The Postpartum Guide

The Postpartum Guide

Recovery from childbirth and discovery of your (new) self.

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This is not a time for keeping the house clean, “bouncing back”, or entertaining visitors who’ve come to “see the baby”. This time is about you. Your rest. Your recovery. Your time with your baby. Pregnancy pushes women to limits of human endurance. It is the most energetically expensive activity the human body can maintain for nine months, and it’s topped off with child birth. Which, no matter how you do it, is hugely taxing on your mind and body. You deserve respite. Time to heal, to slow down and find your feet as a new parent in a protected space.

Entering the world of post-birth is akin to embarking on a profound journey of discovery. Not only have you just introduced a new life into the world, but you're also navigating the transformative changes of your own body and mind. From the immediate physical aftermath of childbirth to the tidal waves of emotions and the mysteries of postpartum recovery, there's a lot to take in. As you tread these uncharted waters, it's essential to prioritise self-care. Whether it's relishing a comforting meal or indulging in a therapeutic massage, remember to take moments for yourself. And amidst the cacophony of baby cries and well-wishers, setting boundaries is paramount. This is a time of adjustment, bonding, and finding a new rhythm. Cherish it, embrace the changes, and always remember: this journey is uniquely yours.

You After Birth

The period of time immediately after birth is compounded by a myriad of both physical and emotional factors. To break down the immediate physical impacts of birth, below we focus on three major aspects; The Body, The Brain and The Bowels.

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The Body

Right after birthing your baby the umbilical cord will be clamped and cut. The baby will then be laid on your chest for skin-to-skin, a moment in time that may feel incredibly surreal. Some mothers will feel an instant and deep bond with their baby but others will not. Neither is ‘normal’ as every experience is completely unique. The benefits of skin-to-skin have been shown to include regulating your baby's heartbeat, their temperature and their blood sugar. Skin-to-skin can also be a positive initiation to breastfeeding. 

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From here you will birth your placenta and then pending whether you birthed via a vaginal delivery or a caesarean, your midwife or obstetrician will stitch up any wounds resulting from a tear, an episiotomy or an abdomen incision (i.e. a caesarean).

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The Brain

In the minutes, hours and the days following the birth, you will experience an overwhelming rollercoaster of hormones. Oestrogen and progesterone will drop while oxytocin and prolactin will rise. If you experience random highs (surges of endorphins) or moments of unexplained sadness, this can often be explained by your changing hormone levels. 

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You may also notice a direct correlation between noticeable emotional shifts and the heaviness of your bleeding. After birth (both vaginal and caesarean deliveries), you’ll bleed for a period of weeks. The bleeding you’ll experience is referred to as lochia and it’s your body's way of readjusting by expelling blood, mucus and uterine tissue. As you engage in moments that draw out emotion such as breastfeeding (where the body releases oxytocin), you’ll notice your bleeding becomes heavier. In this instance, the oxytocin causes your uterus to contract, promoting an expulsion of lochia.  

 The colour of lochia will appear a dark shade of red in the earlier days, fading to a darker brown overtime. If you notice continuous clots or excessive blood loss (for example, if you soak more than two pads in a period of 1 to 2 hours), it’s advised to make contact with your midwife or obstetrician. 

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The Bowels 

For some, the first poo after birth can be intensely overwhelming. Despite how you birthed, your abdomen, your pelvic floor and your buttocks are going to be far from excited about more ‘pushing.’ Fair enough. To help, drink lots of water and include plenty of fibre rich foods in your diet. Suitable probiotic supplements can also work wonders to reset your gut or your GP may suggest OTC stool softeners to get things moving along. The last thing you need during this vulnerable time of life is a bout of stubborn constipation. 

Some extra tips on the subject of poo; get yourself a small step for the toilet as your posture can make a big difference. Keep your knees higher than your hips, lean forwards and make a ‘moo’ sound. While doing so, you will feel both your abdomen expand and some added pressure downwards in the rectum and anus. This will assist with your bowel movement. If you’re worried about prolapse or placing any additional pressure on your pelvic floor, it can help to grab a wipe or some clean toilet paper and firmly hold your vagina while pushing. 

You’ll find some more helpful articles below:

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Postpartum Emotions

As your hormones undergo extensive change following birth, experiencing emotional surges is to be expected, especially in the first 2-5 days. The contrasting rise and fall of various hormones could feel jarring and uncomfortable to manage.

