Postpartum care: What to expect after birth

Awe-inspiring, overwhelming, scary and sweet — the postpartum experience can be a lot of different things at once. While you can do some preparation beforehand, “it is nevertheless surprising to experience the exquisite degree of sensation and open vulnerability of the postpartum time,” says Eden Fromberg, DO, board-certified OB/GYN and director of Holistic Gynecology New York.

Pregnancy and labor might seem like the hardest parts of bringing new life into the world. But as any new parent knows, the “fourth trimester” (the 12 weeks after giving birth) carries a unique set of physical and emotional challenges.

At this tender time, community support can be critical. “They say it takes a village to raise a baby, and it’s true,” says Maggie Tetrokalashvili, MD, chair of the department of obstetrics and gynecology at NYC Health + Hospitals/South Brooklyn Health. Along with the help of family, friends and health care providers, the right self-care items can help make this time of healing and transition more manageable.

Whether you’re preparing for the postpartum period for yourself or for a partner, here’s what’s recommended to have on hand.

In this article:

What does postpartum mean?

The word is Latin for “after childbirth.” Postpartum means just that: the weeks and months following the birth of a baby.

A health care provider might talk about more specific parts of this period, such as one of these phases:

• Acute postpartum is the 6 to 12 hours following delivery.
• Subacute postpartum lasts two to six weeks.
• Delayed postpartum refers to changes that happen six months or up to a year after giving birth.

What are some postpartum symptoms?

“Every woman is different, and every recovery is different,” says Dr. Tetrokalashvili. Postpartum symptoms might vary because of the method of delivery (vaginal birth or cesarean section), complications surrounding birth and preexisting conditions.

In almost every case, though, some pain and discomfort are a given. Other common symptoms include:

• Bleeding and vaginal discharge
• Breast engorgement
• Constipation
• Cramping
• Hair loss
• Incontinence
• Skin changes
• Sore nipples
• Swelling and water retention
• Vaginal, perineum or incision pain for C-sections

Dramatic hormone shifts can also usher in the “baby blues.” Anxiety, irritability and sadness are common for the first two weeks. If these feelings persist, know you’re not alone. It’s crucial to connect with a health care professional to help manage any mental health issues, explains Dr. Tetrokalashvili.

How to help stop postpartum bleeding faster

Postpartum bleeding may look like a very heavy period. But the discharge (called “lochia”) contains not only blood but also bits of mucus, uterine membrane and endometrial tissue. “Clots very often occur, and that is OK as long as the flow is slowing afterward,” says John Horton, MD, associate professor in the department of gynecology and obstetrics at Emory University School of Medicine. As far as which clot sizes are normal for various postpartum milestones, it’s best to check with your provider.

Bleeding might continue for up to five weeks after giving birth. When it comes to stopping the flow, Dr. Tetrokalashvili says, “Nature has the best medicine.” Breastfeeding releases the hormones oxytocin and prostaglandin, which help bleeding taper off. For birthing parents who don’t nurse, nipple stimulation with a breast pump may help.

Postpartum hemorrhoids

Roughly 40 percent of people will experience hemorrhoids and anal fissures during pregnancy or after giving birth. The pressure of the swollen uterus as well as constipation make hemorrhoids much more likely. Dr. Tetrokalashvili recommends starting with witch hazel and aloe vera on the affected area. If that doesn’t help, try hemorrhoid creams.

So, consider putting, aloe vera gel, hemorrhoid cream or witch hazel on your postpartum shopping list.

Postpartum and breastfeeding nipple care

For those who are breastfeeding or pumping milk, it’s common for nipples to get tender — especially in the first few days and weeks as you and your baby get the hang of a new feeding regimen. About half of newborns struggle to latch within the first day of life, and this can lead to further irritation (think cracking and chafing of the extremely sensitive skin).

“With increased moisture and contact, use direct skin protectants and ointments between feedings,” recommends Dr. Horton. For solutions, consider talking to a health care provider or a lactation consultant.

Ice packs like Lansinoh TheraPearl breast therapy pack may help soothe aggravated areas. As for ointments, Lansinoh HPA lanolin cream and Motherlove nipple cream are all favorites of Dr. Fromberg. If painful cracking or bleeding occurs, contact your health care provider; you might have a condition that warrants a prescription.

