Updated March 2019
Get the full lowdown on Postpartum here; including what happens after delivery, the first days, going home, recovering, etc.
This week’s issue details the real postpartum experience, written from our own experiences. It’s very long and meaty, so I apologize in advance.
The First Hours After Delivery
Vaginal Delivery: If your baby is in good shape, they will probably hand him/her over immediately. Having a slippery, bloody, slimy baby plopped on your belly is like no other experience in the world; it’s a special moment that will seem totally surreal. Meanwhile, your partner will be asked to do the honors (cut the cord). Talk to your OB in advance if you wish to delay the clamping of the cord.
While you are getting to know each other, a few things will happen — and you may not even notice ANY of it. You will deliver the placenta and all of the other *gook* usually within 20 minutes or so. You may get an extra dose of pit (pitocin) if the placenta is being stubborn.
Your OB will also stitch up your perineum (if required) and otherwise tend to your undercarriage. If you have an epidural, you will continue to be oblivious to any of this, which is beyond faaaaaaabulous.
This is a great time to inquire as to… the condition of things down thar. Ask your OB about the severity of any tearing or hemmies, as they usually don’t like to ruin your moment with such things.
If you had an epidural, now is when they shut it off. They will also remove your catheter if you weren’t on any other medications for complications. The bottom half of your body will still be numb for anywhere from 1-3 hours. Yeah, it’s pretty strange.
Right after birth (for about 45 minutes), your baby will be very alert and ready for his/her inaugural snack. Take advantage of this time to nurse your baby before he/she succumbs to the post-delivery hangover.
Nursing during this time will release oxytocin, which also helps to expel the placenta and contract the uterus.
Note: Read Lowdown on Latching which will tell you how to properly get your baby latched on–very important!!–Let the nurses help you as well.
This heavy dose of oxytocin will also make you feel extremely and suddenly… sleeeeeepy. I remember fighting just to keep my eyes open. Hand the baby over to your partner if you’re having trouble keeping your eyes open.
In the first hour, the L&D nurses will likely massage your fundus, which is the top of your uterus. This is just an external belly massage that helps ensure your uterus is clamping down, as it should, to slow the bleeding and break up any clots. This can be a little painful if you’re not expecting it.
During this time, you may also receive pitocin through an IV, an injection in your leg, or a suppository if the bleeding is heavier than they would like. From there, nurses will be checkin’ up on that fundus every 2-3 hours or so. They do this to prevent bleeding complications, so be a sport about it.
C-Section Delivery: 30-40% of you will end up having a C-section, whether you volunteered for it or your baby just wasn’t cooperating. Everyone’s C-section experience is very different, but here are a few stories from readers so you know what to expect.
What IS important to remember, is that a C-section is a major abdominal surgery that takes approximately 6-8 weeks to fully recover. The first few days (okay…the first full week) will definitely be…umm…uncomfortable; you will need help getting in and out of bed, getting in and out of the shower, getting dressed, and – yes – even lowering and lifting yourself to and from la toilette. So just take it easy, accept all the help (from nurses, friends, family, etc.) that’s offered, and know that in time your body will heal.
If you know for certain you’re going to be having a C-section (or you just want to be prepared in case), check out our piece about What to Wear after a C-Section (trust me, you’ll want to have comfy clothes on-hand that don’t irritate your incision!) and read about our thoughts on Postpartum Binders/Girdles.
Also in that first hour or so? FOOD. You will be the hungriest mother-effer this side of the Mississippi (whichever side you happen to be on). Here is where you get to order a dry turkey sandwich from the hospital menu and like it. You won’t even care that the food is awful because at this point, you’re so hungry you could eat the placenta (sorry, I just threw up in my mouth).
Note: if you had a C-section, the food will likely have to wait until much later (I’m SO SORRY about that! I know…it sucks). But…on the plus side…you’ll get ice chips! Okay. I know that’s not nearly as exciting as food, but it is what it is. And really, after a big surgery, the last thing you really want to do is eat anyway…so just…enjoy your ice chips.
A couple of hours after you deliver, you will likely be wheeled from the OR/L&D to a recovery room, unless your hospital has rooms where they do both. If you had an epi, you still might not be able to feel your cold, lifeless, meat-like legs, so they may wheel you on a gurney or a wheelchair to your recovery room. This is where you, your partner, and your baby will spend the next two nights (vaginal delivery) or four nights (C-section delivery), unless there are complications, in which case you may stay longer.
After a few hours go by… and the painkillers are wearing off….. you’re gonna be all: oww! What is this contraction-like sensation? You thought you were done – mwaaaa! Those are called afterpains and they are no joke (for me, at least — some people don’t even notice them). Essentially, your uterus is contracting down (which is good), but it hurts. They are usually triggered by nursing. They should be gone by the third day, but in the meantime you will need to manage this pain.
Once in the recovery room, they will proceed to remove your IV (if you had one). You may have some tenderness in your hand or arm from the IV, but it’s no biggie. Now you’re cordless!
After you sober up a bit, the nurses will offer you Vicodin (every four hours) and Ibuprofen (every six hours) to treat your pain (yes, both are safe for breastfeeding). They may also give you a stool softener twice a day (very important!). Do yourself a favor and stay ahead of the pain!