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Baby Blues 

According to The Royal Women’s Hospital, the baby blues is experienced by 80% of new mothers. The baby blues is a period of time where a new mother may feel sad, worried, overwhelmed or a little hopeless. Usually it sets in 2-3 days post birth and it can hang around for a few days or a few weeks. It’s best to contact your GP if it’s still hovering after 2 weeks, or if these feelings are causing you distress or impacting your ability to function.  


The change in hormones are a major contributor to baby blues, as is the overwhelming adjustment to life with a new baby. Eating well, reducing your coffee and alcohol consumption are advised, and it’s encouraged you find ways to catch up on sleep and get out into the fresh, open air. We know, easier said than done, but be kind to yourself and lean on those around you for support.

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Postpartum Depression (PND) or Postpartum Anxiety (PNA)

To differentiate between PND and PNA; Depression is usually distinguished by ongoing (lasting more than a few weeks) feelings of flatness, disconnection, lethargy and hopelessness. Anxiety on the other hand, is characterised by feelings of worry, restlessness and panic. A mother experiencing anxiety may start to catastrophize an outcome before it actually happens. 

 

Differentiating between a bout of the baby blues and PND/PNA, can come down to timing, or the duration of the depressed periods. If your depressed mood extends past a few days – 2-3 weeks, worsens, or causes you distress and impacts your ability to do the things you want/need to do, it’s imperative you tell someone and/or call your GP. Experiencing a low mood or anxiety does not make you a bad parent, but could indicate that you need some support with your mental wellbeing.

 

It can be helpful to remind yourself that you are not alone. 1 in 5 new mothers will experience Postpartum Depression (PND) or Postpartum Anxiety (PNA). The best way to help yourself is to let others help you. 

 

If a feeling of shame surfaces, perhaps write down everything that is challenging you right now. Seeing the words in a physical form may release a sense of empathy. In moments like these, you need to back yourself. Understand that having a baby is exceptionally challenging and it’s to be expected to feel overwhelmed or low as you adjust to such extreme change.

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Both PND and PNA are serious but treatable issues that require immediate support. There are a range of support options available to you (e.g., counselling, psychology, psychiatry, medication) that will be individualised depending on a range of factors (e.g., symptoms, stage).

While you’re in these deep waters, it can be helpful to try to:

-       build a community of support around you

-       look after your physical and mental health (e.g. fuelling and moving your body, staying socially connected, sleeping (when you can), engaging in calming or relaxing activities)

-       Focus your time on things that bring joy 

-       Eliminate unnecessary angst.  

Experiencing either PND or PNA is no easy feat but you have an ocean of support around you. 

 

If you are unsure of whether you need to seek help, there are a range of mental health checklists (dependent on your stage) available at PANDA. These checklists won’t diagnose you but they will ask you questions based on possible symptoms of postnatal anxiety and/or depression. This can help you to better understand what you are experiencing, and assist you to get help if needed. 

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Further resources:


Postnatal Depletion 

Postnatal depletion is another common byproduct of postpartum life. It’s something to look out for as it can wreak havoc during a vulnerable time of life. 

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Postnatal depletion is not the same as being ‘burnt out’, or ‘sleep deprived’, or ‘depressed.’ In the postnatal context, postnatal depletion is a period of time where your body and mind are literally ‘emptying' or becoming ‘reduced.’ Every cell in your body is trying to recalibrate and adjust to life with a baby, however due to the weight of change endured during pregnancy and birth, this adjustment phase can have some hefty implications.

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How will you differentiate if you’re suffering from postnatal depletion vs postnatal depression or postnatal anxiety?

  • If you are feeling exhausted, yet you’re still able to ‘feel joy’ when moments in life bring goodness - this is likely depletion. Those who suffer depression will find their moods very ‘flat line’ and feeling joy and happiness will not be easy.
  • Sleep is another good indication. If you are up during the night and able to fall back to sleep quite easily, again, this is likely depletion. Those with depression, despite utter exhaustion on a physical and mental level will find it very hard to reduce the noise in their brain, keeping them awake for up to an hour or more, before they’re able to fall back asleep.

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Further resources:

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Caring For Your Body

Postpartum is a time for TLC and becoming your own personal cheerleader (and boundary setter). Your body has achieved some serious feats whilst growing and birthing a baby, so it’s important you give yourself time and space to heal.

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After a Vaginal Birth

As your cervix dilates to 10cm, it’s no surprise to learn that a woman’s body is wonderfully intuitive and behaves with such reactionary physicality during birth, and the vagina, in many cases, is the MVP. While some women will birth without ‘injury’ or assistance, others will experience tears or require an episiotomy (a controlled cut in the perineum to allow space for the baby to be born). This is common and you will heal. 