How long does postpartum hair loss last?

A few months after giving birth, many postpartum symptoms may have started to wane, but hair may start to fall out. This type of hair loss is called “telogen effluvium” and forces more hair than usual into the telogen or shedding phase. It’s brought on by major life events like illness, stress, weight loss and — you guessed it — having a baby.

Marie Leger, MD, PhD, board-certified dermatologist at Entière Dermatology in Manhattan, explains that the best remedy for postpartum hair loss is time. “It can be overwhelming and scary to lose so much hair at once,” she says. “But know that this kind of hair loss most often eventually ends, and your hair will grow back!” Normal hair growth typically returns one year postpartum.

In the meantime, the American Academy of Dermatology recommends volumizing shampoos and conditioners formulated for fine hair.

For volumizing shampoo, Agadir argan oil daily volumizing shampoo, Batiste Hair Benefits dry shampoo and L’Oréal Paris EverStrong sulfate-free thickening conditioner may be good options.

What are some postpartum essentials?

Dr. Tetrokalashvili explains that it’s best to stock up on postpartum products before the baby arrives, if possible. “It’s great to be prepared with an essentials kit,” she says. While new parents’ experiences and preferences may differ, health care providers recommend considering these options:

• Birth control options. While another newborn may be the last thing on your mind, Dr. Tetrokalashvili explains that it’s important to consider birth control options sooner rather than later. To avoid complications, the American College of Obstetricians and Gynecologists recommends waiting until your little one is 18 months old before getting pregnant again.

You can talk to a health care provider, including MinuteClinic, about the best option for you.

• Breastfeeding accessories. For those who plan to breastfeed or pump, supplies like nursing pads, breast pumps and bottles can be critical.

Learn more about breastfeeding tips here.

• Donuts and support pillows. From your breasts to your bottom, everything could use a little more cushion during postpartum recovery.

You might try a CVS Health^® foam ring cushion for sitting, the Avana Uno adjustable memory foam snuggle pillow for sleeping and the Feeding Friend travel nursing pillow for breastfeeding.

• Heating and ice pads. Dr. Horton recommends having heating and ice pads as part of your postpartum kit to help manage back aches, breast discomfort, cramping and perineal pain and from nursing and delivery.

Try a Private Packs hot-and-cold vulva personal pad and Frida Mom instant ice maxi pads. Try the CVS Health series 700 fabric heating pad and the CVS Health contour gel therapy cold compress pack for other sore spots.

• Heavy-duty pads. “Especially when moms are busy breastfeeding and they want to sleep, it’s important to have heavy-duty pads available,” says Dr. Tetrokalashvili.

Both maxi pads and overnight maxi pads can come in handy.

• Numbing spray. Local anesthetic sprays can help decrease pain. This may be especially helpful for those who experienced tearing or an episiotomy during a vaginal birth.

A couple options include Dermoplast anesthetic pain-relieving spray or Lansinoh postpartum pain-relief spray.

• Over-the-counter pain medication. Ibuprofen and acetaminophen are typically recommended for postpartum pain and swelling, because they are considered safe to take while breastfeeding.
• Peri bottle. “Having a pericare bottle to help with rinsing will be very helpful,” says Dr. Horton. The product is like a portable bidet.

A few such products include Frida Mom upside-down peri bottle and Lansinoh postpartum peri bottle.

• Protective underwear. Leak-proof underwear, such as period underwear, can help provide extra protection.

Try Unders by Proof regular-absorbency period underwear and Thinx for All super-absorbency cotton brief period underwear for reusable options or CVS Health maximum absorbency underwear and Frida Mom disposable postpartum boy shorts underwear if you prefer single-use options.

• Sitz bath. “Sitz baths help with the discomfort, and it’s nice to soak for a little bit,” Dr. Tetrokalashvili says.

The CVS Health sitz bath is one option.

• Stool softener. Hospitals often dole out stool softeners following delivery, but it may be helpful to have extra at home to manage discomfort from tearing or hemorrhoids.
• Witch hazel pads. Both perineal tears and hemorrhoids can be soothed with cotton pads soaked in witch hazel.

This content is for informational purposes only and is not medical advice. Consult your health care provider before taking any vitamins or supplements and prior to beginning or changing any health care practices.