Be prepared to see blood and lots of it. Your bathroom floor *might* look like the murder scene from Psycho. You will feel sorry for the poor dude who has to clean up after you. Sorry, janitors. I hope you get paid a LOT.
You will also be outfitted with the finest mesh underwear that healthcare has to offer. But wait, there’s more! Call right now and they’ll throw in two gigantic maxi pads and a huge ice pack for your crotch. If you delivered vaginally, this ice pack will become your very best friend over the next two days; use it religiously.
Vaginal delivery: you should also know that you will have no bladder control whatsoever. No siree. Did I mention the giant maxi pads? Verrrry handy. Getting up to pee right after you had your baby REALLY sucks. Not gonna lie.
Bonus for moms who deliver via C-section: your bladder will be largely unaffected! Woohoo.
Okay, enough about you.
When baby arrives, they will weigh him and clean him off. They will apply all sorts of ID bands and even a lojack thingy on his umbilical cord or ankle. Baby will likely receive a shot of Vitamin K (to help with clotting) and his first Hep B shot. He will also get a heel prick, which they will use to detect diseases, such as PKU. If you didn’t already receive them during pregnancy, you will likely be offered some shots as well while you’re in the hospital, including Tdap [a booster for tetanus (lockjaw), diphtheria, and pertussis (whooping cough)] and whatever else is hip at the moment.
Your pediatrician will keep a very close eye on your baby during the first week. They may (depending on whether or not they have privileges there) attend to your baby in the hospital right after birth and every day that you’re both in the hospital. They want to be extra sure that he/she is successfully eating and regaining the weight lost at birth. If your baby loses more than 10% of his/her birth weight, they will pay extra close attention to this situation (although this happens a LOT, so don’t be alarmed).
After leaving the hospital, you can expect to go to the pediatrician at least once the first week, even if just for a weight check. This is why it is so convenient to have a pedi who is CLOSE to you. The last thing you will feel like doing is schlepping your one-week-old baby across town when you are postpartum.
Read about: what to expect if you have a baby who needs to spend time in the NICU.
The First Day & Night
Hopefully at this point, you can catch some zzzzs, although just know that it is really difficult to sleep in the hospital. Like… at all. People are coming into your room around the freaking clock. So many people! What do they all want?? Don’t be afraid to use your “Do Not Disturb” sign, although everyone ignores it anyway.
The nurses will come in to check your blood pressure and take your temperature, like… every three minutes. Okay, maybe not every three minutes but REALLY, really often. They will wake your ass up in the middle of the night to take your damn blood pressure, so be prepared.
You will have the option of keeping baby in your room (called rooming-in) or sending him/her to the nursery. They encourage rooming-in because they hate you and don’t want you to sleep (haha, just kidding) (sort of). Rooming-in is encouraged so you can bond and nurse and get to know each other during those first two days.
Don’t agonize too much about this decision. If you’re well rested and want to keep your baby with you at all times, great, but there is no shame in sending him/her to the nursery so you can both get some shut-eye. You’d be surprised how hard it is to sleep with a snarveling, grumbling newborn in your room. So snarvely.
Hopefully, your partner can get a roll away cot or a pull out sofa so you can all be together as a family. Do yourself a favor and don’t be up and down changing diapers and whatnot — let your partner or the nursing staff take care of this. YOUR job is to rest. The hard work has yet to begin…
Your pain will be at its peak on the second day, but it’s nothing you can’t handle. Keep taking your painkillers, but do get up and walk around if you’re up for it. Your OB will come visit you again to check on things down below decks (or your C-section incision site).
Day 2 is when you really want to focus on nursing (if you are nursing). Again, please refer to our post on latching. Getting a good start with breastfeeding starts here. Take advantage of the free help you can get in the hospital. It will pay dividends.
Remember, if you can’t directly nurse be sure to take advantage of the hospital-grade pump to get your supply going and get that colostrum for your baby! Your breast milk is specifically designed for your baby’s needs.
The second night after birth is when things get a little hairy… your precious little baby has now realized she is out of the womb and isn’t really happy about this situation. I clearly remember a text a friend sent me on the second day:
“2nd night = crazy night”
You won’t read about this in any books, but most moms report this phenomenon (here is a great guide for surviving the 2nd night). Don’t be afraid, this is totally normal; there is nothing wrong with your baby. Or you. Or your milk.
You will be exhausted and in pain, but sleep as much as you can because you are going home tomorrow (NOOOOoooooo!).
(Reading between the lines: the second night kinda sucks, sister. Sorry bout that.)
On day three, eat a good breakfast before you pack up your bags. Hopefully, you brought a cute outfit to bring baby home in. For you, bring some maternity clothes to wear home, as your belly will still be about six months pregnant at this time (sorry, gals, no skinny jeans yet).
Most hospitals require your baby be strapped in his/her infant seat before discharge. If you need extra time with your car seat, have a family member bring it up before you leave. This way, you can take as much time as you need to ensure that your baby is properly secured, since it will be your first time. Bring the manual too!