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Even for those who don’t experience any tearing or require stitches, your vagina will still be quite swollen and sore. Keeping it iced and clean are some of the best things you can do for yourself during this time. 

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As you could be sitting down for long durations in those early weeks feeding, you’ll inadvertently place continuous pressure on your downstairs region. To alleviate swelling, try gentle movement (for example slow walks around the house) or sitting on a ‘donut shaped’ pillow. Something else that may help is to feed in the Side Lying position, which can support rest and pelvic floor recovery, plus be very calming for your baby.

How to care for your perineum

If you experience a tear, an episiotomy and/or you require stitches, it’s normal to feel sore and tender. You potentially have broken skin, fluid retention and bruising surrounding an incredibly intimate area of your body so be sure to go easy. Icing your vagina using cool packs and/or a specific type of maternity pads with inbuilt cooling can be hugely effective quite quickly. 

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For women who have stitches, paying extra attention to hygiene via adequate washing of your perineum is critical. Due to the position of your wound and the expulsion of lochia, the area surrounding your perineum and your vagina can be more prone to bacterial build up. 

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Regularly changing your pads, regularly changing your underwear and showering at least once a day in the first few weeks post birth are simple and effective ways to keep the area clean. In terms of keeping the actual wound clean, a perineal wash bottle is precise in terms of both targeting and cleansing sensitive areas. It can also be used to splash the area after a wee, as urine can lead to an uncomfortable sting.

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After a Caesarean Birth

Caring for your body after a caesarean is critical as you’ll have a delicate abdominal wound to nurse and keep clean as it heals. You will also have to make some adjustments around the house as you may be immobile for a few days or weeks. This is a window of time where you’ll find value in the help from others, like; cooking, helping with the washing and taking other children to and from daycare or school. Maybe order your groceries online, just ensure someone else carries the bags inside and unpacks the food for you.

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Impacts to your body, what you can and can’t do 

In terms of what you can do … you can keep clean and comfortable. After the birth, after your catheter and IV drip have been removed and pending the level of feeling in your lower body, your midwife will help you to wee in the toilet and take a shower. This first shower can be intensely nerve wracking as you’ll probably see steri-strips covering quite a raw abdominal wound. Deep breaths! Warm, running water is fantastic for cleanliness so take this opportunity to enjoy it. Note; it’s advised to avoid soaps, fragrant oils and/or wiping or scrubbing motions around the scar area in the early days to avoid irritation. 

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After your shower, gently pat dry your body and belly and allow your midwife to redress your wound. From here, slip into some postpartum pants to accommodate your bleeding and some comfortable clothing that allows your body to move without restriction and your skin to breathe.

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When you return home, the midwife will continue to change your dressings and check on the healing of your wound for the first days. After a few days (timings are different for all), you’ll be encouraged to expose the wound to fresh, clean air to allow the site to dry and scab. During this time, continue to shower but avoid soaps and irritating fabrics. Smooth, firm (but not overly tight) high waisted briefs are great. You may want to try the ModiBodi Postpartum Control Brief, SRC Recovery Shorts or the 3-in-1 Pregnancy, Postpartum & C-Section Original Belly Band to support your muscles coming back together.

Keeping your scar clean during this time can be made a lot easier with cotton balls and damp q-tips. Both can be used to softly pat or wipe away any dried blood or dampness.

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What you can’t do? In the first 6 weeks this list may feel relatively long. To summarise, you should avoid driving, heavy lifting (including lifting any other children) and all other strenuous movement. 

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How to care for your scar 

Caring for your scar is about keeping it clean, dry and avoiding anything that could rupture your stitches, cause further pain or lead to an infection. Daily showers, clean underwear (especially if you’re wearing high-waisted briefs that cover the scar) and changing your dressing as instructed, are the basics. Keeping your scar warm with layers of clothing can also be helpful as it’ll promote blood flow to the area.

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While strenuous movement is not advised during the healing period, gentle movement such as slow walks around the house can help your circulation, digestion and muscle recovery. Pending the stage of your healing, gentle massage can also help to manage increased sensitivity and numbness, as well as reduce pain and restriction around the abdominal region. Make sure you check with your GP or midwife prior to commencing massage techniques. 

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Linked below is a video demonstrating the above. If or when you feel pain, or whenever you're in doubt - it’s always best to stop and contact your healthcare provider. 

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Above all else, rest, rest, rest. Lay down and put your feet up as often as possible! 

