Women's Health

Postpartum recovery timeline: What to expect in the weeks and months after birth

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You've just had a baby. It's miraculous, beautiful, terrifying and already exhausting in equal measure.

Whether you've had a c-section or vaginal birth, whether your baby was delivered in water or while you were hooked up to machines, you've been through a lot to bring your baby safely earth-side.

And all postpartum women deserve the highest praise imaginable for this achievement.

In the lead up to your first birth, you may have attended childbirth classes with your birthing partner.

These classes are important for getting you into the headspace of childbirth, for asking your midwife questions and for demystifying the birth suite experience.

But we are so rarely prepared for the bits after birth: The postpartum recovery.

Your postpartum recovery timeline will stretch until at least six months after your birth and can be a complicated landscape to navigate.

If this doesn't seem fair to you, you are right— it's really not!

You are soaking up your new baby, completely sleep-deprived and trying to adapt to the new normal of parenthood, but you will also be contending with bruising, scarring, postpartum bleeding, afterbirth pains and cramps, vaginal discharge, swelling and constipation.

Also, you'll cry. A lot. An intense fluctuation of hormones post-birth can give you the baby blues between moments of complete euphoria.

It's an incredible time of change and healing, so drawing upon your support network, as well as having some nifty postpartum care items on hand, will be vital for staying well and recovering as quickly as possible.

How long does it take to recover after giving birth?

Whether you have given birth vaginally or via C-section, you've been through one of the most primal, natural things a person can go through.

However, just because it was natural doesn't mean your body didn't go through trauma to get your baby out safely — it's been stressed and stretched to the max.

The recovery timeline will be different for every woman, but the most important thing is this: Do not pressure yourself into a quick recovery. The postpartum period is about bonding with your baby, resting, asking for help, resting, healing and resting. Did I mention rest?

Rest is not just about sleep — it is about slowing down, listening to your body, nourishing it and letting it do its thing.

Scars need to heal, blood needs to leave your body and your hormones need levelling out.

According to the American College of Obstetricians, postpartum recovery will normally take at least six to eight weeks, going up to 12 or longer depending on birth complications and your overall health.

The WHO defines the postpartum phase as beginning immediately after the birth of the baby and extending for up to six weeks (roughly 40 days).

How long does it take for your pelvic floor to recover after birth?

The uterus is a muscle that expands with a baby and contracts when the baby is out.

By the end of pregnancy, the uterus will have grown outside of the pelvis to just below the breasts, pushing most of your organs to the sides to accommodate your baby.

And, within minutes of the birth, your uterus will start to shrink again, however, it will take about six weeks to fully return to its previous size.

As it shrinks, you will feel uterine contractions which is a pain similar to menstrual cramps.

These will be especially painful if you are breastfeeding. Breastfeeding and nipple stimulation trigger a hormone known as oxytocin to be released into your bloodstream, which helps the uterus contract back into its pre-pregnancy size.

Don't worry if you aren't breastfeeding though as oxytocin, also known as the bonding hormone, is released with skin-on-skin contact between you and your baby.

Not only is snuggling your baby helping them feel safe, love and bonded to you, it's also helping your uterus recover!

Unfortunately, cramps are a totally normal part of the postpartum recovery process as the body works hard to shrink your uterus and limit bleeding. Painkillers and a heating pad can help ease this pain.

The postpartum recovery timeline

The term "postpartum recovery" is often used to describe the first six to 12 weeks after you give birth, but your physical and mental recovery from pregnancy and birth may take much longer.

So much has changed; family dynamics, your sense of self, your body shape and much more so this all plays into your recovery.

Many women still feel like they are in a postpartum stage up until the baby turns one, and that is completely valid.

Here is a non-exhaustive guideline of what to expect.

The first few days

Congratulations! Your baby is here.

The birth itself will be different for every woman, but all women will experience the following bodily and emotional changes as they start to adjust to life with a bub.

