Afterbirth & Aftermath: The First Few Days Postpartum

My postpartum experience in six words or less:

Oh My God, What Just HAPPENED?

(If the challenge had allowed for a couple more words I probably would have included some profanity.)

You might feel the same way too. Awestruck and thunderstruck and monstertruck. Completely amazed at what your body just accomplished…but now your body is…things are not quite…look at that BABY…

Oh my God. What just HAPPENED?

(Or you might not. You might be one of those women who bask in a gentle glowy glow afterwards, with your perfect makeup and hair and oh look! The basketball you’ve been carrying under your shirt is gone and HI AB MUSCLES! And then your milk comes in five minutes later and your baby poops gold ingots and you know what? This column is probably not for you. Move along.)

For the rest of you, now, a few things you should probably be ready for immediately post-birth:

You will still look very pregnant.

I know, I know. No-brainer, right? This isn’t like giving birth in a sitcom. But both times I admit to being a little (okay, very) taken aback by my empty, squashy abdomen. What was once so round and ripe and lovely now resembled a large batch of smushy bread dough. It deflated a bit each day, but there were definitely days when I stood in front of the mirror and regarded myself with frustration because ARGH. GO AWAY BELLY.

It will. Eventually. Patience.

Your uterus will continue to contract, painfully at times.

Uterine contractions are the key to getting your stomach to deflate, but man. They are not super pleasant. I was particularly shocked by the force of my discomfort this time, probably because I didn’t go through the rigors of labor, but instead walked into the hospital feeling all fine and dandy. (I had a scheduled c-section back in October.) Then I was doped to the gills and hacked up and wheeled back to my room and suddenly…what the hell? Why do I feel like I’m in labor NOW?

At their worst, postpartum uterine contractions can feel like labor pains. Other times, they’re more like vicious menstrual cramps. They’re uncomfortable for sure, but ESSENTIAL. Breastfeeding is the best way to stimulate your uterus – it tells your body that indeed, the baby is out and pregnancy is over. My son nursed and nursed and NURSED during our hospital stay and the nurses were always “congratulating” my on my “good work” with my rapidly contracting uterus. I usually just glared at them, since they determined my progress by mashing on my super-sensitive abdomen and OW. GO AWAY.

If you aren’t breastfeeding, you can stimulate uterine contractions just by holding your baby. Skin-to-skin contact is best, so don’t be afraid to undo the hospital swaddle and get him all good and baby-naked and let him curl up on your chest. Smell his head, feel his breath, stroke his skin – these little acts of affection can actually trigger powerful hormonal reactions that will get your uterus in shape.

You will bleed.

So as if menstrual cramps weren’t enough, you’ve also got the privilege of having the LONGEST PERIOD OF YOUR LIFE. Lochia. It’s blood, mucus, placental tissue. It lasts a freaking long time. Four to six weeks, usually. (Although it’s normal for it to stop and start during that time frame as well, or to even stop completely and then come back with a vengeance right around six weeks.)

The first three to five days after you give birth, the blood will be bright red and constant and totally something out of Carrie. The first trip to the bathroom will be gory, to say the least (particularly if you’ve been confined to bed for any reason, like after a c-section). (I swear the first time I got up to pee it was a freaking HORROR MOVIE, and BONUS, post-section a nurse accompanies you the first time and it’s awkward and gross and I kept making weird inappropriate jokes while trying not to get woozy at the sight of all. that. blood. and keep most of it off the floor and in the toilet.)

At some point the blood will start looking pink or brown, and eventually it will be more like white-ish or yellow-ish mucus. The hospital will provide a wide variety of pads, in different sizes and shapes and you’ll want to steal pretty much every pad you can get your grubby mitts on.

(Lochia shouldn’t smell, by the way, or at least shouldn’t smell any different than your run-of-the-mill period. If you do notice an order or any green-looking gunk, call your doctor right away to get checked out for infection.)

You may be in a lot of pain.