Further resources:

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Aiding your recovery

Recovery is defined by; ‘a return to a normal state of health, mind, or strength.’ While physical recovery is important (i.e. caring for your scar), allowing space, patience and time for the entirety of your mind and body to recalibrate is an integral part of the postpartum period. Focus on finding your own rhythm. It won’t come overnight, but it will absolutely come with time.

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Food

Nourishing your body with warm, rich and comforting foods is a no brainer. Nutrition plays a pivotal role in digestion, lactation, energy (including sleep) and physicality. It’s unlikely you will have the opportunity to shop, cook and serve delicious nutritious meals directly after birth. Instead, outsource! Ask your partner and family and friends if they can bring you a meal (fresh or frozen). 9 times out of 10, the answer will be, ‘Of course!”. Another great option is to engage in a meal delivery service like Golden Month or New Bub Club, who specifically cater for women in postpartum.

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Making time for yourself to lean into nurturing self care such as postnatal massage is a helpful way to nurse your fatigued and vulnerable body back to health. Mother Roasting is another self care ritual worth looking into. Mother Roasting is based on traditional restorative technique that involves ‘warming’ the postpartum body while providing deep, relaxing, restful, restorative massage. It’ll allow your physical self to unwind which is exactly what you need during this all-consuming time of life.

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Setting Boundaries

Returning home with your new baby can be many things. It can be exciting, overwhelming, stressful, exhilarating … exhausting. While some new mothers will experience a bubble of utter love and deep connection to their baby, others may feel slightly detached from ‘life as they know it’ as waves of ‘newness’ entangled with sleep deprivation leave them feeling like a fish out of water.

Regardless of how you feel, claiming personal space and family time is important. Make sure to set times or designated days where you feel comfortable inviting visitors. There is no rush and plenty of time for meet and greets. For now (and for as long as you need it), your recovery comes first. Take time to bond, adjust, rest and just ‘be’ without worrying about anything else. This time is yours.

Postpartum contractions

After birth, it’s not uncommon to experience ‘after birth pains’ i.e. postpartum contractions. This pain is experienced as your uterus retracts (shrinks) to its pre-pregnancy size. The level of pain endured by women will vary. Some will feel almost nothing and others will find they're curled over and unable to talk. For around 7-10 days post birth, these contractions are likely to spur at random times, however they’ll usually ramp up when you’re breastfeeding, because it releases oxytocin, which causes your uterus to contract.

What are they? 

Postpartum contractions feel similar to cramps. They’re simply indications that your uterus is contracting and shrinking back to its usual size. This is a normal part of recovery. 

How long do they last? 

Usually speaking, most women will experience postpartum contractions for around 7 to 10 days following the birth. The contractions tend to be the most painful around the second or third day and from here they should ease off. 

What to look out for if they continue? 

It’s advised to contact your GP if you notice any of the following; 

  • If the contractions continue for more than 10 days following birth. 
  • If you notice the odour of your lochia is offensive or just unusual. 
  • If you develop a fever.
  • If the pain does not dilute with pain relief.
  • If your postpartum contractions feel less like muscle cramps and more like sharp/stabbing pains. 
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Postpartum sleep deprivation

There is something to be said for the urgent need to wee 10 times or more per night during pregnancy. There is even a little something to be said for pregnancy insomnia, as insidious as it can be. While these sleep interruptions are irritating and emotionally testing, there is one positive side.They can help women prepare for aspects of sleep deprivation when their baby comes along. 

Be prepared for sleep interruptions in those early days 

During the immediate period after birth, your baby will be itching to feed, cuddle, develop and grow. These are all beautifully positive signs of a happy, healthy baby but it can be particularly hard on those breastfeeding. 

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You could be awake every 1-3 hours in the first 6-12 weeks (less or more for some), so it’s a nice idea to create the most comfortable, secure and inviting space possible for your overnight feeds. 

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Create a breastfeeding station: a cosy chair, a nightlight, a supportive pillow, and a caddy stacked with water, snacks, airpods, burp cloths and all your breastfeeding aids.

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How to work with your partner 

Every couple will differ in terms of how they support each other or how they manage the night feeds as a pair … 

  • If you feel your partner is best left to sleep so that they can care for other children in the morning, walk the dog or take the lead in the housework - perfect.
  • If you’d prefer your partner to share the load by taking charge of the dream feed (around 10/11pm) or doing a bottle feed during the wee hours - make it happen. 
  • If you can make it work and you’d prefer to alternate nights or perhaps designate the weekends to your partner - do it. 

The right solution is whatever works for you and enables you to operate. If you’re open with your partner and they feel as though they have purpose during the turbulent nights, you may find that your household feels cohesive and united. 

