Here are some handy postpartum recovery tips from a L&D nurse. Your uterus is now healing from a “placenta scab” left from the baby making their exit. This post includes info on pads, pain medicine, and the timeline you’ll likely follow.
Having a baby is hard work! Sometimes you don’t think about all that your body is going through (or WILL go through AFTER you go through labor). I know I was guilty of thinking I’d be 100% back to normal when I got out of the hospital. Wow, was I in for a surprise!
First off, hello! I’m Hilary — many people know me as The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience. I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have had 3 babies of my own, I have seen THOUSANDS of moms deliver, and taught them what to watch for when bleeding is problematic.
I think having a PLAN for life postpartum is going to be a BIG win. Grab my starter pack here:
Table of contents
If you’re looking to learn more about your postpartum recovery, I love this class for it. Whatever you do make SURE to take a class that thoroughly covers what to expect in life after baby. Your life will thank you for it! It now includes my BRAND NEW class Postpartum Care Made Easy.
This is a topic I am so passionate about I actually just did a podcast on it (especially on 4 areas that can be real trouble) I think it will help you know even more what to expect!
And, I also made a video on how we help your bottom to heal after baby that I think you’ll find helpful:
Ok, let’s dive in:
Your Placenta Scab
I know, super gross right.
But I think a lot of time women wonder why they need to to go slow those first few weeks after having their baby.
Yes, your bottom has had a big change, but you also need to realize what your uterus has gone through as well!
When the baby exits, within a few minutes the placenta comes off. That leaves a big wound on your uterus where the placenta site was.
It slowly applies “direct pressure” (think back to first aid class) by cramping back down to its normal size. The uterus contracts and causes this.
It helps to visualize that if you got a cut on your hand, if you made a fist, it would help put pressure on that area and stop the bleeding.
So, when your uterus cramps down (or goes back to a “fist”) it helps that area not bleed out. If for some reason, your uterus stop cramping down and becomes loose (or, boggy – -that’s what we call it) it can be a real problem.
After you have your baby, the nurse will push on your uterus to make sure that it cramping back down, to prevent a postpartum hemorrhage (which can be REALLY bad). It is a good idea to just breathe when they do it — and yes, I do talk a LOT about this here.
Keep in mind the uterus has a TON of blood flow right after delivery, because it was just growing a human. Your body needs to slow that down as well as stop the bleeding from the scab. Every delivery is very similar to major surgery (even though you won’t have scars on the outside).
This is all just the normal process of the placental site scab (but not fun). But if there’s ever a question about your bleeding, be sure to seek medical help.
Placental Scab FAQ’s
It varies for each person. And it lengthens with each pregnancy. Most new moms stop around 3 weeks postpartum but some go shorter and many bleed up into their 5th week. Most people stop by 6 weeks.
It is often like a very heavy period once you go home from the hospital, and then tapers from there.
With each baby, women likely bleed more and longer. Your uterus is just getting more tired and doesn’t cramp down as well. It is not unusual to have more prolonged heavy bleeding when you’ve had several babies.
It is from where your placenta attached to your uterus so that your body could feed your baby as it grew.
If a part of the placenta stays attached, it’s called retained placenta. It can cause increased bleeding and possibly even infection.
When you deliver, your healthcare provider will check your placenta to make sure that it is intact. If there is a question, they may go into your uterus to check (using their hand). And if they think there is retained placenta, you may go to the OR to get it removed.
I do not — I have a post on placentophagy which shares why I don’t recommend it.
Yes, as the placental scab is still there, you will still bleed, just like a vaginal birth (most of the bleeding with a vaginal birth is from the placenta, not the birth canal).
It is the tissue that grows next to your uterus to give your baby nutrients and take away waste through the umbilical cord.
Your nurse will assess your bleeding in the hospital and you should get a good idea of what’s normal for you (because it REALLY varies). When you go home, if that increases, you need to call your provider.
Again, you’re doing too much. Unless it’s enough to soak through your pads and panties I’d clean up, put a new pad on, rest with my feet up and see if it keeps happening — or, contact your provider with any questions.
Also, take note of the type of blood. If it’s brown, that’s older blood (not as worry-some). If it’s a sudden gush of bright red blood, that’s more problematic.
Most often it’s because you are doing too much (and not allowing your uterus to cramp back down). However, sometimes pieces of the placenta can be left behind (even if your provider looks to make sure it’s intact). That requires medical treatment.
That first week can be a doozy, but it should get a little better — bit by bit. It can seem like a long time though.
In my first prenatal class I took, they acted like it would all be unicorns and rainbows after the baby came home. When I created my own class I knew I wanted it to be different. I wanted to let you know exactly what to expect.