C-sections, episiotomies, tears, rough deliveries and other complications can lead to pretty significant pain afterwards. Don’t feel the need to be a hero here – you’ve got enough going on, including the responsibility of a WHOLE NEW HUMAN BEING. Take care of yourself and speak up. Percocet and Ibuprofen are effective and breastfeeding-compatible.

For all my fellow c-sectioners out there: do NOT mess around with missing or even delaying your pain medication. My first birth was an emergency c-section after hours of labor and pushing and you know what? I FELT GREAT. The hospital staff administered my medication like clockwork and the first time I really felt significant pain was when I got home and – you guessed it – got distracted and missed a dose. You don’t even realize it until you go to get out of bed or reach for the milk or do some other small movement and suddenly you realize that OH, I HAVE BEEN NEARLY CUT IN HALF.

This time I had the scheduled c-section, which I had been assured by tons of people was actually easier and less traumatic than the emergency procedure. The problem was that the hospital had switched medication policies and it was now completely up to the patient to request pain medication. Every. Single. Dose. Of pain medication required me to monitor the clock and call the nurse and justify my pain level using the 1 to 10 scale. The bigger problem was that NO ONE TOLD ME THIS, so I sat in my room for hours after the surgery wondering when the Percocet would arrive. (Look, you might also be super mentally sharp afterwards either, you know?) My husband finally caught on before I did and called the nurse, but by this point I was literally sobbing from the pain and it took a few doses before I felt like it was really back under control. LET THIS BE A LESSON TO YE ALL. Stay on TOP of that medication. If you’re allowed to take Ibuprofen every six hours, set your watch, set your partner’s watch, set an alarm on your phone, buy a stopwatch, whatever.

Your milk may take a few days to come in.

I gave birth on Wednesday afternoon and my milk came in on Sunday morning, just BARELY in time for us to avoid the dreaded 10% weight loss marker. (Your baby WILL lose some weight, that’s unavoidable. The goal is to keep it within a reasonable percentage amount.) With my first baby, my milk took a full seven days to come in, and we simply had to supplement in the meantime, as Noah lost more than 10% of his birth weight and was getting lethargic and a little sickly looking.

This time, I was so petrified of that happening again I packed Mother’s Milk tea and fenugreek supplements in my hospital bag (both are herbal remedies that increase and stimulate milk production). Once I got the all-clear for a regular diet, I started taking them. I do believe they made a difference, as I had a very abundant milk supply right from the get-go. If you have no reason to believe you’ll have supply problems, there’s no reason to be this aggressive: your baby will get colostrum in the early days and your milk will follow at some point. A hospital may offer you formula regardless, and you can decide for yourself if you think it’s necessary. (I turned it down but ended up giving Ezra an ounce or two the night we got home, more because I just needed a break from his round-the-clock tongue-tied nursing.)

Your emotions are yours and yours alone.

There’s no “right” way to feel about your birth experience or your body or your baby. You might burst into tears every time you look at her because the force of your love has just up and pummeled you senseless. You might look at her and not be so sure about this motherhood thing after all. You might be preoccupied with how you look and your own discomfort. You might have a hard time coming to terms with how the birth happened or the fact that you are no longer pregnant. You might be too exhausted to give a crap about any of it.

For now, cut yourself a LOT of slack. Yes, giving birth is the most natural thing in the world and been done for millennia blah blah blah, but this time it’s YOU who gave birth and YOU are your own damn unique person. Your hormones are going haywire, but will settle down after a few days. (I found day five to be the most emotionally draining, like every pregnancy hormone I’d built up over nine months just crashed through the floor and left my body.) A little sadness or a crying jag or two immediately postpartum does not mean you’ll have postpartum depression or never bond with your baby or be a terrible mother woe woe weep omg. Likewise, feeling absolutely ecstatic and wonderful at first doesn’t mean you might experience a little crash later on, or even a major one. Stay aware of your emotions (we’ll cover PPD in more detail another day) but in the early days it’s important to just…let yourself feel how you feel, look how you look and take it one day (or one Ibuprofen dose) at a time.

If you landed here but are still pregnant, visit Amalah’s Pregnancy Weekly. You won’t regret it.