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Some ways a non-birthing parent can get involved.

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Exercise, sunlight, fresh air 

Overtime sleep deprivation can naturally compound with other postpartum factors such as changing hormone levels, learning to breastfeed and physically healing. Feelings of sadness, overwhelm and spiralling confidence are all things to look out for when your body is deprived of rejuvenating rest and deep sleep. You may feel teary, irritable, snappy or exceptionally foggy more often than not at times - and none of this is your fault. It’s an exceptionally tough phase, so try and be kind to yourself. 

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To help your mood find a smile, the release of endorphins through exercise and the release of serotonin through exposure to natural sunlight are two beautifully accessible ways to feed yourself a little TLC. Getting outside with your baby and into the fresh air can do wonders. While some days it may feel almost impossible to leave the house, it’s worth a go.

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Sometimes just sitting in a cafe and enjoying surrounding chatter can lighten feelings of loneliness and ease the discomfort that follows exhaustion.

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Postpartum Nutrition

Similar to craving hydration, electrolytes and carbohydrate rich food after running a marathon, after giving birth your body will be hungry for hydration and nutrient dense foods. Think of foods and meals that champion iron (to cater for blood loss), protein (tissue repair), good fats (inflammation reduction), grains (energy and milk supply) and of course, fibre or food rich in probiotic properties (digestion and bowel movements). 

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If you’re breastfeeding, don’t be alarmed by big hits of hunger. The production of milk requires a lot of energy, and the more you fuel up, the more balanced and calm you will feel and the better your supply. Please note that adequate calorie intake is not the only factor affecting a woman’s milk supply. 

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To prevent your blood sugar levels from dropping too low, which may cause feelings of lethargy, fatigue and shakiness, be mindful to snack often throughout the day. Steer clear of sugars and processed foods and if you drink coffee, ensure you maintain good levels of hydration. A big water bottle will be your best mate. 

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Many women rave about the benefits that come with incorporating Chinese Medicines and herbs into their meals during the postpartum period. Bone broths and congee are highly regarded for their tissue repair qualities, and warming foods such as cooked vegetables, soups and eggs will favourably nourish your inner body with vitamins, minerals and omegas.

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Finally, research has shown that deficiencies in particular nutrient sources such as iron and zinc, can increase a new mothers risk of postnatal depression and anxiety. Loading up on red meat, poultry and hearty grains is a good way to ensure you’re nurturing your body with adequate meals in terms of their nutrient levels. 

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Food to prepare and have on hand

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Ask loved ones to support you by bringing you a fresh meal and/or freezer ready meal. Curries, soups, broths, salads loaded with leafy greens, roast vegetables and warm grains, pastas, quiche and of course, a few good ol’ lasagnes to line your freezer … just say yes! Think comforting, balanced and warmth inducing foods to stock up on. 

Throughout the day, snacks are king, to keep your energy levels sustained, your mood in check, your milk production humming and your inner body healing. Raw balls, lactation teas and cookies, nut and seed bars, vegetables and dip, cool fruits, wholemeal toast with nut butter or avocado, breastfeeding safe protein bars or smoothies and/or a warm cup of broth or soup. Postpartum is a time to cater to your body's needs like never before.

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Supplements to take

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Postpartum supplements can be a fantastic way to ensure you’re feeding your body with adequate vitamins and minerals to both sustain healthy levels and balance lingering deficiencies. While the postpartum experience is varied for all women, navigating sleep deprivation, adjusting to breastfeeding and supporting the tender state of your body, can be a good time to look into a supplement/s to ‘pick up the slack’.

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Supplements that hero safe and helpful herbs, vitamins and minerals can offer new mothers effective and efficient ways to care for their mind and body, while getting through the first few tough months. For mood and sleep (magnesium and saffron are wonderful), energy (vitamin B-12, iodine, iron), lactation (protein, vitamin D, vitamin K, iron), and digestion (probiotics, vitamin C, ginger, digestive enzymes). 

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Around the 3 or 6 month mark postpartum, it could help to test your bloods and check for any noticeable deficiencies, simply ask your GP for a referral. You might be completely fine or you might spot a very treatable issue which could save you from future health implications such as low iron, leading to fatigue. 

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Shop the memo range of supplements here and remember to check anything over with your health practitioner prior.

Further Resources: 

Postpartum Supplements

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Postpartum Hair Loss

From thick, glossy locks during pregnancy to those awkward moments in the shower where you wash your hair and find a clump of hair swirling around the drain. It’s full on, and unfortunately, a by-product of giving birth. Not cool, but common. 

