Through my work as an IBCLC breastfeeding and lactation consultant and family supporter with some further training, I am able to support families individually in an outstanding process and in different situations.
From my experience in counseling mothers, I know that many pregnant women and expectant parents think intensively about the topic of childbirth, but put breastfeeding and the postpartum period into the background.
In this blog post, I would like to explain what you can expect during the postpartum period and what you should know about postnatal recovery.
Hard facts – the postpartum period.
Obstetricians distinguish between the early postpartum period, up to the tenth day after birth, when the woman should really take it easy—meaning she can spend as much time in bed as possible—and the late postpartum period, up to eight weeks. Some also call the postpartum period the 'fourth trimester,' and a midwife colleague aptly describes the first few weeks as the bathrobe period.
The early postpartum period
In the early postpartum period, birth wounds heal, milk production begins, and the uterus gradually shrinks, noticeable through afterpains. If you're wondering what the word means or what the meaning is, then the name says it all. You should spend most of the first few days in bed and lie down a lot; after all, rest and relaxation are particularly important, both for healing your birth wounds and for settling into your new role as a mother. Some women feel empty or surprised by strong emotions after the previous birth experience. They need rest for these new experiences and for the bonding process with their baby.
The late postpartum period
The postpartum period ends when your body returns to its pre-pregnancy state, after about eight weeks. It serves as a process of adjusting to family life and your hormonal changes. The well-known midwife Ingeborg Stadelmann beautifully compares the postpartum period to a couple's relationship, with the various phases of falling deeply in love, getting to know each other, and the trials of everyday life. She goes on to write in her book, "...ultimately, the postpartum period will be a high point in the relationship."
Through extensive bonding and getting to know each other through skin-to-skin cuddling, your mother-father-child bond will be particularly strengthened. During this transitional phase, you as parents are getting acquainted with your new daily routine, and the web of relationships between you as parents is also completely reshaping.
From pregnancy to the postpartum period, your body undergoes physical and emotional changes, accompanied by many new sensations and questions. In the first eight weeks, not only does your uterus shrink, but the breastfeeding bond between you and your child also develops during these first few days.
A mother experiences enormous hormonal fluctuations, so her emotions will often experience ups and downs, also known as crying days or baby blues. During this sensitive initial phase, a family needs a lot of mindfulness and care to regain their strength, as well as plenty of rest and affection. A healthy, varied diet, as well as sufficient support and attention from those around them, are especially important in those first days and weeks after birth.
Here are some tips to prepare for your postpartum period:
- Clarify the visitor policy in advance. Who is welcome in the initial period? Visits after the birth should be carefully controlled, as they often mean stress for you as a new mother. Ask visitors to bring cake, food, and flowers instead of food, and perhaps even take on tasks for your family or household chores. Keep in mind that during the first two weeks, visitors will be visiting you and your baby in your most intimate space—the bedroom! There's no time for styling and tidying up.
- Find a midwife as early as possible to care for you before and during birth and during the postpartum period.
Contact a pediatrician (especially if you are planning an outpatient birth) - Organize additional support services (family, friends, household help, maternity nurse, doula, errands, etc.)
- Pay attention to your diet and drink enough (perhaps cook small portions in advance, create meal plans with your partner, get breastfeeding tea), both during pregnancy and after birth, especially while breastfeeding!
- Do as much as possible before the birth (shopping, basic supplies, preparing forms, hospital bag, courses, hygiene items, etc.)
- Prepare your bedroom so everything is within easy reach. When you're busy breastfeeding or your baby has just fallen asleep in your arms, you'll be glad to have the essentials within easy reach (breastfeeding tea or a jug of water, power snacks (trail mix, granola bars, fruit, etc.), breastfeeding cream, burp cloths, your favorite book, diaper changing supplies, and much more).
- If you and your partner want to feel more confident handling and caring for your baby, plan ahead for breastfeeding preparation, infant care, and first aid courses.
- Many courses and workshops are now also offered in a convenient online format! After the birth, your focus will be more on your sweet baby than on parenting courses.
What is lochia?
During the first two days, your bleeding will be heavier than your period, perhaps even more than you can imagine. Postpartum bleeding lasts up to four weeks, possibly a little longer. It is heaviest in the first ten days and gradually changes from reddish to brown, yellowish, and then whitish. From the third day onward, the bleeding will become more flesh-colored and somewhat watery, becoming the familiar postpartum bleeding, also called lochia.
Avoid using tampons during the postpartum period and get soft, unscented cotton pads, so-called fleece diapers, before the birth. This will allow you to effectively collect and control even larger amounts of blood. If you need more than one pad per hour to collect your blood or if you find larger clots (blood clots), you should consult your midwife or call your gynecologist. For the first two days, you will use two to three pads in a larger pair of cotton underwear, changing them every three to four hours.
If you need something cooling, you can insert ice packs into the mesh panties. You can spray the packs with hydrosol (rose, lavender, recommended by your midwife), sprinkle them with a carrier oil or water and essential oils, and chill them in the freezer until needed.
I would recommend using a changing mat, incontinence pad, or a towel as a base for your bed at first. You may experience a rush of blood clots just by sitting up or going to the bathroom. Your midwife will check the amount, color, shape, and smell of your lochia and will ask you about it regularly.
