After Pregnancy and Childbirth (Postpartum): The Body’s Return to Normal

Area Affected	What Happens
Uterus	After delivery, the uterus contracts as it returns to a nonpregnant size, which takes several weeks. These contractions cause lower abdominal cramps, which can be painful.
Vaginal discharge (lochia)	For 3 to 4 days after delivery, a woman has vaginal bleeding and may pass blood clots. The volume of bleeding should be the same or lighter than a menstrual period. After a few days, the bleeding becomes lighter and turns into a blood-tinged vaginal discharge for up to 2 weeks. This becomes lighter in volume and color over time. The discharge turns pale brown for about 2 weeks and eventually becomes yellowish white. Overall, vaginal discharge may continue for up to 6 weeks after delivery. At about 1 to 2 weeks after delivery, women may have a gush of blood from the vagina. Inside the uterus, a scab forms over the site where the placenta was attached. When the scab comes off, about a cup of blood is released by the uterus.
Vagina, vulva (labia), and perineum (skin between the vulva and the anus)	After vaginal delivery (or after labor and pushing, even if a woman ended up having a cesarean delivery), the vagina and surrounding tissues (vulva and perineum) are usually sore and swollen. Tears of the tissue from delivery or an episiotomy (an incision that widens the opening of the vagina to make delivery easier) are repaired with stitches, which may also make the area sore. The area may sting during urination. Swelling of the vagina and surrounding tissues resolves in 1 to 2 weeks. Complete healing of a tear or episiotomy requires about 6 weeks. Sexual activity is not recommended until at least 6 weeks after delivery. Some women, particularly those who are breastfeeding, may experience vaginal dryness or pain with sexual activity after delivery. If there is severe or persistent pain, a woman should contact her health care professional.
Fertility	A woman may be able to become pregnant again as early as 2 weeks after delivery.
Urination	Urine production often increases noticeably after delivery. It usually returns to normal within about 2 weeks.
Bowel movements	The first bowel movement after delivery may be difficult, sometimes with hard stool or pain in the anal area. This is sometimes because the vulvovaginal area is sore. Also, the first bowel movement may be delayed for a few days, sometimes because a woman is concerned about bearing down and putting stress on stitches. The pushing during delivery or constipation after delivery can lead to or worsen hemorrhoids, which can be painful during bowel movements or in general. Hemorrhoids usually resolve within 2 to 4 weeks after delivery. Women who had a cesarean delivery or other reason to have severe pain may be prescribed opioid pain medications, which can cause constipation.
Breasts	For the first 2 to 6 days after birth, the breasts produce colostrum, which is thick and usually yellow. The breast then begins to produce milk. When this transition happens (called "when the milk comes in"), the breasts become more full and warm. The milk is white in color and a thinner consistency than colostrum.
Abdomen	After delivery, a woman's abdomen may initially look like she is still pregnant, but the abdomen gradually reduces in size over about 6 weeks as the uterus contracts and muscle and skin tone increases. Abdominal muscle tone is low after delivery because the muscles have been stretched, but tone gradually increases. In some women, the abdominal muscles separate in the midline and a gap can be felt (diastasis). This gap closes in some women over several weeks to a month, but in some women it is permanent. Abdominal skin tone may return to normal or, in some women, the skin remains looser than before pregnancy. Stretch marks on the abdomen do not go away, but they may fade over a period of years, turning from red or purple to silver. After cesarean delivery, the incision is closed with sutures, staples, or surgical glue. Usually there is a bandage that is removed after a few days. Complete healing of the incision takes 6 weeks.
Heart rate	The heart rate, which is increased during pregnancy, starts to decrease within the first 24 hours and returns to normal soon thereafter.
Temperature	Body temperature may increase slightly during the first 24 hours after delivery, usually returning to normal during the first few days. If a woman has fever of 100.4° F (38° C) or higher and/or chills at any time during the first 6 weeks after delivery, and especially during the first week, she should call her doctor. Many women get night sweats for a few weeks after delivery. These are due to hormonal changes, particularly the decrease in estrogen levels. However, if night sweats continue after 4 weeks post-delivery, a woman should contact her health care professional.
Weight	Many women do not lose weight immediately after delivery, and weight may even increase during the first few days. Although the baby and placenta have been delivered, the uterus is still enlarged. Also, increased fluid in the blood from pregnancy and sometimes additional intravenous fluid received during labor are still present, and breast milk may add weight. Extra fluids leave the body through urination during the first 2 weeks. A return to prepregnancy weight usually takes 6 to 12 months, with healthy eating and exercise habits.
Hair	Many women are concerned about hair loss in the first several weeks after delivery. However, this is actually the loss of excess hair that was retained during pregnancy. In a nonpregnant state, about 50 to 100 hairs fall out per day. During pregnancy, higher estrogen levels result in fewer hair follicles entering the resting phase (hair falls out during this phase). So, during pregnancy, hair is thicker than normal. However, after delivery the estrogen levels and hair growth cycle return to normal, so the additional hair falls out.
Mood	Many women feel blue or mildly depressed in the first 6 weeks after giving birth. The sad mood (called "postpartum blues" or "baby blues") usually passes after about 2 weeks. Some women also feel anxious about themselves or the baby. If depression or anxiety is severe or does not resolve after 2 weeks or if there are any other mental health symptoms, a woman should call her health care professional.