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For context, we can thank heightened levels of oestrogen for that gorgeously thick pregnancy hair. Your body isn’t actually growing more hair but you are losing less hair at a slower rate. Postpartum hair, on the other hand, is a little different. 

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In the 6 months+ after delivering, it’s very common for women to lose hair and in some cases, a lot of it. Women may experience clumps falling out in the shower or noticing stray strands on their pillow every morning.

Just as hormones affect the thickness and the length of your locks during pregnancy, hormones are also the culprit behind hair loss when the baby arrives. There is a big decline in your oestrogen levels which triggers your body to get back to the ‘normal hair shedding routine’. Rather than losing the regular 80 or so strands of hair per day during postpartum, women can lose up to 400 strands per day! 

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To explain the hair loss in simple terms, your head is playing catch up. All of the hair that it proudly held onto during pregnancy now needs to fall away sadly. Like many aspects of life with a newborn, it won’t last forever, so hang in there.

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Further Resources

Pelvic Floor Recovery

What can happen during childbirth?

While women have been birthing for countless centuries, it doesn't mean we are exempt from any post birth injury, pain or ailment. Even if you have a seamless birth experience, you still might feel a little bruised and battered post birth. Below are some common conditions some women experience: 

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Perineal trauma 

Perineal trauma can refer to injury during birth such as a tear (to which there are 4 degrees) or an episiotomy (a controlled cut in the perineum area, allowing space for the baby as they're born). Injuries such as these have varying levels of severity and they'll almost always require stitches. In some cases, a severe tear such as a 3rd or 4th degree tear, will require surgery post birth.

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The skin within this region of the female body is phenomenally forgiving, so if you do experience perineal trauma work closely with your GP or women's health physio to create an appropriate recovery plan to give your body the best shot of efficiently healing. 

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Pelvic floor weakness 

Given the weight of the baby you carry through pregnancy (not to mention the extra fluid, additional blood, the placenta and uterine tissue), your pelvic floor will hold a significant amount of extra weight and pressure. For this reason, as well as the effects of pregnancy hormones such as Relaxin (which softens your ligaments and muscles allowing your body to stretch as the baby grows), it's not uncommon for your pelvic floor to experience fatigue and weakness during pregnancy and postpartum.

After birth, you may notice a degree of incontinence (spontaneously weeing when you laugh, sneeze or cough), trouble controlling wind or a degree of prolapse. Prolapse is the descent of any pelvic organ (bladder, uterus, rectum or bowel) into the vagina, or beyond the vagina introitus, which is the exterior side of the vaginal opening). The presence of a vaginal lump or bulge is the most specific sign correlated with a prolapse. 

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In order to both prevent weakness and re-strengthen your pelvic floor muscles, it’s recommended you do pelvic floor exercises as advised by a women's health physio. They can provide one-on-one support and deliver instant feedback which will help to better demonstrate where you're at.

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When to seek further help

You may experience:

  • Accidental loss of urine or faeces - i.e. with coughing, sneezing, laughing, exercise and/or a heightened sense of urgency.
  • Vaginal heaviness or experience a dragging sensation. 
  • Pelvic pain such as pain during pap-smears, tampon insertion and/or penetrative intercourse.

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What can happen if you carry on without addressing this issue?

If you disregard pelvic floor issues after birth, the issues could become exacerbated. While it can seem like 'just another thing' on the daily to-do list, if you engage in proper healing activities within the weeks and months following birth, the quality of your life will benefit in the long run. For some women recovery will be a set of daily exercises and a series of physio appointments. For others it may be a little more intense and involve surgery. Patience and perseverance. Your body deserves the very best. 

Postnatal strength and recovery

Returning to exercise

It’s important that for 6 weeks after birth you rest and recover. Your physio or midwife may recommend a few gentle exercises to encourage your recovery but unless they instruct you, stick to slow and gentle walks which are great for circulation, digestion and mood, and practise some breath work.

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After receiving the green light from your GP at the 6 week check up, this is usually a safe time for women to incorporate added motion and physical exertion into day-to-day activity. The level of motion and physical exertion will vary from woman-to-woman, so rather than asking your friends for tips, it’s highly advised to direct these queries to your women’s health physio, your GP or your midwife.

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Best types of exercise 

Following the first 6 weeks from birth and after you’ve received the tick of approval to reintroduce exercise, start slow. As you work on an appropriate and safe exercise routine that is suitable for your body and situation, for now you could try some low impact movements to get the ball rolling. As always, make sure you check everything over with your GP or physio first.

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Some examples of safe movement and low to medium exertion. 

