Last Updated: 1/9/24
Postpartum care: What to expect after a vaginal birth
After a vaginal delivery, postpartum care is crucial for a mother’s recovery. You can expect several physical changes and symptoms as your body recovers. This includes vaginal soreness, bleeding, and hormonal fluctuations. It’s also common to experience emotional changes as you adjust to motherhood. Healthcare providers typically schedule postpartum check-ups to monitor your recovery and address any health concerns.
Evolutionarily, postpartum mothers would have been supported by a village. No kidding, some indigenous cultures documented have been observed to have more than a dozen different people tend to the newborn within any given hour. It is possible that this behavior—which is so incredibly different from modern industrialized cultures—arose due to the recognition that it’s important for the postpartum mother to have high levels of rest and support.
Vaginal and perineum soreness
Vaginal and perineum soreness is a common experience after vaginal delivery, especially if there was tearing or an episiotomy. The perineum, which is the area between the vaginal and anal openings, may be swollen and painful. To manage soreness, you can use ice packs, sit on a cushioned surface, and take warm baths. Over-the-counter pain relief can also be helpful, but remember that your inflammation response is your body’s natural method for bringing healing cells to the area. You can help this healing speed by eating nutritious foods, keeping stress low, and taking time to rest & sleep when you can. Soreness typically lessens significantly within a few weeks post-delivery.
Bleeding and vaginal discharge
After childbirth, it’s normal to experience vaginal bleeding and discharge, known as lochia. This discharge is initially bright red and heavy, gradually becoming lighter in color and flow over a period of several weeks after delivery. Use sanitary pads instead of tampons during this time to reduce the risk of infection. If you notice large clots, a foul smell, or if the bleeding increases instead of decreases, contact your healthcare provider as these could be signs of a complication.
Postpartum recovery timeline
The postpartum recovery timeline can vary radically for each woman. Conventional medicine suggests a 6-week timeframe before going back to exercise, but this is a simplistic blanket-statement that unfortunately misleads many.
After your neurological system spends months learning how to operate with a very full midsection, that fullness suddenly disappears as soon as your baby is born. Think about that. Months of muscular adaptation, followed by sudden immediate need to re-adapt to a completely different core alignment. Any postpartum person who does not have a solid connection to her core, and body in general, is likely to begin muscle compensation on day #1.
So conventional medicine says, “wait it out,” hoping it will all be figured out in the next 6 weeks after delivery. I do believe in the innate wisdom of the human body. However, there is a lot going on in those first 6 weeks postpartum, and most people enter pregnancy & postpartum with already-existing muscle imbalances (more on that below). Could this be why so many report never ever getting back to their preferred physical state once they’ve had a child?
Remember, our modern culture does not send you back to our evolutionarily-honed village. Modern women are lucky if they have a partner who doesn’t have to return to work immediately, and maybe a few visits from family members. In other words, most postpartum women will spend their 6 weeks quite busy with a demanding infant, on top of many of the same house chores, and a complete upheaval of home circumstances.
Many women will cope with those demands, as our society is forced to adapt. But many will feel absolutely blasted. It is unfortunately true that we may not (yet) have adapted to the demands of modern culture, especially when a new infant enters a small household (instead of a village).
How long does it take to heal after giving birth?
In more than two decades of working with pre & postnatal women, I have seen some return to the gym the very next day, feeling great and loving people trying to figure out, “what’s different about you today?” I have also seen 50 year postpartum women complaining that they’ve never recovered since delivering their children.
There is a way to return vibrantly and quickly. More on this below.
Baby Blues and Depression
“Baby blues” and postpartum depression are two different experiences following childbirth. Baby blues are more common and mild, characterized by mood swings and crying, typically resolving within a few weeks after delivery, due to hormonal shifts and lifestyle changes. In contrast, postpartum depression is a more intense condition with symptoms like persistent sadness and thoughts of self-harm, which can emerge anytime during the first year after birth and may last for months without treatment. It is currently thought to occur in about 10-20% of new postpartum moms. The foundational suggestions (mindfulness, breathing, nutrition, sleep, and exercise) listed below in this article have been scientifically proven to help with both conditions. However, postpartum depression is considered to be a major depressive disorder, which may require the help of mental health professionals. If you are in a crisis, please call the emergency lines in your country. To understand more about these two, including trauma and PTSD, as well as a discussion regarding “cures” and more support, please visit here.
How can you speed up the postpartum healing process?
