The First Few Days: What to Expect After Birth
As postpartum doula, I’m a strong believer in learning about (and preparing for) the postpartum period, just like we typically do for birth.
Why?
Not only because postpartum is much longer than giving birth, but also because we usually experience the fourth trimester better if we’re a little more prepared, a little more aware and a little less surprised about what to really expect during the first few days after birth.
In fact, many of the families I support during the early days of the fourth trimester tend to bring up questions about the same subjects.
In today’s article, I'm sharing a few common things that you can expect to happen in early postpartum. My hope is that this will help you be a little better prepared to really enjoy the first few days.
You will bleed for a few weeks
Your uterus will continue contracting
Expect your baby to sleep and feed a lot
The second night is often the hardest
You may experience a lot of strong (and mixed!) emotions
Your breasts will change, whether you breastfeed or not
You will likely need lots more support than you anticipated
Disclaimer: This blog article is not meant to be an exhaustive list of everything that happens in postpartum but is intended for general guidance and education only. For more in-depth information, please consult your postpartum doula or your trusted perinatal health care professional.
1. You will bleed for a few weeks
After giving birth, you will experience vaginal bleeding for a few weeks.
This phenomenon is called “lochia” and unrelated to whether or not you give birth vaginally or via cesarean section. Through vaginal bleeding, our postpartum body is expelling blood and other vaginal discharge such as mucus or uterine tissue.
(Source: 4 Weeks Postpartum Bleeding)
As pictured above, postpartum bleeding comes in several stages and decreases in colour and intensity as time goes on. Unlike a regular period, lochia starts off strong and then eases in intensity.
►►Tip: Remember to avoid using tampons – postpartum underwear or overnight pads are best for absorption and to minimize the risk of infection. It’s best to stock up on these items as you prepare for postpartum.
2. Your uterus will continue contracting
Many new mothers are surprised about painful sensations that feel similar to period cramps or contractions, also known as “afterpains”. They are short, sharp cramps that usually coincide with nursing (which stimulates uterine contractions).
During afterpains, your uterus will contract for two primary reasons:
To stimulate postpartum bleeding (as described above) and naturally prevent the risk of postpartum hemorrhaging
To slowly move back into its original shape after having expanded up to 1,000 times during pregnancy
Afterpains are not related to your first period after birth, which tends to come in after 6-12 weeks for bottle-feeding or mixed feeding mothers or after several months (or even years) for exclusively breastfeeding mothers.
►►Tip: If you experience bright red, heavy blood flow with large blood clots and severe pain beyond the first few days, please seek immediate medical attention. This may be indicative of postpartum hemorrhaging.
3. Expect your baby to sleep and feed a lot
Newborns tend to be very sleepy for the first few weeks of their lives, and pretty much only wake up to feed.
Ideally, newborns should eat at least 8-12 times within a 24-hour period, meaning that they will feed at least every 2-4 hours.
However, don’t be fooled into thinking that newborns will feed or sleep on a schedule. Feeding schedules or rhythms, as I prefer calling them, are usually all over the place.
New parents are often surprised about periods when babies cluster feed and pretty much spend long stretches of time on the breast or the bottle. Know that this is very normal during growth spurts and developmental leaps, and a normal part of infant development.
Also, keep in mind that babies don’t know the difference between night and day yet. As long as their circadian rhythm hasn’t developed yet, they have no notion of time and will be up and feed overnight as much as they do during the day.
►►Tip: If you’re concerned about how often (or how little/ much) your baby feeds, please reach out to a certified lactation consultant (IBCLC) for a thorough evaluation. If you’re worried about sleep, reach out to a baby sleep consultant who’s trained in normal infant sleep development.
4. The second night is often the hardest
Also known as the “second night syndrome”, it’s pretty common that babies have a harder time during their second night of life compared to the first one.
Right after they’re born, newborns are usually very exhausted and sleepy from the birthing process. On the second night, however, newborns are a little more alert, will feed frequently and become very fussy. As babies attach through the senses during their first year of life, they sense that their new reality is suddenly very different to what they’ve been accustomed to.