Area Affected

What Happens

Uterus

After delivery, the uterus contracts as it returns to a nonpregnant size, which takes several weeks. These contractions cause lower abdominal cramps, which can be painful.

Vaginal discharge (lochia)

For 3 to 4 days after delivery, a woman has vaginal bleeding and may pass blood clots. The volume of bleeding should be the same or lighter than a menstrual period.

After a few days, the bleeding becomes lighter and turns into a blood-tinged vaginal discharge for up to 2 weeks. This becomes lighter in volume and color over time. The discharge turns pale brown for about 2 weeks and eventually becomes yellowish white. Overall, vaginal discharge may continue for up to 6 weeks after delivery.

At about 1 to 2 weeks after delivery, women may have a gush of blood from the vagina. Inside the uterus, a scab forms over the site where the placenta was attached. When the scab comes off, about a cup of blood is released by the uterus.

Vagina, vulva (labia), and perineum (skin between the vulva and the anus)

After vaginal delivery (or after labor and pushing, even if a woman ended up having a cesarean delivery), the vagina and surrounding tissues (vulva and perineum) are usually sore and swollen. Tears of the tissue from delivery or an episiotomy (an incision that widens the opening of the vagina to make delivery easier) are repaired with stitches, which may also make the area sore. The area may sting during urination.

Swelling of the vagina and surrounding tissues resolves in 1 to 2 weeks. Complete healing of a tear or episiotomy requires about 6 weeks. Sexual activity is not recommended until at least 6 weeks after delivery.

Some women, particularly those who are breastfeeding, may experience vaginal dryness or pain with sexual activity after delivery. If there is severe or persistent pain, a woman should contact her health care professional.

Fertility

A woman may be able to become pregnant again as early as 2 weeks after delivery.

Urination

Urine production often increases noticeably after delivery. It usually returns to normal within about 2 weeks.

Bowel movements

The first bowel movement after delivery may be difficult, sometimes with hard stool or pain in the anal area. This is sometimes because the vulvovaginal area is sore. Also, the first bowel movement may be delayed for a few days, sometimes because a woman is concerned about bearing down and putting stress on stitches.

The pushing during delivery or constipation after delivery can lead to or worsen hemorrhoids, which can be painful during bowel movements or in general. Hemorrhoids usually resolve within 2 to 4 weeks after delivery.

Women who had a cesarean delivery or other reason to have severe pain may be prescribed opioid pain medications, which can cause constipation.

Breasts

For the first 2 to 6 days after birth, the breasts produce colostrum, which is thick and usually yellow. The breast then begins to produce milk. When this transition happens (called "when the milk comes in"), the breasts become more full and warm. The milk is white in color and a thinner consistency than colostrum.

Abdomen

After delivery, a woman's abdomen may initially look like she is still pregnant, but the abdomen gradually reduces in size over about 6 weeks as the uterus contracts and muscle and skin tone increases.

Abdominal muscle tone is low after delivery because the muscles have been stretched, but tone gradually increases. In some women, the abdominal muscles separate in the midline and a gap can be felt (diastasis). This gap closes in some women over several weeks to a month, but in some women it is permanent.

Abdominal skin tone may return to normal or, in some women, the skin remains looser than before pregnancy. Stretch marks on the abdomen do not go away, but they may fade over a period of years, turning from red or purple to silver.

After cesarean delivery, the incision is closed with sutures, staples, or surgical glue. Usually there is a bandage that is removed after a few days. Complete healing of the incision takes 6 weeks.

Heart rate

The heart rate, which is increased during pregnancy, starts to decrease within the first 24 hours and returns to normal soon thereafter.

Temperature

Body temperature may increase slightly during the first 24 hours after delivery, usually returning to normal during the first few days. If a woman has fever of 100.4° F (38° C) or higher and/or chills at any time during the first 6 weeks after delivery, and especially during the first week, she should call her doctor.

Many women get night sweats for a few weeks after delivery. These are due to hormonal changes, particularly the decrease in estrogen levels. However, if night sweats continue after 4 weeks post-delivery, a woman should contact her health care professional.

Weight

Many women do not lose weight immediately after delivery, and weight may even increase during the first few days. Although the baby and placenta have been delivered, the uterus is still enlarged. Also, increased fluid in the blood from pregnancy and sometimes additional intravenous fluid received during labor are still present, and breast milk may add weight.

Extra fluids leave the body through urination during the first 2 weeks. A return to prepregnancy weight usually takes 6 to 12 months, with healthy eating and exercise habits.

Hair

Many women are concerned about hair loss in the first several weeks after delivery. However, this is actually the loss of excess hair that was retained during pregnancy. In a nonpregnant state, about 50 to 100 hairs fall out per day. During pregnancy, higher estrogen levels result in fewer hair follicles entering the resting phase (hair falls out during this phase). So, during pregnancy, hair is thicker than normal. However, after delivery the estrogen levels and hair growth cycle return to normal, so the additional hair falls out.

Mood

Many women feel blue or mildly depressed in the first 6 weeks after giving birth. The sad mood (called "postpartum blues" or "baby blues") usually passes after about 2 weeks. Some women also feel anxious about themselves or the baby. If depression or anxiety is severe or does not resolve after 2 weeks or if there are any other mental health symptoms, a woman should call her health care professional.

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Overview of Postpartum Care