  • Pain: We're sorry to say that pain is unavoidable after a baby's birth. Perineal pain, sore nipples, back pain, episiotomy scars, afterbirth cramps and hormonal shifts will mean you need all the support you ask for. The right postpartum equipment is essential, as well as reaching out to your support network to bring you hot meals at home, do your laundry, bring you cups of tea and sometimes to hold your baby while you rest.
  • Sleep? What sleep?: Apart from the fact it's difficult to sleep in a hospital ward, your baby will be waking up with hungry cries every two to three hours looking for you. Babies are confused at this point — where am I? What happened to the safety of my lovely womb? The only thing in the whole world they understand is you, that you know them, love them and your body is their home. Skin-to-skin contact, as well as colostrum and milk, is what your baby needs, so whip your top off and let your baby snuggle up to you as often as you can.
  • Toileting after childbirth: After the birth, your bowels will be blocked up. Your midwife or obstetrician will watch you closely and if you cannot pass urine within a few hours, a catheter will be inserted to help it out. Bowel motions will also be few and far between, so start taking stool softeners straight away.
  • Breastfeeding: Your midwife will be helping your baby latch within the first few hours of birth. This is often harder than most women anticipate: Your nipples will become sore and there may be some light bruising, and your breasts will become heavy, hot and leaky when your milk comes in. Use breast pads for soaking up excess milk in your maternity bra and nipple balm for those painful nipples. And don't be afraid to ask for as much help as you need to get that latch right.
  • Colostrum becomes milk: While in hospital, your midwife or lactation consultant will be helping you get this magical liquid gold into your baby through breastfeeding or through syringe extraction — the latter may happen if your baby takes a bit longer to latch or if you're not going down the breastfeeding path. Colostrum is a thick, sticky substance that will eventually turn into milk after a few days, and they call it "liquid gold" as it's packed with antibodies for your baby's first ever snack; it helps fight infection, assists with important physiologic functions, maintains the baby's blood sugar and even has a laxative effect. You'll only produce a few teaspoons of this amazing stuff, but that's all your baby needs before it thins out and becomes milk.
  • Hormonal shifts: After you give birth, you may feel very weepy, fragile and prone to feelings of sadness. This is normal and is not necessarily postpartum depression! Progesterone and estrogen, the hormones you had an abundance of during pregnancy, decrease as soon as both the baby and the placenta are delivered. Oxytocin, the bonding hormone, surges immediately following birth to compensate for the initial drops in progesterone and estrogen. Oxytocin will help your mothering instincts kick into gear, but the rapid hormonal shift will certainly set off an emotional rollercoaster. Rest assured these hormones start to even out within three to six weeks postpartum.
  • Swelling: This won't happen to all women after birth, but many experience swollen legs, face, feet, ankles, hands and arms within the first few days. During your pregnancy, you retained a lot of fluid to keep your baby healthy and that won't disappear overnight. This, combined with an IV drip with your C-section or epidural, means that there's a lot of water floating around your body. Elevate your legs, walk around the house when you can, dress in light clothing and drink lots of fluids to help ease swelling. Compression stockings and some light massage can also help.
  • Vaginal delivery recovery: Depending on how much you have torn, your vagina will hurt. A lot. Perineal pain is normal and can be soothed by treating your vagina like an open wound. Use a perineal spray bottle instead of wiping as wiping can accidentally open up stitches. Cold pads for your underwear are lifesavers to help heal and numb the ache. Witch hazel foam is also extremely helpful for soothing hemorrhoids which may develop from all the pushing you did in labour. And of course, maxi pads are necessary for vaginal bleeding, which will start immediately after the birth and last for a few weeks. You may even need more than one pad an hour. For keeping cooling pads and maxi pads in place, a pair of comfy, high-waisted mesh undies will work wonders.
  • C-section delivery recovery: One in three Australian women opt for a cesarean birth. You will likely have a longer stay in the hospital than if you had a vaginal delivery just so the midwives and doctors can keep an eye on you. A C-section is a major surgery that requires lots of care and as much rest as possible. The incision will be very delicate and doctors actually recommend you hold your abdomen when you need to sneeze or cough. A belly band can work well for C-section recovery as they are proven to reduce swelling, protect the incision and even provide pain relief. Unfortunately, C-sections don't let you off the hook with vaginal bleeding, so mesh undies and maxi pads will be your best friends for a while.

Kin's Postpartum Recovery Kit (above) includes everything you need — and nothing you don’t — to help heal your vagina and relieve discomfort. The C-Section Recovery Kit is perfect for those recovering from a caesarean birth.

The first few weeks

You will be starting to get the hang of this whole baby thing. Great work!

But you should still expect little of yourself physically and emotionally, this is only the beginning of your postpartum recovery timeline.

