Postpartum Reality: From a Midwife

The transition from woman to mother is a profound experience that affects you in many ways, especially physically. Postpartum recovery is often not discussed openly, leading many expectant Mamas to start their birthing journey without understanding the challenges of the fourth trimester and the essential products required to support them through it.

As a Midwife, I've seen it all and I want to help you be as prepared as possible for the fourth trimester. 

What recovery may look or feel like - bleeding

After childbirth, it's important to give yourself the time and space to heal. Remember your body has gone through several months of carrying and growing a new life, it might have gone through labour, or it could have undergone a major surgery.

You will notice some bleeding in the first few days from your vagina. This is completely normal as your uterus has a placenta-shaped wound left over. The bleeding should be like a heavy period that gets lighter and lighter over time. You may also see some blood clots come out on the first day. Keep an eye on the amount of bleeding you are experiencing and escalate to your midwife or doctor if you are concerned. You may feel more comfortable wearing disposable postpartum briefs for the first few days when bleeding is heavier to prevent leakages.

What recovery may look or feel like - tears/cuts

If you had a vaginal birth, you might have experienced some grazes, tearing or needed an episiotomy (a cut). It's important to remember that this is a wound, so keeping it nice and clean will help heal and recover. Making sure to change your pads frequently and showering regularly will help to keep that area clean. Keep an eye out for signs that the wound isn't healing well or infected. If you are concerned about your wound, let your midwife or doctor know. 

The tear/cut may also feel tender and sore. Simple pain relief medication such as paracetamol can help manage the pain. Using cool therapy, such as placing an ice pack on your perineum, can help to numb and soothe the area as well as reduce swelling. Make sure to change these frequently to keep the area clean. 

Some women may experience stinging from the wound when urinating in the first week. Drinking plenty of water can help dilute your urine and lessen the sting. Using a periwash bottle filled with warm water as you urinate can also help lessen the sting. Leaning forward on the toilet so the stream of urine avoids the tear/cut can also help minimise pain.

What recovery may look or feel like - breast engorgement

After your baby is born, your breasts may start to produce milk which is usually whiter in colour and larger in volume than colostrum. Milk usually comes in between days 1-4. Breast engorgement is when the breast tissue fills up with milk and other bodily fluids that can cause your breasts to feel full, hard and swollen. 

To help reduce the discomfort, empty the breasts either by breastfeeding or expressing. Applying a warm compress before a feed can help with milk flow. Follow this up by applying a cold compress over the breast after the feed for about 10-20 minutes.

Sex after a baby

After having a baby, you can have sex again when you feel ready (unless your doctor has advised otherwise). It is normal to take some time for your interest in sex to return. 

Some new mums may feel pain or discomfort during sex, but this usually improves with time. Using lubricants can help with the discomfort. If you are experiencing challenges with this, chat with your GP or maternal child health nurse.

It is important to consider contraception after birth too. Remember, some women will be fertile and able to get pregnant again before they get their first period back. Breastfeeding is not an effective form of contraception. Chat with your GP about a contraception option that will suit you.

Don't forget to take a moment to take it all in. You've just grown a human from scratch and brought them into the world. There will be a lot of changes and information and things to learn, but take a second to step back every now and then look at your perfect bub you've created, look at their eyelashes, their finger nails, their button nose. The days are long, but the years are short. You got this mama

The Baby Blues

If you are having thoughts of self-harm or suicide, call Lifeline on 13 11 14 for immediate support.

There are a lot of hormonal changes in your pregnancy and birth. As you recover in the fourth trimester, your body's hormones settle down from all the changes from your pregnancy and birth. This, along with changes to your lifestyle, sleeping patterns, and other factors, can lead to emotional changes after birth.

"Baby blues" is a term used to describe episodes of mood swings or other big feelings that occur in the first week after birth. 

It is a common occurrence, with 4 in every 5 new mums experiencing this in the first week. 

Signs and symptoms

• Mood swings
• Tearfulness
• Anxious, stressed
• Overwhelmed
• Difficulty sleeping

It most commonly surfaces around days 3-5 and settles within the first week without needing treatment.

Some ways to look after yourself during this time:

• accept help and support
• eat a healthy, nutritious diet
• keep active
• maintain relationships
• prioritise getting sleep and rest when you can

Being organised before you have your baby by sorting out meals and other chores can help to make things more manageable. Download our postpartum planner to help guide this discussion.

If you feel like your baby blues might be something more serious like postnatal depression, please reach out to your doctor or maternal health nurse for more support.

Some helpful resources include:

PANDA (Perinatal Anxiety & Depression Australia) — 1300 726 306

Beyond Blue — 1300 22 4636