  • Pelvic floor exercises such as pelvic tilts and kegels, both of which can help to regain muscle strength.
  • Slow, deep breathing to help reintroduce the use of your abdominals and core region.
  • Light walks or moderate power walking with the pram is good to get your circulation going (reducing the risk of blood clots), release endorphins and to boost your energy levels. 
  • Swimming, if your bleeding has completely stopped and your wounds have healed to avoid infection. As it’s a low impact exercise that removes unwanted pressure from your joints, swimming may welcome a sense of relief. Buoyancy experienced in the water can also be a way of feeling weightless when you’re physically and mentally exhausted. 
  • Gentle squats when rocking your baby to sleep or some light walking lunges around the house or the park. Good for pelvic floor recovery, muscle use and circulation. 
  • Guided yoga or mat pilates. With an experienced professional in the pre and postnatal space, discover a series of low impact poses or sequences to strength, tone and gently re-engage your muscles. 

Further Resources:

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Importance of taking it slow 

Think of your pelvic floor as a strong and very muscular pair of cupped hands. The ‘cupped hands’ are in actual fact muscle and fascia and their job (along with the help of ligament support from above), is to hold your uterus, bladder and bowel in place. In other words, the cupped hands are in charge of holding everything up and in.

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During pregnancy, as your baby grows heavier by the week, keeping these ‘hands’ strong using safe pelvic floor exercises is paramount. Without strength during pregnancy, organs such as your bladder and uterus can start to sag or droop downwards. As they’ve worked so tirelessly for quite some time (9months), it’ll take work and patience to recover… but you will get there. 

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Other than the pelvic floor, after birthing your baby you can only imagine just how fatigued the rest of your body is. Despite how you birthed, every ounce of your muscle mass, your tissues and your ligaments will need adequate time to rest as they heal. Laying down as often as you can will remove the pull of gravity, giving your body a rest.  

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Taking slow walks, avoiding heavy lifting and easing your core back into use (even when you sit up in bed, try rolling onto your side and using your hands to push you to a sitting position) can be helpful ways to lead your physical self back to life. 

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First postpartum period

When might women expect to get their period back? This will differ for all women and it can be dependent on breastfeeding. The presence of prolactin, which is the hormone responsible for breast milk production, can suppress ovulation. Therefore, for women who exclusively breastfeed, it may be that their period doesn’t return until the baby is off the boob. Women who don’t breastfeed (or who don’t exclusively breastfeed) are more likely to welcome the return of their menstrual cycle between 4-8 weeks following the birth. 

The first period after birth can be noticeably heavy (which is normal), so any left over maternity pads will come in handy now! 

Further Resources:

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Sex after birth

Irrespective of how you gave birth, most doctors will advise that you wait at least 6 weeks post-delivery before having sex again. By this stage your lochia should have stopped and unless you had postnatal complications, your scars (from a tear, episiotomy or a caesarean) should have healed. 

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Despite 6 weeks being the ‘rule of thumb’, this is not to say you can’t enjoy other activities such as masturbation, oral sex, or intimate massage. And when it comes to having sex again, enjoy! And don’t forget lube. Lots and lots of lube, as the fluctuation of hormones can lead to dryness.

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Once again, the question of ‘when’ will change from woman to woman. If you’re unsure it’s always recommended to have an open conversation with your GP or even just your close friends. If you still don’t feel ready 6,10,12, 20 weeks later, that’s okay.

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Further Resources:

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Can I get pregnant again?

Women ovulate for the first time after birth at different times. Some after just weeks, some after months. The same goes for the return of your period. A largely contributing factor to this timing is whether or not you’re breastfeeding.

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Despite timing, the return of the ovulation phase and the menstrual phase of your cycle are both important factors to come to grips with, as they directly affect the chance of falling pregnant again. While some women will be open to conceiving again within the first year, others will not. 

Ovulation vs period 

Ovulation is the phase of the menstrual cycle where an egg is released from one of the woman’s ovaries. It usually occurs around 2 weeks before the start of the menstrual period (the bleed). During the ovulation phase, women are highly fertile. They’re most fertile during the 2 day ovulation window, however it’s still possible to conceive during the days immediately before and after. 

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Your period (the bleed during the menstruation phase) on the other hand is the shedding of the uterus lining. The period itself is a combination of both blood and tissue from inside the uterus which passes out of the body through the vagina. 

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Is it possible to become pregnant without your period returning?

Yes.

Even if you’re yet to get your period back, you may be in the ovulation phase of your cycle. For this reason, if you do not want another pregnancy, you’ll need contraception. Your 6 week checkup is a great time to talk to your GP about your options.