Postpartum Recovery
Feeling overwhelmed — grab my postpartum recovery checklist:
Get the Best Postpartum Pads
Your uterus has a giant placenta-sized scab. Your placenta peels off after your baby is born and you are left with a big wound inside you that has to heal. That means you can’t move your household the week after you have a baby {guilty!}.
If your bleeding starts back to bright red or increases you need to SLOW DOWN.
Let me say it again (because I get a LOT of emails about it)…
If your bleeding picks back up after it has slowed down — you NEED TO SLOW DOWN. It is mother nature’s tip that you’re doing too much!
Your uterus will thank you for it! BTW, it’s smart to have some GOOD sanitary pads at home, so you don’t have to worry about leakage — something like these are nice (it seems like overkill, but it’s not), and I’ve also heard of people really liking these.
Postpartum Pain Management
For cramping pain — most people take ibuprofen. Ibuprofen needs to be taken with a meal. I was guilty of popping ibuprofen like it was candy on #3. Those after-birth cramps weren’t pretty. I would have taken an epidural with some of them if they had offered it. I ended-up ripping up my stomach lining and it hasn’t been the same since. {sad face}. Ibuprofen is GREAT for cramps — just take it with food {and, FYI — with each baby the cramps get worse, hooray!}
In my postpartum comforts I go over some of the things to keep you comfortable — but I hear SO many good things about this stuff — I’d definitely check it out!
Some doctors will also provide you a prescription medication that you might take for further pain. Please remember that you shouldn’t drive when you’re on prescription pain killers.
This just in: I just did a Tushy Review. Cliffnotes: It’s amazing. Check it out! {save 10% with code CURLS too!} It sprays water on your bum. It’s not hard to install and I may have had a love affair with it postpartum if I’d had it back then!
Postpartum Blood Clots
You shouldn’t be passing clots larger then a golf ball. If you are, you need to call your doctor.
Be sure that you have a BIG pad for when you get home. I recommend these for the first few days home, and this pack for after that. I’ve also heard a lot of people loving these undies.
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Postpartum recovery timeline
In general you should be bleeding less and less each day. If you notice a lot more bleeding suddenly, that’s mother nature’s sign that you’re working too hard. Even if you think you’re not — do less. Your body needs that!
Every person’s timeline will be different… just know it should be a little better each day….
Pro Tip: Bright red bleeding is new blood and darker brown’ish blood is older.
What to do if your bleeding is slowing down and suddenly is more?
This is a sign that you’re doing too much.
You might not FEEL like you’re doing a lot — but that really is what it is.
Do less, drink more water. Put your feet up more. Less walking and less carrying things (besides the baby).
Postpartum Swelling
Likely, after the hospital you’ll be swollen. BUT, in your postpartum recovery you will pee. A lot. You will sweat, a lot. Your blood volume increase like CRAZY when you are pregnant — your blood’s just going back to normal. Free weight loss, enjoy!
Postpartum Depression – how to know?
If you have been more crying then happy and you’re on day 3 of that — you need to call someone. It’s not a perfect rule of thumb — but it’s a good start. It really helps you know the difference between baby blues (which are totally normal) and when it’s a problem. Emotional swings are totally normal, but living on one end of that swing set isn’t good for you. There are a lot of ways to get help, and talking to someone about it is the first start. If your OB is worth their paycheck, they should be concerned about you and want to know.
I love this podcast I did on postpartum mental health with a social worker.
Whatever you do. Be kind to yourself. There’s just a lot going on with your body. Rest, love, and give yourself time to adjust to the change. Make sure family members are checking on you (and not just the baby).
Postpartum Discharge
It’s normal for the bleeding to taper (like we’ve talked about previously), and then maybe just have some different vaginal discharge for a bit as your uterus fully heals. If it smells (a foul odor) or looks foul, call your provider.
Related Post: Postpartum Comforts & What to do before baby
Ok, if you are still pregnant, NOW is the time to get prepared for all this kind of stuff with a high quality prenatal class. After 20 years in the delivery room I know SO many families just can’t fit it in — which is why I created the solution just for you.
- Use Hilary’s 20 years at the bedside to help you know what you NEED to know.
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If you’re not quite sure you’re ready for the full class, check out my free birth toolkit — you can sign up right here:
Amber says
OMG. Way to freak me out hahaha. Then again, would I rather be expecting golf ball sized clots or just pass a few without knowing. I’d think I was dying!! So, Thank you for your list. I will keep those in mind as these months pass by and try not to have a panic attack about not being able to clean my house that first week or so hahahahaha.
Katie Harding says
They get worse with each baby? {Sad face, indeed!} Can’t wait to have baby #3 in August, but I remember wishing I could put them back in!
Hilary says
It is a huge sad face. I wonder if, at a certain baby, they level out. I mean — Ms Duggar must’ve needed an epidural AFTER, right?