Aside from basic postpartum period care discussed above, there are five postpartum foundations that can be addressed to speed up the postpartum recovery process:
- Mindset
- Nutrition
- Sleep
- Breathing
- Movement Patterns & Corrective Exercise
We will touch upon them each briefly, and then help you understand more in-depth how to be mindful of your breathing, daily movements patterns, and corrective exercise.
Mindset: First, try not to be in a hurry. Wishing it was going faster is actually a thought-induced stress. You can read more about how thoughts create physical & hormonal stress here. Having said that, reducing mental-emotional stress wherever possible is critical. To be sure, it is a moment-by-moment practice, and there are a myriad of ways to practice. 6 Strategies for managing emotions can be viewed here.
Nutrition: Without going into great details here, natural unprocessed foods are the ones that our body’s are generally more able to extract nutrition from. Processed foods simply don’t have that same primary and secondary nutrients. How fast your physical body heals depends a whole lot on your ability to provide the building blocks for that healing.
Sleep: Since your sleep is about to be limited and broken, it is particularly important to emphasize the other foundations during this initial postpartum period.
Breathing, Movement Patterns, and Corrective Exercise: The remaining postpartum foundations will be addressed below in more detail…
Breathing, Movement Patterns, and Corrective Exercise
There are a few muscle imbalances or misalignments that nearly every new mom should address, and some of these can start as soon as you deliver, yes even in the first days after delivery! There are two types of postural imbalances: ones that are occurring frequently in the population (due to chair sitting, car pedals on the right foot only, and pregnancy-expansive bellies), and ones that are specific to you (placing bodyweight more frequently on your right leg, placing your tablet on the left side of your computer, holding baby more commonly in the left arm).
An article like this will help you understand frequently occurring imbalances. An understanding of your personal imbalances will require you to pay deep mindful attention to your body habits, and possibly require a formal assessment by a pre & postnatal certified trainer (or physical therapist).
Day #1: Use diaphragmatic breathing to circulate healing blood flow and gently reconnect the core.
Breathing can be a major cause of healing or strain, depending how you do it. Proper diaphragmatic breathing will generally fill your torso as you inhale, and allow your abdomen to “come back together” as you exhale. Doing this, instead of solely breathing into your chest or upper “shoulder and neck” areas reduces musculoskeletal strain from your body.
Proper diaphragmatic breathing also naturally stimulates your core to respond. In general, inhaling into your torso will gently allow your pelvic floor muscles to relax, while exhaling is coupled with the tummy muscles mildly corseting and your pelvic floor also mildly activating. This is natural and proper “inner unit” mechanics. After delivery, you can use any number of your 20,000+ times you’ll breathe each day to gently encourage your body to remember this innate cyclic contrast.
There are two reasons why this gentle reconnection does not always happen in the core inner unit.
First, many people simply do not have these mechanics working even before pregnancy, due to modern and sedentary lifestyles. This previous pattern typically is exacerbated during pregnancy. Expecting an already dysfunctional core to suddenly start working after delivery is just not often a good bet.
Second, even a fully functional pre-pregnancy core is common to suffer some sort of trauma that disrupts proper function. This could come in the form of a c-section, tearing of the pelvic floor muscles during vaginal delivery or an episiotomy. There are also internal traumas like pelvic organ prolapse, that can not be so readily seen from the outside. Even when nothing “obvious” happens, it is quite common that the core muscles will need to recover. Will they recover back into proper function, or will they recover into dysfunctional compensatory patterns?
That is often determined by what you do within the first few days, let alone weeks.
So, on day #1, be conscious and mindful of your breathing:
- Inhale, allowing your torso to expand (be especially gentle if you’ve just had a c-section, but also know that this kind of breathing is exactly what will directly bring healing factors in & out of the right areas).
- Exhale, gently encouraging your pelvic floor muscle and tummy muscles to activate. Gently. You’re not trying to win a competition, you’re aiming to gently reconnect these areas.
At the very least, this conscious “core breathing” practice should be exercise #1 within the first 6 weeks of delivery.
First 6 weeks Exercise Routine.
Now, being that you will be carrying a baby, bending, lifting, squatting to sit & stand, etc, it would be wise if you knew what muscles were supposed to be working for those movements!!
Will you bend over with your glutes or with your lower back? This is one of the main determinants for your level of back pain in the following months. Will you also remember to keep your core breathing working as you sit on the toilet, or stand up from the couch?
Every time a new mom bends over to pick up her child, gets up out of a chair, or performs a movement of any kind, especially in the first 6 week, she should be conscious of which muscles she is using (and which she is not).