Leaving the hospital is an emotional moment. Hopefully, you had an amazing experience and are hugging the nurses goodbye. If you are renting a breast pump from the hospital, have your partner pick it up before you check out because it takes a long time to fill out all that paperwork, blah, blah, blah. You’re not going to be in the mood to dilly dally around.
The Car Ride Home
Boy, I am getting really granular here, no? The car ride home can be nerve-wracking. Please, please bring a pacifier with you to use – even if only on this one special occasion. A crying newborn will not make for a good homecoming. If possible, you may want to ride in the back seat with your baby so you can keep an eye on things.
Sitting in the car will only remind you how bad your lady parts or C-section incision hurts. Remind your partner to avoid bumps (ahem) at all costs. I actually held a pillow over my C-section incision to protect it from said bumps.
The First Week Home
The first week home from the hospital is pretty tough.
There, I said it.
If anyone tells you differently, they are lying or just don’t have a very good memory.
P.s. This is not the time to stress about groceries – check out the Lowdown on Grocery Delivery Services.
The reason I say this is not to scare you, but to give you some realistic expectations. If you know that you are expecting Hurricane [enter baby’s name here] to make landfall as a Category 4, you can prepare yourself accordingly. Remember: It’s only a week or so. After the first several days, things get better. I promise.
For thousands of generations (except for the last one or two), women lived in tribal societies where mothering skills were passed along in tightly-knit communities. A newborn baby would have been cared for by grandmothers, aunts, cousins, siblings, etc. A new mom would not be alone to figure things out on her own. You can’t be expected to *know* what to do, you must learn these things. To be honest, it requires a bit of hand holding.
During this first week (or two), it is so important to have loved ones at your house to help you. Your partner is great, but let’s face it, he is as clueless as you. I highly recommend a mother, MIL, a sister, or a good friend – preferably someone who has been through this before. Unless all of the aforementioned people drive you nuts, don’t go it alone. I know a lot of FTMs who insisted on flying solo so they could figure everything out for themselves and bond with their baby. This may sound like a great idea on paper, but it’s not. You are way too tired, achy, and hormonal.
— from Brooke Shields in Down Came the Rain
“Chris and I had planned to spend a week alone at home with the baby, just the three of us, before having our families come for a visit. We had wanted uninterrupted time to bond as a family.
We chose not to have a baby nurse, either, because not only did we not want a stranger in our home, but we figured we could handle it ourselves until our relatives came to stay. We couldn’t have been more wrong. We were anything but peaceful, and because we were alone, we were overwhelmed.”
Having said this, be careful not to have your whole extended family invade your house all at the same time. Space out your visitors so they don’t overwhelm you; this is not the time for a huge family reunion chez vous. You’ll want some alone time sprinkled in there as well.
Your body is recovering from one of the most traumatic physical experiences in life. Even if you had a picture-perfect delivery, your body will still be dealing with the fact that it squeezed something the size of a watermelon out of something the size of a lemon. This coincides with other ill-timed events, like sleep deprivation, hormonal craziness, physical pain, and the stress and anxiety of caring for a completely helpless little monkey. You’ll get through it, but you should be emotionally prepared and set your expectations accordingly.
—>See also: Our Vaginal Recovery Kit
After you deliver, your hormones are going haywire. Prepare to be on Mr. Toad’s Wild Ride, courtesy of estrogen, progesterone, prolactin, and oxytocin. After delivery, your estrogen and progesterone levels drop sharply, reaching pre-pregnancy levels by the fifth postpartum day. This sudden droppage will make you feel REALLY out of sorts.
You can expect that you will be on a rollercoaster ride of elation, sadness, and a little anxiety. You will burst into tears at the drop of a hat (tears of joy? Tears of sorrow? Who really knows). This is normal. Just ride the wave and know that it will take you back to shore.
According to Dr. Alan Greene:
“Most new mothers (perhaps as many as 90%) will have periods of weepiness, mood swings, anxiety, unhappiness, and regret. Usually this lasts for a few days or less and is quickly forgotten.” Read more here.
A note about Postpartum Depression: This is different — much more severe and prolonged — than the aforementioned “Baby Blues”. In fact, be aware that Postpartum Depression can come on any time during the first year postpartum. Please, please let your doctor know if you aren’t feeling any better after a few weeks. There is no shame in getting help. If you had high blood pressure, you wouldn’t think twice about seeing your doctor and taking medicine; this is no different. Be kind to yourself – your body just went through quite the ordeal. (Read Marissa’s story about battling Postpartum Depression here).
Your hormones also do a number on your body temperature. Around Day four, you will be FREEZING cold. So cold you don’t know how you will ever feel warm again. Then you will wake up sweating and peeling your clothes off. Then you will be cold again. Nobody knows why. You may also have a complete loss of appetite. Don’t worry, it’s all normal.
Ok! That was a TON of info! If you are still reading, I thank you for getting through it.
Don’t worry, it’s ALL GOOD. You’re GONNA HAVE A BABY!!! (Cue: I got a feelin’ (WOOOO-hooooo) that tonight’s gonna be a good night…)