractions, also known as afterpains, help in that process by constricting the uterine blood vessels to prevent blood loss, and though they tend to be uncomfortable, they’re a normal part of postpartum recovery.

In the first few days after delivery, postpartum patients often experience vaginal discharge, known as lochia. Lochia starts as bright red bleeding (lochia rubra) and transitions to pink (lochia serosa) and then white or yellowish (lochia alba) over time. The discharge is a natural part of the healing process as the uterine lining sheds.

Learn the Risks of Postpartum Hemorrhage

Postpartum hemorrhage refers to excessive bleeding following childbirth. According to the University of Rochester Medical Center, 1-5 mothers experience postpartum hemorrhage. Vaginal delivery is associated with a lower incidence of postpartum hemorrhage compared to cesarean delivery.

It’s categorized into an early postpartum hemorrhage, which occurs within the first 24 hours after delivery, and a late postpartum hemorrhage, which happens after the initial 24 hours up to several weeks postpartum.

Risk factors or things that trigger postpartum hemorrhage often include

• Uterine overdistention
• Prolonged labor

A history of bleeding disorders.

Postpartum hemorrhage, particularly in the early postpartum period, requires careful management. So, keep a close watch on blood loss and report any excessive bleeding to your healthcare provider.

Additionally, understanding the difference between normal bleeding and excessive blood loss will help you know when to seek timely care.

Healthcare providers are trained to monitor your blood pressure and blood loss to ensure timely intervention if necessary. In some cases, certain medications are administered to control bleeding and facilitate uterine contractions.

Monitoring Blood Pressure

Maintaining a close watch on your blood pressure is vital during the postpartum period. Monitoring diastolic blood pressure is particularly important, as raised diastolic blood pressure may develop shortly after parturition in previously normotensive women due to increased plasma volume. For instance, a huge drop in blood pressure may indicate excessive bleeding or postpartum hemorrhage, while elevated blood pressure might suggest preeclampsia or other hypertensive disorders.

Managing Discomfort and Recovery

For many women, pain relief options include nonsteroidal anti-inflammatory drugs (NSAIDs) or prescribed pain medication, especially if you’ve had a cesarean delivery or vaginal tearing. Warm sitz baths also provide relief for vaginal discomfort and promote healing.

For those recovering from a cesarean delivery, special attention is needed for your abdominal incision. Keep the area clean and dry, and avoid strenuous activities for proper healing. You may also try gentle exercises and pelvic floor muscle training for recovery. Pain relief strategies, including pain medication prescribed by your healthcare provider, should also help manage discomfort.

Addressing Breastfeeding Issues

Breastfeeding mothers may face challenges such as breast engorgement, where the breasts become overly full and painful. The condition typically resolves as milk production stabilizes and your baby feeds more regularly. Engorgement will likely reduce if you breastfeed or pump frequently..

An added advantage is that breastfeeding helps stimulate the uterus to contract and reduces the risk of bleeding.

Managing Postpartum Health: Beyond the Basics

Postpartum patients should be aware of potential complications such as postpartum depression (PPD) and postpartum psychosis. Urinary tract infections (UTIs) are also common postpartum complications, as postpartum changes in the body contribute to an increased risk of developing these bacterial infections affecting the bladder or urethra. Why? According to the postpartum depression dot org website, 1 in 10 women will experience postpartum depression after giving birth, with some studies reporting 1 in 7 women, with the condition known to last 3 to 6 months.

Alongside postpartum psychosis, PPD affects your emotional and mental health, and it’s important to seek support if you experience symptoms like severe mood swings or persistent sadness. Engage in routine postpartum care and discuss any concerns with your healthcare provider to get the appropriate support.

Routine Postpartum Visits and Health Monitoring

Routine postpartum care is vital for tracking your recovery progress and addressing any concerns. According to clinical guidelines from obstetric gynecol, a comprehensive postpartum visit with your healthcare provider is typically scheduled within six weeks of delivery.

During your visit, your healthcare provider will assess your recovery, including monitoring your blood pressure, checking for signs of infection, and discussing any issues related to milk production or uterine involution.

Blood pressure monitoring is particularly important, as fluctuations may indicate complications such as postpartum hypertension or preeclampsia. Regular check-ups also help ensure that your blood pressure remains within a healthy range and that any necessary interventions are made promptly.

Emotional & Professional Support

If you find yourself feeling overwhelmed, experiencing persistent sadness, or struggling with thoughts of harming yourself or your baby, seek professional help.

Also, building a support network and engaging in self-care practices helps. That might include setting aside time for yourself, connecting with other new mothers, or seeking therapy if needed.

Book a 30-minute call with Dr Kristal and get all the support you need.

Frequently Asked Questions

What are the physiological changes during postpartum?

During the postpartum period, your body undergoes several physiological changes to return to its pre-pregnancy state. Said changes include:

• Uterine Involution: The uterus contracts and shrinks back to its normal size, a process often accompanied by uterine cramping.
• Hormonal Adjustments: Hormone levels, including estrogen and progesterone, drop heavily, which affects various bodily functions.
• Milk Production: Milk production begins, leading to changes in breast tissue and potential breast engorgement.
• Blood Volume Reduction: The blood volume that increased during pregnancy decreases as your body adjusts to the new state.
• Vaginal Discharge: Known as lochia, the discharge changes in color and consistency as the uterus heals.

What is the normal physiological response in the early postpartum period?

In the early postpartum period, typically within the first few days after delivery, several key physiological responses are expected:

• Immediate Postpartum Hemorrhage: There may be bleeding right after childbirth, which usually decreases in intensity over time.
• Uterine Contractions: Contractions help the uterus return to its pre-pregnancy size and could be uncomfortable.
• Vaginal Discharge: Lochia starts as bright red bleeding, transitioning to pink and then white or yellowish over the following days.
• Breast Engorgement: As milk production ramps up, breasts may become swollen and tender.

What are the three types of lochia?

Lochia is the vaginal discharge that occurs after childbirth, expelled from the uterine cavity, and it progresses through three stages:

• Lochia Rubra: Bright red bleeding that typically occurs for the first few days postpartum.
• Lochia Serosa: Pinkish-brown discharge that follows lochia rubra, lasting up to two weeks.
• Lochia Alba: White or yellowish discharge that may continue for several weeks as the uterus finishes healing.

What color is lochia?

Lochia begins as bright red, known as lochia rubra, and gradually changes color. It transitions to a pinkish-brown color (lochia serosa) and then to a white or yellowish discharge (lochia alba) as the postpartum period progresses.