Jan Barger, RN, MA, IBCLC, FILCA, described this phenomenon quite accurately:
“All of a sudden, your little one discovers that he’s no longer back in the warmth and comfort – though a bit crowded – womb where he has spent the last 9 months – and it is SCARY out here! He isn’t hearing your familiar heartbeat, the swooshing of the placental arteries, the soothing sound of your lungs or the comforting gurgling of your intestines. Instead, he’s in a crib, swaddled, in a diaper, a tee-shirt, a hat and a blanket. All sorts of people have been handling him, and he’s not yet become accustomed to the new noises, lights, sounds and smells. He has found one thing though, and that’s his voice… and you find that each time you take him off the breast where he comfortably drifted off to sleep, and put him in the bassinet – he protests, loudly!” (Source)
Unfortunately, the second night often coincides with the moment that new parents are being sent home from their hospital or birthing center. Remember that this is a normal phase of infant development and that it will pass.
►►Tip: If you can, line up support for the second night at home so that you can spend as much time with baby as needed. Have meals ready. Prepare a little station next to you and baby that contains the essentials (snacks, water, nipple cream, diapers, baby wipes etc.).
5. You may experience a lot of strong (and mixed!) emotions
Postpartum is a time of intense emotions. We must adjust to our new reality as parents, learn a million new things about caring for our baby (and ourselves!) and go through huge hormonal shifts.
Our estrogen and progesterone levels will drop dramatically after birth, which often leads to us feeling a little down, irritable or sad (the infamous “baby blues”).
Then, a new set of hormones takes a more prevalent role: prolactin and oxytocin.
Prolactin is the hormone responsible for lactogenesis, the production of milk. Without prolactin, we cannot produce colostrum or breast milk. Interestingly, breastmilk secretion increases when nipples are stimulated more frequently, more intensely and longer.
Oxytocin, also called “the love hormone”, is activated through many of our senses: by touch, warmth, smell, hearing, etc. It is released to stimulate our uterus to contract during childbirth (to help birth the baby) and during postpartum (to expel uterine contents and help the uterus move back into shape). Breastfeeding stimulates oxytocin release and helps us better bond with baby, heal, promote mental health etc.
Hormone Levels of Lactation (Source)
This hormonal rollercoaster ride means that we will experience a lot of strong, often mixed emotions. We may feel over-the-moon in love with our newborn, yet also very sad and anxious about our new role as parent. We may be happy with our reality yet feel overwhelmed and mourn our old life.
Remember that mixed feelings are normal and be gentle with yourself.
►►Tip: Should you experience feelings of sadness, anxiety or anger for prolonged periods of time or not feel quite yourself, you may be having a perinatal mood and anxiety disorder (such as postpartum depression, anxiety, OCD, rage etc.). Please consult a trusted mental health practitioner to get help. Postpartum Support International has great free resources and a fabulous network of perinatal mental health specialists.
6. Your breasts will change, whether you breastfeed or not
Regardless of whether you choose to breastfeed or not, expect your breasts to change.
Right after birth, your breasts will begin producing colostrum, the perfect first food for baby. Colostrum is a thick, yellowish liquid also called “liquid gold” that is rich in calories, fat, vitamins, minerals and protein. It contains everything baby needs until the actual breastmilk comes in.
Once your milk comes in after a few days (usually after 2-5 days), you can expect your breasts to become bigger, feel harder to the touch and very full. If you experience discomfort or pain, remember to feed your baby frequently to relieve some pressure or express some milk manually. With time, your milk production will adjust and signs of discomfort should disappear.
►►Tip: Especially during the first few days, many new mothers leak from their breasts and wake up soaked in breastmilk at night. If that’s the case with you, you could place a waterproof pad under your sheets and have a change of clothes handy. And no worries, your milk production will regulate.
Related post: 7 Common Breastfeeding Challenges and How to Overcome Them
7. You will likely need lots more support than you anticipated
As much we can educate ourselves on the postpartum period, a huge factor is how we experience the fourth trimester is our support system. And generally, we tend to need more support than we anticipate.
My best advice for preparing for postpartum is always less stuff, more support.
And while the type of support needed is very individual and different for each family, the following types of support are usually most helpful:
More support from friends and family to drop off groceries, cook freezer meals or send us meal deliveries.
More support from postpartum health professionals such as lactation consultants, pelvic floor physiotherapists or mental health professionals.
More practical support from a trusted postpartum doula, so that you can catch up on sleep, bond with your baby or get evidence-based guidance on breastfeeding, healing and baby care.
►►Tip: At any time, practice asking for help. You could incorporate the sentence “I feel … and need help with …” in your vocabulary. This will help your network better understand your needs and cater to them when you become a parent. For extra support, consider hiring a postpartum doula to support your wellbeing during the fourth trimester.
