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Postpartum recovery: your first six weeks after birth

What to expect physically and emotionally in the first six weeks after birth, a postpartum checklist, and the warning signs that need urgent care.

By the Prego team · Updated · 4 min read · How we create content

A 3D clay mother holding her newborn baby on a soft peach background

The weeks after birth, sometimes called the fourth trimester, are a time of huge physical and emotional change. Your body is healing while you learn to care for a newborn on very little sleep. Be patient with yourself. Here is what is normal, what helps, and when to get help.

What to expect physically

Bleeding (lochia). You will bleed after birth, whether you had a vaginal birth or a cesarean. It starts heavy and bright red, then gradually becomes lighter and pink or brown over 4 to 6 weeks. Use maternity pads, not tampons.

Afterpains. Cramps as your uterus shrinks back to its normal size, often stronger while breastfeeding. They usually ease within a few days.

Perineal soreness. After a vaginal birth, especially with a tear or stitches, the area between your vagina and anus may be sore for a few weeks. Ice packs, a peri bottle for rinsing, sitting on a soft cushion and pain relief help.

Cesarean recovery. Your scar may be sore for several weeks. Avoid lifting anything heavier than your baby, and follow your provider's advice on driving and exercise.

Breast changes. Your milk usually comes in 2 to 4 days after birth, and your breasts may feel full and tender. Feeding often and a well-fitted nursing bra help.

Bladder and bowels. Leaking a little when you laugh or sneeze is common after birth; up to 1 in 3 people experience it. Pelvic floor exercises help (see our pregnancy exercises guide), and a pelvic floor physiotherapist can speed recovery. Earlier is better.

Night sweats and hair loss. Both are caused by falling hormone levels and are normal.

Your emotions after birth

Baby blues. Up to 8 in 10 new parents feel weepy, anxious or low around days 3 to 5. It usually passes within two weeks.

Postpartum depression and anxiety. About 1 in 7 mothers develop postpartum depression. Signs include low mood or anxiety lasting more than two weeks, losing interest in things, feeling hopeless or unable to cope, trouble bonding with your baby, or intrusive, frightening thoughts. It is common and treatable, and asking for help is the strongest thing you can do. Talk to your doctor, midwife or a helpline.

Your postpartum checklist

These are the same postpartum items in the Prego app's to-do list:

  • Postpartum check-up. Usually within 3 weeks of birth, with a full check by 12 weeks (often around 6 weeks). It covers your healing, blood pressure, mood, feeding, contraception and when you can exercise again.
  • Pelvic floor check. Ask for a referral to a pelvic floor physiotherapist if you have leaks, heaviness or pain.
  • Feeding plan. Whether you breastfeed, formula feed or both, line up support, such as a lactation consultant, before the first days if you can.
  • Newborn screening. Heel-prick blood test, hearing test and heart screening in the first days.
  • Vitamin D for baby. Breast milk contains very little vitamin D, so most health authorities recommend 400 IU a day for breastfed babies from birth.
  • Register the birth within your country's deadline. You will need the certificate for a passport and benefits.
  • Safe sleep. Baby on their back, on a firm, flat mattress, with no loose bedding, in a room at 61 to 68°F (16 to 20°C).
  • Baby's first vaccines. Mark the date of your baby's first immunizations.
  • Contraception. You can get pregnant again before your first period, even while breastfeeding, sometimes as early as 3 weeks after birth.

Tips for the first weeks

  • Sleep when your baby sleeps, at least sometimes
  • Accept every offer of help with meals, laundry and older children
  • Keep water and snacks wherever you feed your baby
  • Limit visitors if you need to rest
  • Take gentle walks when you feel ready
  • Keep taking your prenatal vitamin, especially if you are breastfeeding

When to get urgent help

Call your local emergency number or go to the emergency room if you have:

  • bleeding that soaks a pad in an hour, or large clots
  • chest pain or trouble breathing
  • a seizure
  • thoughts of harming yourself or your baby

Call your provider the same day if you have a fever of 100.4°F (38°C) or more, a severe headache or vision changes, a red, painful or swollen leg, a wound that is red, hot or leaking, or foul-smelling discharge.

Frequently asked questions

How long does postpartum bleeding last?

Usually 4 to 6 weeks, getting lighter over time. If it suddenly gets heavier again or smells bad, call your provider.

When can I exercise after giving birth?

Gentle walking and pelvic floor exercises can usually start within days. Most people wait until their postpartum check-up before returning to more intense exercise, and longer after a cesarean.

When will I get my period back?

If you are not breastfeeding, often within 6 to 8 weeks. If you are breastfeeding, it can be months later. Remember you can ovulate before your first period.

Sources

General information only, not medical advice. Always follow the guidance of your doctor or midwife.

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