A Woman’s Body…Six Weeks Postpartum
A woman’s body goes through many changes in postpartum, the
six-week period after delivery, as the body attempts to return to its
After delivery, many women
will look 5-6 months pregnant. Contractions (after pains) will decrease the
size of the uterus gradually so that by six weeks postpartum, it will have
returned to its position behind the pubic bone.
By six weeks postpartum,
many women will have lost 15-20 pounds. Approximately 10 pounds of the
excess weight is fat the body reserves for breastfeeding. The body may also
rid of extra fluid gained by increasing the amount of urine passed or by
having “night sweats.”
Hair loss is a postpartum
symptom which many women experience 2-6 months after baby’s birth.
Including pubic hair, this loss is typically followed quickly by new
growth. It is believed to be caused by hormonal changes.
shrink the uterus back to its normal size. Some women feel these contractions
as after pains during the first days following delivery. These after pains may
be more painful for women who have had other children. Walking, emptying the
bladder often, pain medication, breathing and relaxation help lessen the pain.
A vaginal birth
causes stretching and bruising of the perineum and this can be worse for those
who have some tearing or an episiotomy. It is painful when stitches are pulled
by swelling so women are encouraged to use ice on the tear or episiotomy
throughout the first day following delivery. Afterward, they may find the moist
heat of a sitz bath or tub bath followed by the dry warmth of a blow dryer
several times daily, speeds healing. Sitting on a pillow may be helpful during
the early weeks as well.
Some from a vaginal
bleeding or discharge will persist for 4 to 6 weeks after delivery. This
blood loss is called lochia. During the first few days the lochia is bright
red, then it becomes pinky-brown in colour, and by the tenth day the
discharge is usually yellowish white. The amount of lochia decreases daily,
but some women notice an increase after being too active or overdoing it.
It’s important for a woman to contact her doctor/midwife if her flow
increases to the extent that she is soaking a “pad” within an hour. A
portion of the placenta may have remained in the uterus, which can prevent
the uterus from contracting and closing off the blood vessels, leading to
hemorrhage. A woman should also contact her doctor/midwife if the lochia
develops a foul odour, if she develops a fever, experiences malaise or
abdominal pain, which are signs of infection.
Bladder and Bowel
Perineal tenderness may
make a postpartum woman reluctant to empty her bladder. Diluting the urine
by drinking lots of water may help to reduce the burning. Spraying water
from a squirt bottle over the perineum while urinating, or urinating in the
tub or shower may also help.
Discomfort may lead to
reluctance in having a bowel movement (BM). Often women do not have a BM
until several days after delivery because of loose stools during labour, a
pre-delivery enema, or little to eat during labour and the days following.
Activity, lots of fluids and high fiber foods will help soften stools. With
stitches, it may be helpful to support them with a wet washcloth when
passing that first bowel movement.
Because it is difficult to
predict when ovulation and menstruation will return, birth control is
recommended. Normally a first menstrual period begins 1 to 4 months after
baby’s birth, if mother is not breastfeeding. If breastfeeding, this may be
delayed until baby is weaned. Remember that an egg is released two weeks
before menstruation, so another pregnancy could be conceived before a
woman’s first postpartum menstrual period.
At the six-week checkup,
discuss birth control options with your doctor.
Visit the Sexual Health section for more
information on birth control options.
Sex may be the last thing
on the minds of new parents. The woman is recovering and may have perineal
pain and vaginal dryness from altered hormone levels. She and her partner
are adjusting to their new parenting role and may feel tired or overwhelmed
with the increased responsibility and change in priorities.
When you are ready, spend
time getting reacquainted. Chances are you have only talked to each other
about the baby. Becoming intimate may require some mood setting. You may
want to try a water-soluble gel (K-Y jelly) for lubrication. Experiment
with different positions for lovemaking to lessen the discomfort of a tear
or episiotomy. Visit the Sex During and
After Pregnancy page for more information.