Articles (EN)

Recovery from natural childbirth

2026-05-27 12:00 Childbirth
In short: the body recovers gradually after childbirth – full recovery takes from 6 weeks to several months. The main tasks of the first weeks are rest, perineal care, monitoring discharge and establishing breastfeeding.

What happens to the uterus after childbirth

Immediately after childbirth, the uterus weighs about 1 kg and is at the level of the navel. Within 6 weeks, it returns to its pre-pregnancy size (about 60 g) - this process is called uterine involution. You may feel cramping pains (especially when breastfeeding – due to oxytocin), which confirm that everything is going right.
Postpartum discharge (lochia) accompanies this process for 4-8 weeks: first red, then pinkish, then yellowish and scanty. This is the norm.

Perineum and sutures

If there have been tears or episiotomy, the perineum will hurt and swell for the first few days. This is normal. Assistance measures:
  • Cold compress (ice in a towel) for 20 minutes every 2-4 hours on the first day.
  • Washing with warm water after each toilet (do not wipe, but get wet).
  • Sit on a ring pillow or on your side for the first days.
  • Painkillers (ibuprofen, paracetamol) as prescribed by a doctor.
Read more about the care of sutures in the article stitches after childbirth.

Fatigue and sleep

Postpartum fatigue is not weakness, it is physiology. The body survived the marathon. Add to this night feedings, pain and hormonal changes - and it becomes clear why the first weeks are so difficult.
The main rule: sleep when the child is sleeping. Postpone cleaning, refuse unnecessary guests, ask for help with everyday life. Sleep is not a luxury, but a medical necessity. Mom's sleep disorders increase the risk of postpartum depression.

Breastfeeding and postpartum pain

When breastfeeding, each feeding stimulates the release of oxytocin, which causes uterine contractions - these are "postpartum pains". In primiparous women, they are usually weak, in multiparous women they can be quite intense in the first 2-3 days.
Breastfeeding can take 2-4 weeks. This is normal. Do not give up early: if your breasts hurt, ask for a consultation with a midwife or lactation consultant.

Physical activity

The first 6 weeks are recovery time, not training time. What you can:
  • Walking is from the first day, gradually increasing the distance.
  • Kegel exercises – from the first days (if there are no strong tears).
  • Breathing exercises to restore the abdomen.
What is not allowed before 6-8 weeks and without a doctor's permission: abs, running, jumping, strength training. Premature loading can increase lochia and slow healing.

Sex and contraception after childbirth

Most doctors recommend abstaining from penetrative sex for at least 6 weeks - until the perineum and cervix are completely healed. Libido can be reduced for months: low estrogen during lactation causes vaginal dryness. This is normal.
Important: lactation is not a reliable method of contraception. Ovulation can occur as early as 4-6 weeks after childbirth, even before the first menstruation. Discuss contraception with your geologist at your postpartum checkup.

Emotional state

"Baby blues" - slight sadness, tearfulness and irritability in the first 2 weeks after childbirth - occurs in 50-80% of women. This is a normal hormonal reaction.
If the symptoms do not go away after 2 weeks or worsen, postpartum depression is possible. This is a treatable condition, do not hesitate to talk about it with your doctor.

When to see a doctor

See a doctor if:
  • temperature above 38 °C;
  • very abundant lochia (saturate the pad in less than an hour) or lochia unexpectedly intensified after a decrease;
  • strong unpleasant smell of discharge;
  • increasing pain in the perineum or abdomen;
  • pain when urinating or inability to urinate;
  • pronounced sadness, anxiety or thoughts of harming yourself or your baby.

Frequently Asked Questions

When will menstruation return after childbirth?

In breastfeeding women, usually after 6-12 months (sometimes later). In non-lactating women, it takes 6-8 weeks. The first cycles may be irregular.

When can you do sports?

Light walking - immediately. Running and strength training – no earlier than 8-12 weeks and after the doctor's permission. Ideally, a consultation with a pelvic floor physiotherapist is ideal.

Is it normal for hair to fall out?

Yes. Postpartum hair loss (telogen-effluvium) begins 2-4 months after childbirth and lasts 3-6 months. This is normal and reversible.

Conclusion

Recovery after childbirth is an individual process. Be kind to yourself: the body has done something grandiose. Rest, food, support for loved ones and timely medical care are your main tools during these weeks.

Bibliography

  1. ACOG. Optimizing Postpartum Care. Committee Opinion. 2018. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2018/05/optimizing-postpartum-care
  2. WHO. WHO recommendations on postnatal care of the mother and newborn. 2013. https://www.who.int/publications/i/item/9789241506649
  3. NICE guideline CG37. Routine postnatal care of women and their babies. 2006 (updated 2015). https://www.who.int/publications/i/item/9789241506649
  4. Ministry of Health of the Russian Federation. Clinical guidelines: Postpartum period. 2022. https://cr.minzdrav.gov.ru/
  5. Dennis CL et al. Interventions for treating postnatal symptoms of depression. Cochrane Database. 2021.
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.