Wondering what normal is? Here’s your postpartum recovery guide for week one after giving birth, from a postpartum nurse.
Thanks for stopping by my timeline! I’ve worked hard to put together a postpartum care guide for you. I know firsthand how unexpected postpartum recovery can be. After birthing three of my own babies and caring for thousands of new moms, I hope to bring you a guide along with some encouragement. Let’s look at postpartum week one.
I just recently stepped into the doula role for a friend who birthed her firstborn. She has truly moved through the recovery process so well! Breastfeeding went smoothly for her and with a minimal tear, her perineal healing hasn’t been an issue. What a blessing!
Not all moms experience a breezy first week. Many of us don’t have breastfeeding kick-off to the right start. That in itself can be so tough. The soreness that comes from cracked nipples is unlike anything else (more on that later). Though a small number of moms have a lovely postpartum experience, the rest of us can feel we are “in the trenches” for a time.
Postpartum Week One
During the first week postpartum, your body is healing and recovering. Your abdominal muscles are beginning to move back into place, and your pelvic floor muscles are healing.
Your goals for this week are ample amounts of much rest, drinking plenty of water, eating a healthy diet (or at least eating), and taking care of your new baby. Have a goal of taking one shower this week. The most physical activity you should be doing the first week postpartum is light walking when needed.
Vaginal Bleeding:
You will have medium to heavy vaginal bleeding the first week postpartum, especially the first couple of days. You may see a few blood clots. If they are the size of a softball, call your healthcare provider. You will need heavy or overnight sanitary pads or disposable postpartum diapers for the first week. Expect vaginal discharge to continue for four to six weeks after a vaginal birth and two to three after a cesarean birth. But each week, the bleeding gets lighter.
This week bleeding will look bright to dark red and is similar to a period. You may notice more bleeding when you nurse your baby. This is because the uterus contracts with nursing due to oxytocin release. You may also notice bleeding if you’ve been lying down for a while and then get up. This is normal.
Perineal Care:
Taking care of your bottom is a priority the first week postpartum. I recommend using a sitz bath with warm water at least once a day for the first week. This helps soothe and clean your bottom. Perineum soreness can also be soothed with ice packs.
Using padsicles is a great way to relieve the discomfort in your perineum (the skin between your vagina and anus). I also recommend Dermoplast (with the blue lid) for an instant pain relief. Never use Dermoplast at the same time you use padsicles or ice packs. This can lead to tissue damage. Using Proctosol or Hydrocortisone cream on hemorrhoids can provide instant relief.
One of my favorite OG nursing tips is to sit on your Boppy pillow. It instantly takes all pressure off of your bottom. You could also buy a little donut pillow to do the job.
Bowel Movement: Pooing and Peeing
You may have experienced stinging at your urethra right when you start to pee. This is normal and comes from all the stretching of birth. If it burns the entire time you pee, let your doctor know. You may notice some urinary incontinence. This will get better as time goes by. All of your organs are beginning to shift back into place, and even your bladder and pelvic floor need some time to heal.
It’s also normal for you to feel you aren’t emptying your bladder all the way when you go. This gets better after a couple of days. Try to pee every few hours, even if you don’t feel like you need to go. After having a baby, it’s common to not feel the urge to pee. Sometimes a new mom tells me her uterus hurts, but I can feel a distended bladder. At times, the problem is she just had to pee but couldn’t feel it.
You will more than likely have your first postpartum poop this week. Stay hydrated. Take stool softeners until regular and don’t strain when you go.
Exercise:
Regular exercise probably won’t be resumed until six weeks postpartum, but we will look at some safe activities you can begin to do in a few weeks. The American College of Obstetricians (ACOG) recommends resuming exercise at six weeks postpartum. This is because all women, no matter birth method or birth injury, can safely start exercising then, BUT many moms will feel ready before that. More on that soon, but for now, no exercise this week.
Do not do pelvic floor exercises in the first week of the postpartum period. These will come later. Postpartum exercise started too soon can lead to worse diastasis recti (the separation of the abdominal muscles).
Normal activities this week are getting up to the bathroom, showering, and walking around the house as needed. It’s safe to go up and down stairs if needed. No heavy lifting of older children, but they are welcome to climb on your lap if you are sitting down. Feel free to venture outside at one week postpartum, if you would like, but don’t go far. Even if you are feeling great, you can quickly get sore in your bottom.
Emotions:
Thanks to hormone levels this week, you may deal with the baby blues. This is when you have feelings of sadness, decreased energy levels, feelings of dependence, or anxiety. It isn’t your fault. Thanks to hormonal changes, exhaustion, and lifestyle changes over 80% of mothers tend to feel this way at some point.
If you have the baby blues, know first that it’s normal and you didn’t do anything wrong. You’re a good mom. If they get severe or you feel like you are having symptoms of postpartum depression, let your doctor know. The baby blues usually fixes itself after postpartum week three.
Cesarean Birth:
I spent many years caring for c-section mothers. They have a special place in my heart. I know firsthand how hard it was to get up for the first time. I know how your incision may have burned like a hot iron. Not only are you caring for a newborn, you’re recovering from surgery, and that’s no small feat!
The first week postpartum for you is making sure your pain is under control. It’s taking your meds when needed. Using a belly binder will help give you extra support and will help fix the feeling of your “guts hanging out.” Be sure to take a stool softener/laxative until you are pooping regularly again. Between surgery and pain medicines, you can be at risk for constipation.
If you have staples, you will see your doctor sometime this first week to have those removed. Don’t worry, it doesn’t typically hurt at all.
Pain:
Most healthcare providers recommend rotating Tylenol and Motrin every six hours for the first week postpartum as needed. Heating pads can also add soothing relief to a cramping stomach.
Breastfeeding:
Learning to nurse the first week can bring unexpected surprises with it. For a first-time mom, your breast milk will usually come in around days 4-5. With it comes engorgement, but thankfully it only lasts about 48 hours. After this, your sore breasts will get better. You may have sore nipples as they adjust to breastfeeding. Using lanolin, coconut oil, or nipple butter can help with this. If you are having cracked or bleeding nipples, call your lactation consultant. This makes breastfeeding painful, but it can heal.
It’s normal for nursing to hurt for the first few seconds when your baby latches on, but it should never hurt the entire nursing session. Don’t suffer through a poor latch! Stick a clean finger in the side of your baby’s mouth to break the latch, reposition, and try to latch again. Remember to let your baby open their mouth really wide like a yawn before latching them on.
If you can make it through the first two weeks of breastfeeding, you can make it as long as you want. Be sure to reach out for professional help if you need it. Most breastfeeding issues can be resolved with some help.
Many breastfed babies experience jaundice the first few days after birth. To help keep this at low, untreatable levels, feed them often. Babies get rid of jaundice by pooping. Once you are home, place them in indirect sunlight in a window to also help jaundice levels stay low.
Follow-Up Visits:
If you had a c-section, you may have an appointment to get your staples out. Your baby may also have a pediatrician appointment this week. Vaginal birth patients usually don’t have an appointment with their healthcare provider until week six.
Postpartum Week One
Major healing and recovery is taking place this week. Rest as much as you are able. Less is certainly more right now. Taking care of your basic needs, and bonding and feeding your baby are your priorities right now. This week is the beginning of a metamorphosis journey into becoming “mama.” You’re doing great!
See you next week for Postpartum Week Two