Postpartum Recovery: a realistic timeline for healing
I see & work with a lot of postpartum moms, and one of the most common things I hear is: “I was not prepared for this”. There is such a lack of education for expecting moms on the reality of postpartum recovery. I want every new mom to go into postpartum feeling prepared, empowered & knowing where to turn to for support. Postpartum is forever, and we need to start planning for the long term when we talk about this next chapter of life.
Now, let’s break down a realistic timeline of recovery and what to expect:
Weeks 0-2
No matter how you birthed your baby, these first two weeks are critical healing time for your body. You can expect to feel sore, swollen & tender. You will be bleeding (hello adult diapers). You may have fresh stitches. Your uterus will still be contracting back to it’s normal size and you may feel some discomfort from that. Your milk will come in and your boobs & nipples may hurt as you adjust to feeding. It’s important to prioritize rest, nourishment and accept tons of support from your people. Stay in bed as much as possible, minimize trips up & down stairs and sleep when you can. Ice, herbal sitz baths, compression underwear and ibuprofen are necessary. Peeing & pooping may not feel very comfortable, use a peri bottle & rely on your stool softeners. Movement is minimal in these weeks but gentle mobility & breath work are a great way to support the healing process and ease bodily aches/pains.
Weeks 2-6
For a lot of moms, the 2-3 week mark is where soreness & bleeding start to minimize and you may start getting the desire to move your body a little. Your body is laying down collagen and doing a lot of work to heal your wounds. This is a great time to see your pelvic PT and begin some guided rehabilitation work. It’s important to know that you are still healing so you do not want to over-do it. But easing back into a walking program and reconnecting with your core & pelvic muscles is a great way to help your body on a healing path. You are going to be tired, so rest always comes first and honor what you have energy for. Hydration and nutrient dense food continue to be essential. Peeing & pooping should start to return to normal by 6 weeks, if not - it’s time to see a pelvic floor PT!
Weeks 6-12
At your 6 week check up, you will likely be cleared to resume exercise & sexual activity. If you have stitches, they should be healed at this point. It’s important to remember that just because you are cleared, doesn’t mean you are ready! No matter what your prior fitness level is, everyone needs to go back to the basics and rebuild from the ground up in postpartum. If you are able to get back into an exercise program - it’s essential that you work on rebuilding strength and progressively load your body. Low impact exercise is best during this time as your pelvic floor is still healing. Motherhood has a high demand on your body, you have to take care of you so that you can take care of your little one. If you find yourself with any pain or symptoms of pelvic floor dysfunction, make sure you have a plan with your pelvic floor PT to address this. And if sex doesn’t sound appealing to you, rest assured you are not alone and there is no rush!
Months 3-6
The tensile strength of scars maximizes in this time. Assuming you’ve done the foundational work in the earlier months, you may be ready to start introducing higher impact activities and returning to sports/recreational activities. I think it’s important to remember that healing is not always linear. It’s really hard to be consistent with exercise when your sleep is inconsistent, you may be returning to work, childcare is a barrier, your mental health is struggling, etc etc. Give yourself a lot of grace during these months. For most, these are the hardest months of postpartum. Society forgets that you are still postpartum during this time, but you still very much are and continue to require so much support. This is where a lot of my patients get frustrated that they still aren’t feeling back to normal and I have to gently remind them that they are still SO early in their postpartum journey. If you fell off the band wagon with exercise, you can get back on at any time. Take it one day at a time. What helped me & helped others is to try and move your body everyday in some way. Maybe that’s getting out for a walk, maybe that’s doing a few stretches during tummy time, maybe that’s getting to an exercise class with a friend. You may have 5 mins or you may have 60, just move in a way that’s accessible and feels nourishing for body, mind & soul.
Months 6-18+
This is a big window of time, but I include the large range because there is such a large range of normal! Pelvic floor muscle function starts to normalize by 6 months on average. Your hormones will gradually regulate in this time and depending on your breastfeeding journey, your cycle may return to some normalcy. You may start to experience a gradual return of your libido. Some may even find themselves pregnant again in this window! It’s important to know that a lot of people don’t start feeling like “themselves” again until after a year postpartum, and oftentimes longer than that. The first year of motherhood is so much about finding your feet underneath you again. Your body has done so much. It’s important to remember that strength takes a long time to rebuild, especially in the muckiness & complexity of postpartum. The focus during this time is about finding consistency and creating new wellness routines/habits. You got this, mama! Know that if you struggled to take care of your body during the earlier months of postpartum, it’s never too late to begin. We’re here for you when you’re ready!