What to Expect Postpartum

     If you’re reading this, you are most likely pregnant and may be very knowledgeable on pregnancy symptoms and even the birthing process. This is common for many women to focus on these two topics as pregnancy is the task at hand and birth can be a bit overwhelming to think about, especially for first-time moms. It also seems like these are the topics that are discussed with other mothers. I’m sure you’ve had numerous women tell what symptoms they experienced each trimester and they’re entire birth story. But one topic that doesn’t get discussed as much is postpartum. The six to eight weeks after you give birth are considered the postpartum period. (1) During this time you will experience physical and emotional symptoms that can be unexpected and hard to cope with while also caring for your newborn. In this blog post, I will cover specific symptoms you may experience and tips on how to prepare for and deal with them. 

Vaginal Discharge

     One thing you can be sure to expect postpartum is vaginal bleeding/discharge, also known as lochia. This occurs due to the uterus shedding any blood or tissue from your 9 months of pregnancy. Lochia is made up of blood, tissue from the lining of your uterus, amniotic fluid, bacteria, leftover fetal membranes, and cervical mucous. In the first week, you can expect to fill up a maxi pad every few hours which will resemble a heavy period. As time goes on (about a week), the discharge will become less bloody and more watery and pink/brown in color. After about two weeks, the lochia will become creamy and yellow/white in color. You will want to wear thick maxi pads in the beginning and eventually, you should be able to transition to thinner panty liners. You do not want to use tampons because nothing can be put into the vagina for 6 weeks after birth. (2) 

Uterine Cramps

     Also known as uterine contractions, uterine cramps can be an unexpected part of the postpartum period. Many women do not realize that is a normal, necessary part of healing from birth. These cramps occur because the uterus is shrinking back to its normal size. During pregnancy, it stretches to 25 times its original size and will take about 6 weeks to get back to the size of a pear! The cramps can be pretty intense the first few days but will taper off and become less noticeable after the first week. Some things you can do to mitigate the pain are to take deep breaths when they are intense, apply a heating pad to your lower abdomen, and/or gently massage your abdomen during a cramp. It is also recommended to try to keep your bladder empty because a full bladder can decrease the effectiveness of the contractions. Lastly, if you are choosing to breastfeed, you will most likely experience cramps during breastfeeding or pumping. They can also be more intense for breastfeeding mothers, but on the bright side, the uterus is shrinking at a more rapid rate. (3)   

Hormonal Changes

     The postpartum period can be a time full of different emotions. It’s the beginning of a huge change in a woman’s life and sometimes can leave us feeling completely overwhelmed. So many things are happening at once, your body is healing from giving birth, you’re in love with your new baby but at the same time may feel unprepared to care for them, and you’re sleep deprived! On top of all this, your hormones are making huge shifts which can affect your mood and emotional stability.     

     As you probably know, when you become pregnant your hormones are on a totally different level than when you’re not pregnant, specifically estrogen and progesterone. Progesterone is a relaxing hormone and its job in pregnancy is to keep the uterus fit for housing the baby. It also relaxes muscles and ligaments as well as gives women a happy mood. After a woman delivers her baby and the placenta, progesterone levels immediately drop. And, you will not start producing progesterone until your cycle starts back up. A decrease in progesterone can cause feelings of depression, anxiety, and sadness. (5) It’s no surprise that many women report having the “baby blues” during their postpartum period. (4)

     Another hormone that increases during and after pregnancy is prolactin. Prolactin is the hormone responsible for the production of breast milk, but its increased levels usually aren’t noticed until postpartum. This is because progesterone counteracts prolactin. It is also known to affect the production of dopamine, which gives feelings of happiness. Therefore, prolactin can also play a role in causing moodiness and feelings of depression postpartum. (5) 

     While feeling emotional and exhausted is a normal part of postpartum, some women experience extreme emotional shifts that are long-lasting. This is not considered normal and can be categorized as postpartum depression or at its worst, postpartum psychosis. Below is a list of postpartum depression symptoms that differ from your normal “baby blues.”

• Crying often and uncontrollably 
• Difficulty bonding with your baby
• Difficulty sleeping or sleeping too much
• Feeling hopeless 
• Feeling worthless
• Severe anxiety or panic attacks
• Thoughts of harming yourself or your baby 
• Recurring thoughts of death or suicide (6)

     Sometimes if postpartum depression goes on without help or treatment, it can turn into postpartum psychosis. Below is a list of postpartum psychosis symptoms. 

• Feeling confused and lost
• Obsessive thoughts about your baby
• Hallucinating and having delusions
• Feeling paranoid
• Making attempts to harm yourself or your baby (6)

      If you do experience any of these symptoms, please reach out for help. You can contact your doctor, midwife, the Nurturing Center, or call a toll-free help line. See below for resources.

– Postpartum Support International 

– HRSA Maternal and Child Health

– Mass.gov

If you have any questions or concerns, please contact;

Nurturing Center of Lubbock
3303 66th Street
Lubbock, TX 79413
Phone: 806-780-6853 (available 24 hours)
Text: 806-317-4480
Email: info@nurturinglife.org

Resources 

1. https://www.uptodate.com/contents/overview-of-the-postpartum-period-normal-physiology-and-routine-maternal-care#:~:text=There%20is%20consensus%20that%20the,prepregnancy%20state%20by%20this%20time.
2. https://my.clevelandclinic.org/health/symptoms/22485-lochia#:~:text=Care%20and%20Treatment,-What%20do%20I&text=Use%20only%20sanitary%20maxi%20pads,ve%20seen%20your%20healthcare%20provider.
3. https://www.lamaze.org/Giving-Birth-with-Confidence/GBWC-Post/all-about-after-pains-cramping-after-giving-birth-1
4. https://www.medela.us/breastfeeding/articles/postpartum-hormonal-changes-how-they-affect-you
5. https://www.drjennarayachoti.com/blog-drjenna/progesterone-is-quite-amazing#:~:text=We%20know%20that%20progesterone%20stimulates,anxiety%2C%20sadness%2C%20or%20depression.
6. https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617