Call upon family and friends to support you as much as you need — accept help, ask for help and know that this is your time to be looked after.

  • Blood: Over the next few weeks you will be losing a lot of blood from your vagina regardless of your vaginal or c-section delivery — blood is inescapable. After the first three weeks, your blood will go from bright red to a dark brown, just like at the end of your regular period, then you'll experience a decrease in flow and then it will disappear.
  • Pain: You will still be in some pain in your perineum and nipples, but your cramping should have stopped by now. Your perineum wounds will have healed up within four to weeks postpartum as new tissue grows in the torn area. Talk to your healthcare professional if you don't think you're healing properly and use pain meds as directed.
  • Breastfeeding: Your breast milk should be established by now and you will be leaking all over the place as you establish a feeding routine with your baby. It will be sticky and you will wet through a number of shirts, but this is totally normal! Breast pads will still be essential for the first six months of breastfeeding.
  • Constipation: This will likely still be an issue in the first few weeks of birth. Keep stool softeners on hand and, if you can, do some light walking to get things moving down there, but avoid strenuous exercise.
  • First postpartum checkup and midwife visit: After one week, you will be expected to visit your GP so they can examine your new baby and to ensure you're recovering well. Ask them to check your blood pressure, your perineum or your C-section scar and arrive armed with any questions you might have about recovering. Within two to three weeks, a midwife will come and visit you in your home to check up on your baby, your recovery and your mental wellbeing. You can ask them as many questions as you need to — they are there to support you. Don't forget you can also hire a private lactation consultant or postpartum physio to visit you at home to give you that extra support.
  • Postpartum hair loss: The drop in estrogen, the hormone that made your hair and nails strong and shiny throughout your pregnancy, will lead to your hair falling out. Don't be surprised if you find lots of hair in the shower drain, on your pillow and around your house — this is normal and stops around the six-month mark.
  • C-Section: your incision will still be healing and so the belly band and cold packs will still be necessary at this point. You also won't be able to drive until the six-week mark, so make sure you're delegating lots of tasks to those around you.
  • Exercise: Avoid strenuous exercise, but do take gentle walks as often as you can. The movement will help your body heal and prevent constipation and blood clots. Plus, walks are a great way to introduce your baby to the world. Keep up those pelvic floor exercises while at home.
  • Hormonal shift: If you are still feeling the "baby blues" (depressed, anxious or having trouble bonding with your baby), this is OK and nothing to be ashamed of. Your hormones will have balanced out after two to three weeks, but if you believe you may have the beginnings of postpartum depression, contact your midwife, GP, counsellor, psychologist or social worker. They will help you organise a support plan to make sure your emotional health stays well.

One to three months

  • Pain: By the three-month mark, your perineal pain will have subsided completely, and your C-section incision would also have healed up. Keep up the creams and balms on your C-section scar to help it along and to prevent itchiness.
  • Breastfeeding: Your baby will grow and need more milk in a short space of time. Cluster feeding will happen at the five to six-week point for both breast and formula-fed bubs, meaning there will be a period of 24 to 48 hours where it will feel like you are constantly feeding your baby. This is normal — your baby is letting your breast milk know they have to increase in production to keep up with your growing baby. A feeding routine will have been established by now, but if you are experiencing hard, hot, lumpy breasts you may have the beginnings of mastitis. Try heat packs on the breasts, massage them in hot water or use a lactation massager to help unblock ducts and keep breast production moving.
  • Exercise: At this point, some light walking is recommended for both C-section and vaginal delivery, but strenuous exercise is still not recommended. Walking can help with constipation, preventing blood clots and aids the overall healing process. Plus, your baby will love being pushed in a pram and getting acquainted with the world.
  • Your tummy: After birth, your tummy will be wobbly. It's a fact. You might have been hoping to "snap back" quickly after birth, but this timeline will be different for every woman. It is normal for your tummy to look flabby as it recovers from holding a baby for nine months, and it's important you do not put pressure on yourself to change quickly. Eat nourishing foods and do some light exercise at this point. The most important thing is ensuring you and your baby are healthy.
  • Bladder control: After birth, most women will experience urinary incontinence to some degree. Be prepared to accidentally pee yourself after sneezing, coughing, laughing or during exercise. This is all totally normal due to the stretching of the pelvic floor muscles during pregnancy and delivery. Pelvic floor exercises are vital for helping for preventing long-term incontinence. But if your tummy still looks pregnant or feels abnormally large, call your doctor, as you might be experiencing abdominal separation and require help treating this.
The Lactation Massager helps unblock milk ducts, stimulates milk production and flow, aids let-down reflex, relieves swelling and fights off infection.