If there were only two things to remember during this time, it would be core breathing and using your glutes (your butt muscles) to propel any activity of daily life movement that involves your lower body. Just these two items: core breathing and glute activation are typically enough to solve about 80% of postpartum aches and pains.
As far as more formal exercise, remember that medical professionals are defining exercise not as “core breathing” or “corrective exercise” but more commonly as high intensity of some sort. Yes, some women definitely do return to high intensity training of various sorts in less than 6 weeks, but you certainly don’t need to. In fact, there is some hormonal evidence that suggests making the entire 6 weeks a low cycle in your periodization schedule (if you are an athlete, for example).
Consider qi gong and tai chi for example. These are more healing movements than most of what you’ll be doing carrying your baby around the house. These should easily be included within your first 6 weeks! At Fit For Birth, we do something similar called Moving Mediations. These are postpartum exercise routines designed to be healing rhythmic movements, including both stretch and strength-based movements. And yes, we do them as soon as the postpartum mama feels excited to do so, even on the day after delivery!
The truth is that many forms of otherwise intense exercise could be slowed down, reduced in ranges of motion, and otherwise regressed to be specifically energy-enhancing and corrective exercise rebalancing. This is why doctors so often like Pilates and yoga at this time. These forms of exercise are often associated with therapy and less intensity.
However, even Pilates and yoga cause imbalances. Oblique dominance and hypermobility are two of the most common. How do you know if you’re using the right muscles? Well, that’s a whole topic, but the movements should feel really good, like strength building, rather than draining. And you should not have aches and pains associated with your fitness routine. It is just a fact that even the most well-intentioned group classes are not able to teach for your specific imbalances. You will have to be your own advocate there.
Reconnect Your Core Muscles
Core breathing is using your breathing—something you do all day every day—as an opportunity to gently activate your “inner unit” core muscles. The top of your inner unit core is your diaphragm and the bottom is your pelvic floor muscles. The “sides” that corset-wrap around your torso is primarily your transverse abdominal muscles.
Kegel exercises are one of the names given for pelvic floor exercises, and you can feel free to do a variety of these at any point during the postpartum period (gently if you have a tear or episiotomy). However, even more important than sitting down to do several minutes of structured Kegel exercise program, you should be encouraging your pelvic floor muscles to reconnect naturally, 24/7, within as many breaths as you remember to do so, especially in the first few weeks after delivery.
Avoiding Back Strain
Postnatal women are often more likely to overuse their lower back and knees. Their buttock glute muscles are often not activating on their own, leading to this outcome. A new mother is often trying to do many things at once while holding her delicate baby and picking up the diaper bag or car seat, and so is likely to hurt her back if she is overusing it. Instead, try using core breathing and using your mind to load into your glutes as you do these kinds of activities of daily life.
Postnatal women are also likely to spend fatigue-induced hours slumping down, for example as they nurse their infants. The initial alignment idea is to bring shoulder blades together a bit more, but what do you do if you’re already having pains in your upper back? In this case, you’ll have to first lay down on your back, relieving some of the tension by letting gravity help you “bring your shoulder blades together” instead of fighting against gravity. At Fit For Birth, we have many of our clients lay vertically on a 36-inch foam roller. This allows your shoulders to fall more deeply together, again thanks to the help of gravity.
The take-home message is to be more present, and take notice of your movement habits. Unfortunately, this is likely at a time when you’ve got a whole lot of new things to take care of with your baby, so don’t be too hard on yourself. This need not be a race. Instead, you can use your postpartum time period to be your opportunity to begin your journey toward even more health and fitness. This postpartum time frame is the trigger for you to become aware of your movement habits! Soon, some of these foundational corrections will become automatic, and you will be solving your own aches and pains. Begin this change now, and you’ll be securing your right to enjoy many more pain-free activities throughout the growing years of all your children.
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If you would like to receive fun guidance during your postpartum core rehabilitation, with qualified corrective exercise specialists, please view Fit For Birth personal training.
We also offer Free Weekly Online Postpartum Group Exercise Classes! Register now!
For more information on how to activate your core breathing during your next pregnancy, you can register for a free report here.
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James Goodlatte is a Father, Holistic Health Coach, Corrective Exercise Practitioner, Speaker, Author, Professional Educator, and the founder of Fit For Birth. Since 2008, when he found out he would be a father, his passion for holistic wellness shifted to children and families. Today, he is a driving force in providing Continuing Education Credits for the pre and postnatal world, with Fit For Birth professionals in 52 countries. James is also the program director for Fit For Birth pre & postnatal personal training worldwide, and is a contributing member of the First 1000 Days Initiative at the Global Wellness Institute.