Christina says
I found that they were the same after baby #3 and baby #4. So maybe after the 3rd?
Hilary says
That makes sense. I never made it to the magical land of 4. 🙂
Hilary says
Katie, just make sure you take ibuprophen with food. If you keep up with that you should be OK {I thought I could take it without food and I KILLED my stomach — WAY awesome!}
Jamie Blanchette says
Got any advice on breastfeeding. I feel like in losing my milk. It’s completely stopped on one side. Baby is 6 weeks now. He seems to be getting enough but in still concerned. Thanks for any input.
Hilary says
Huh, that is a normal time for supply to taper. I would see a lactation consultant, if you can. I would make sure you’re drinking a lot. You could try a fenugreek tea….
Pam says
The only thing I would add is that sometimes Postpartum depression isn’t just about the crying. I was seriously apathetic. By week two my mom was worried but I figured it would pass. Unfortunately, my son was a year old before I decided to get help. And by then I needed medicine, not just therapy.
Hilary says
Pam, that is really true. I think anything really out of the ordinary from your own personality is something people should consider.
Angela says
And don’t forget that it can include crazy anxiety. I had PPD and PPA, seriously, for the first 6 weeks I thought there were people hiding behind bushes and cars waiting to hurt me and my girls. It was like I had a worst case scenario movie playing in my head and I couldn’t find the erase button. I didn’t even know about PPA until I was almost done with it. It would have saved my husband and I some additional emotional issues if I’d known about it.
Hilary says
Very true. I didn’t realize that the Anxiety came with it (10 years of a labor nurse, I guess I never realized that) but I had panic attacks daily for no particular reason. Good point!
Sarah. says
I know not everyone will experience this, but PUPPPs. I got it, surprisingly it was worse after my son was born. So bad I wanted to remove my skin. I had never heard of it before. I had to look it up. The only thing that helped was a prescription cream. Being dressed was miserable. Oh it really put a damper on things.
Hilary says
Oh man, that sounds like FUN *not*. I’m so sorry. Good thing babies don’t care if you’re naked! 🙂
Chelsey says
Is there anything you would recommend for people who can’t take ibuprofen? I have issues with peptic ulcers and if I take ibuprofen, I wake up in the middle of the night in agony.
Thanks for the tips! I’m actually not pregnant or anything, just curious. 😛 Though my SIL is on her 8th month with her first child and I have so much that I think is useful information…but I also don’t want to scare her. I’m the kind of person who wants to know exactly what special brand of hell I’m going to go through before any type of medical procedure, so I know what’s normal. Otherwise, I freak out about ANYTHING I wasn’t warned about, thinking something went wrong. 😛 But I don’t thinks she’s quite the same and I don’t want to be one of those horrible women who tells pregnant women horror stories right before they give birth, you know?
Hilary says
Chelsey, I ate-up my stomach last time poppin’ ibuprofen like they were candy. Big mistake. I’m not sure if oral toradol has the same ill effects as ibuprofen, but I think that’s what I’d ask for next time. 🙂 I’d also make SURE to take it with a good meal!
I try to only give advice when they ask. I have FAR too much of it. 🙂 hence, I have a blog. 🙂
Om Mohammad says
You left out hemorriods.
Hilary says
That is a good point, I need a part b. 🙂
Stephanie Lynn Tanner says
I do really love the “crying more than smiling for 3 days” rule. That’s such a simple, good indicator that I’ll be using with my patients and clients. Thank you!
That said, I wish your site was more friendly towards the midwifery model of care and included language that could be digested by families who didn’t have a doctor to call. So easy to just say “provider”, although I get the impression that at the facility you’re in, you see your fair share of poor outcomes and necessary obstetric intervention. Balance in all things. <3
-Stephanie (RN, doula, childbirth educator)
Hilary says
You know, even when I worked with midwives I don’t think I’ve ever said “call your provider”… and currently I don’t work with midwives (although I wish I did). I think it’s just not how the community I am around talks. But I agree, talk to your provider. 🙂
janifer says
Thank you for the suggestions you give here! I will be facing this in the future and I think I could definitely try several of these. I like the snack idea and the nursing box idea. 5 idea i should bear in mind.
Hilary says
I hope they’re hopeful!
Tierney says
This is a great list! I had NO CLUE about most of these things after my first baby! Even with my second I’m still learning and #3 is due anyday now and I appreciated this refresher.
Hilary says
So glad!
Suzanne Lee says
I love your article, so straightforward and much needed. I am a postpartum doula and so many of my clients are shocked that they can’t/should not just pick up where they left off before the baby came. It takes time to heal wounds you cannot see. Thank you for your wonderful reminder!
Hilary says
Happy to help. I love me a good doula!