Three to six months

You are doing so well. Your baby will now be smiling, laughing and making little noises at you.

But they still need you more than anything else in the world. Skin-to-skin contact is still highly beneficial for your baby as they navigate this whole new world.

Your postpartum symptoms will be starting to completely subside. Your C-section incision/perineum pain should be gone, but if it hasn't, please talk to your doctor.

At this point, you will still be experiencing postpartum hair loss and issues with bladder control (keep up those pelvic floor exercises), but you will also be cleared for sexual activity and more exercise than walking.

Your C-section scar might feel numb or itchy, but it will be generally healed. Your period may come back within three to six months, although this may take longer if you are breastfeeding.

And, you may be feeling overwhelmed and exhausted. You are still in the postpartum recovery period, and life has changed forever.

If you are experiencing severe feelings of depression and anxiety, reach out to a mental health professional. Postpartum depression is highly prevalent in Australian women — you are not alone.

Six months to one year

By now, you're a baby expert. Your baby will start to roll over, clap and show signs of wanting to play.

Your baby's feeds will be more spaced out, allowing you to sleep slightly longer, and you have survived cluster feeds, leaking breasts, poo explosions, and many a sleepless night. You are amazing.

If your period hasn't returned, it should come back sometime within six to 12 months.

Your milk will be well and truly established and, if you're not breastfeeding, it would have completely dried up by now. Your hair will have stopped falling out and you'll have much more control over your bladder.

Postpartum depression can actually occur at any time within the first year of your baby's birth, and not necessarily within the first few weeks.

According to the American College of Obstetricians and Gynaecologists, a person is more likely to develop postpartum depression if they have had a history of depression, but also if they have little in the way of support from family and friends.

If you think you have postpartum depression, a combination of talk therapy, getting support with your baby, minimising fatigue and, sometimes, antidepressants can help.

Can I speed up the postpartum healing process?

Sometimes in life, you have to let nature take its course. Healing from birth takes time and if you look after yourself as much as your baby after delivery, this will ensure a smooth recovery — it is far better to recover well than to hope for a speedy recovery.

But most importantly, you are in charge here. You are the one who knows your body best, who knows what you can and can't handle and only you know how well you're recovering.

This postpartum recovery timeline is not a fixed guide.

Your recovery will depend on many factors including the health of your baby, complications during labour and delivery and many other lifestyle and health-related aspects.

While you technically can't speed up the recovery process, you can slow it down if you do not get enough rest, if you put pressure on yourself to exercise quickly, or if you do not ask for help.

Ease pain, rest, use your postpartum essentials, cuddle your baby and don't worry about your baby weight — all these things will happen in the time that is right for your body.

You are amazing for all you've achieved and now it's time to let your support network take care of you.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992410/

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care

https://www.nwh.org/patient-guides-and-forms/postpartum-guide/postpartum-chapter-2/postpartum-care-pain-management

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7495339/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094397/?report=reader 

https://www.nwh.org/patient-guides-and-forms/postpartum-guide/postpartum-chapter-2/postpartum-care-pain-management

https://www.cdc.gov/breastfeeding/data/mpinc/maternity-care-practices.htm

https://pubmed.ncbi.nlm.nih.gov/32761813/

https://www.medela.com.au/breastfeeding/mums-journey/colostrum 

https://www.thewomens.org.au/health-information/pregnancy-and-birth/your-health-after-birth/what-to-expect

https://www.betterhealth.vic.gov.au/health/healthyliving/caesarean-section

https://pubmed.ncbi.nlm.nih.gov/28241386/

https://raisingchildren.net.au/grown-ups/looking-after-yourself/new-mums/new-mums-first-weeks

https://www.aad.org/public/diseases/hair-loss/insider/new-moms 

https://raisingchildren.net.au/newborns/breastfeeding-bottle-feeding/breastfeeding-challenges/blocked-duct-mastitis-abscess 

https://www.ncbi.nlm.nih.gov/books/NBK555904/

https://www.acog.org/womens-health/faqs/postpartum-depression

https://www.acog.org/womens-health/faqs/postpartum-depression