The aftermath
To return to its original shape, the uterus will contract and shrink within a few days due to afterpains. Breastfeeding is the best way to support a successful uterine involution! You'll usually feel a brief pulling sensation, especially during breastfeeding, when your body releases increased levels of oxytocin.
What can you do about pain while breastfeeding during afterpains?
If this is very painful and you want to get relief, you can do the following:
- Maintain constant body heat, keep abdomen warm
- Place a hot water bottle/warm pack or warm cherry stone pillow on your stomach
- Warm, moist compresses on the stomach or sacrum
- Abdominal-kidney belt stabilizes and supports
Conscious or groaning exhalation (as in childbirth; your midwife can certainly show you good techniques and other tips) - Gentle abdominal massage with oil (native, pure, cold-pressed, if necessary with essential oils), clockwise
- Prone position, especially on the first day as often as possible – good for recovery and to relieve pressure on the perineum
- Warm shower, warm (sitting) bath (if circulation is stable) in the first few days not alone
- Yoni Steaming – vaginal steam bath in the late postpartum period
- Please discuss your individual situation with your midwife!
When can I start the recovery process?
You should only begin postnatal exercises, pelvic floor training, and physical activity after consulting your midwife or doctor, usually six to eight weeks after the postpartum period. If you had a cesarean section, it is often recommended to wait eight to ten weeks before postnatal exercises.
After consulting with your midwife, you can begin breathing exercises in which you consciously tense and relax your pelvic floor during the postpartum period.
Training and sports that place particular strain on your abdominal muscles should only resume once any diastasis recti (abdominal muscle separation with abdominal wall weakness) has healed. Midwives or trained physiotherapists also offer special postnatal classes if your abdominal muscles are significantly separated. Regular pelvic floor strengthening exercises are also beneficial after the postnatal recovery period.
Even if it's not the nicest idea to attend a postnatal exercise class after giving birth on top of the new, often stressful daily family life, it is a major investment in a fit body, better fitness, and a positive body image. If you don't do any postnatal exercise at all, you may encounter problems in your midsection later on, such as weak bladder, back or pelvic pain, or pain during sex. Around 20 percent of all women suffer from urinary incontinence in the first few weeks after giving birth. It's important to take the postnatal exercises seriously and integrate them into your everyday life with a baby, even if you aren't experiencing any discomfort yet. Uterine prolapse or incontinence can occur months after giving birth or possibly not until menopause.
Depending on the federal or state, health insurance companies usually reimburse the costs of a postnatal exercise class up to a certain date. Many classes even allow babies to attend. It's never too late for effective exercise!
Breast care during the postpartum period
No special hygiene or preparation of your breasts or nipples is necessary for breastfeeding. During the first few days and weeks, go topless in a bathrobe or wear a comfortable nursing top that allows you to open your milk supply for your baby at any time. It's important to get plenty of air to your breasts, especially if your nipples are irritated or sore.
If you have very dry skin or sensitive or sore nipples, you can apply a nipple ointment containing lanolin (purified wool fat) (also over a larger area when pumping).
Once your nipples become sore or cracked, it's important to clean the area daily with saline solution until it heals properly. It's best to let the saline solution drip over them so it's not too painful. Let the saline dry, and then apply a slightly thicker layer of breastfeeding cream to promote moist healing.
If you have sore nipples, it's important to find a good, comfortable breastfeeding position. Ask your midwife to show you how to position your baby optimally (asymmetrically if necessary, with as much breast tissue as possible in the mouth). Breastfeeding should never be painful!
Recovery after birth
Don't push yourself too hard and give your body time to recover so that you can adjust to the new situation with your child and your partner without pressure and with as little stress as possible.
All the best for the birth and a wonderful time getting to know your family.
Elisa Steiner, IBCLC Breastfeeding and Lactation Consultant, Health and Pediatric Nurse, Family and Motherhood Counselor
Always seek medical advice
Important note: This article contains only general information and should not be used for self-diagnosis or treatment. It is not a substitute for a consultation with a doctor.
For dry and irritated skin in the intimate area, a suitable intimate care cream is the perfect choice. Our ELANEE Intimate Care Cream moisturizes the external intimate area thanks to valuable oils and regenerating panthenol, protecting it from natural influences such as moisture.
If vaginal dryness occurs during menopause, it is advisable to consult a doctor to determine the cause. Treatment may include hormone preparations, vaginal suppositories for lubrication , or moisturizing creams .
In order to enjoy sexual intercourse despite a dry vagina, there are various creams or lubricants that prevent painful friction.
Moisturizing creams can moisturize the external intimate area. Their ingredients soothe irritated skin and relieve itching. Moisturizing suppositories are available to nourish the mucous membranes and aid regeneration.
If you experience vaginal dryness before your period, there can be various reasons. Hormonal fluctuations, for example, or external factors such as stress, inadequate intimate hygiene, or menstrual products could be the cause. Use an intimate care cream to care for dry skin in the external intimate area. Before your period starts, you can also use vaginal suppositories to moisturize the vaginal mucosa. If vaginal dryness persists during your period, we recommend using menstrual cups . Unlike tampons, they don't need to be replaced as quickly and don't remove additional moisture from the vagina.
Vaginal dryness after childbirth is a normal side effect caused by hormonal changes. A drop in estrogen levels is particularly responsible for this. To alleviate the symptoms, appropriate intimate care products or home remedies can be used. In severe cases, estrogen supplements can also help regulate hormone levels. We recommend consulting your midwife or doctor.
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