What happens after you have a baby

Pregnancy is a waiting game. We count down to 40 weeks, get everything ready, wonder about labor and delivery, and when it's all over, baby is here! And a new phase begins: postpartum. What happens after you have a baby? It's not something that is talked about quite as much. Depending on the way baby is delivered—whether a vaginal delivery or surgical delivery called a cesarean section--there are several similarities and differences to consider.

Let's talk about similarities.

Sleep disturbances. Sleep will be interrupted. Whether you choose to feed your baby breastmilk or formula, you will need to do so at intervals of every few hours initially.

Breast engorgement. Breast engorgement, or milk production, can be uncomfortable. Expressing milk if you are breastfeeding, using hot washcloths or ice packs, and wearing a tight-fitting bra are helpful to relieve this discomfort.

Vaginal discharge. Regardless of mode of delivery, you will have vaginal bleeding and discharge called "lochia" after your delivery. Lochia is a product of the uterus healing itself after pregnancy. This can vary in amount and length, but in general starts out like a normal menstrual period and will taper off during the ensuing weeks.

Mood changes. The postpartum period is a time of significant change, both in your family life and in your body. It is very common to experience mood swings and feelings of sadness, anxiety, and hopelessness, especially within the first two to three weeks after delivery. Some women go on to develop postpartum depression and may require treatment for this.

Please be sure to talk with your health care provider if you experience any mood changes. While it is normal, your provider may be able to give you tips and resources to support you during this time of significant change in your life. For you and baby, your emotional health is just as important as your physical health.  

Now, let's address some differences.

Pelvic rest. Pelvic rest is recommended for 6 weeks following both a surgical and vaginal delivery with a vaginal tear or episiotomy. This means avoiding sex, the use of tampons, and vaginal douching. Some women may not have a tear and want to have intercourse at less than 6 weeks following a vaginal delivery. In this situation, that is reasonable as long as you are preventing pregnancy!

Incision. A visible difference of frequent concern with a cesarean section is the abdominal incision. This requires incisional care to avoid infection and also makes doing things like sitting up or turning over in bed more painful, at least at first. Stronger medications are often prescribed to assist with this discomfort and these are safe while breastfeeding.

Lifting/activity restrictions. It is recommended that you avoiding lifting anything heavier than 15 pounds until 6 weeks after your cesarean surgery, as it could disrupt the strong layer called the "fascia" which was stitched back together after your surgery. Additionally, after a cesarean section, you should avoid strenuous activity during this 6 week time period. Walking is okay, and is actually encouraged to help with the healing process. Be careful not to overexert yourself, no matter your mode of delivery.

One thing I always encourage patients to remember, regardless of mode of delivery, is the biggest similarity: you have just welcomed a new little person into your life! Your heart will be so bursting with love that it makes the recovery process a little bit more tolerable.