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Breastfeeding can reduce fertility, but it’s not a contraception 

There is an old wives tale that women who are breastfeeding cannot fall pregnant. This is false. You are less likely to fall pregnant when breastfeeding but it’s absolutely still possible.

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In a nutshell, breastfeeding releases oxytocin which suppresses the ovulation phase. Without ovulation, no egg is released and therefore a baby cannot be conceived. This methodology however can vary pending various factors, meaning it is not airtight. 

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If you are breastfeeding and you want to become sexually active again but you also don’t want to risk falling pregnant, visit your GP and talk through the best method of contraception. 

Your relationship after birth

Couples are faced with extreme change in a very short amount of time during the newborn phase. Due to this change, it is entirely normal to experience a downward shift in your sense of closeness, your libido or simply your usual relationship habits. 

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Go easy on yourself and communicate how you’re feeling with your partner. If your libido is low, rather than addressing it in terms of sex, try and shift your focus to intimate touches such as a hug or holding hands to foster an emotional connection and add a touch of intimacy. Little things count in a big way.   

As the busyness of life with a newborn can easily consume you both, scheduling ‘adult’ time, when it’s available to you, is a nice way to touch base and see where you're both at. If you can leave the baby with someone or simply take a long walk with the pram, you might find the space to talk about things you haven’t spoken about in a while. 

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For more on this topic, find a link below to a conversation with the wonderful Aleeya Hachem, a highly regarded sexologist:

Postpartum identity

Matrescence refers to the period of time where a woman transitions into a mother. Matrescence doesn’t only encapsulate the fact a baby is born, but it also acknowledges all aspects of the physical and hormonal shifts a woman endures. 

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While the mother role is something we seem to innately adopt when we fall pregnant, it doesn’t discount the deep challenges this transitional period brings. Navigating such a number of changes to life can lead a woman to question her identity post birth. Who is she? What does she value? How does she seek resolution? How does she rest and recharge? What motivates her? What is her purpose?

Understanding that ‘her’ is actually ‘you,’ is quite a peculiar idea to conceptualise and it can be very isolating. For this reason it’s rational that women endure a period of time where they feel a little lost and disconnected from self. 

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If you’re going through a low patch, mourning your ‘pre baby self’ or you’re desperately scrambling to find a deeper sense of purpose, you’re not alone. Scheduling regular ‘you time’ is an important way to remain connected to the parts of yourself and your life that you adore and that inspire you. Prioritise this. 

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Below is a link to an article that may bring you comfort and lightness;

Going back to paid work

Deciding when to return to paid work is unique to every woman. There are a number of familial, professional and financial considerations that will come into play. Here are some things to keep in mind.


Consider childcare options


Looking into childcare is something you could start doing before the birth. Some women may find this reassuring in terms of future planning. You may find that many childcare centres have waitlists (some waitlists are 6-12 months). So getting ahead is a great idea! Talk to friends and family in and around your area and organise some tours, where you pop in and have a poke around the facility. You’ll get an instant feeling if the centre is right for you. 

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In terms of fees, have a chat with each facility (fees can vary centre to centre, state to state) and find out if you're eligible for any government subsidies. You may also want to ask each centre if they have a minimum in terms of how many days your child is enrolled. A two day minimum is not uncommon. 

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Further Resources:


Consider parental leave


Have a look at your employment contract when you fall pregnant and assess your parental leave clause and entitlements. Your employer may offer a period of paid leave (they also may not), which means you’ll have some money coming in during the early days with your new baby. 

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On top of this, investigate if you’re eligible for the Paid Parental Leave government payments which can be paid to whoever assumes the role of the primary carer within the household. If you’re a freelancer, just be wary that the government will usually only grant you Paid Parental Leave if you’re working 0 hours of paid work. Every household is circumstantial, so give CentreLink a call to discuss your personal situation. 

Returning to paid work while breastfeeding


If you decide to return to paid work while you’re still breastfeeding comes with additional considerations, including how and where you’ll pump and store your breastmilk, and the time it will take to have these breaks in your day.

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To start, invest in the right equipment including a portable, comfortable pump, the right clothing (comfortable maternity bras and outfits that grant easy boob access) and a decent supply of nursing pads (just in case of a leak). You’ll also need milk storage bags and a fridge to store it in.

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You can discuss with your employer and/or perhaps other female colleagues who are also mothers about how to most comfortably accommodate your expressing needs. 

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If you’re interested in reading about lived experiences, below is a list of stories from women in the community who returned to paid work.

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