The Fourth Trimester – Postpartum Recovery

What happens the first hours after the baby is born?

If you are having a hospital birth, right after your baby is born, he/she will be placed on your chest or belly (barring any medical intervention necessary). This skin-to-skin contact is very important and sometimes called Kangaroo Care or The Golden Hour. You and your newborn will benefit from this bonding experience that should last at least an hour and culminate with your baby’s first feeding. If you are having a home birth, you can be sure that any doula or midwife will ensure that you take advantage from the Golden Hour to the fullest.

Skin to skin contact with Baby

The skin to skin contact during the Golden Hour helps to regulate baby’s temperature, stabilize his breathing and heart rate.

Your care providers will evaluate your baby to be sure they are transitioning well.  They will listen to the baby’s heart and lungs, check respiration and take their temperature.  Unless there are medical issues, this can be done while your baby is still benefiting from skin to skin.

Getting weight and other nonessentials should be delayed until after that Golden hour.  You may want to include this when making a birth plan and deciding your preferences.  You will both continue to benefit during the next 4-6 weeks from skin-to-skin contact.  This is not limited to mom and baby.  Both parents and even siblings can bond using skin to skin holding.

Delivery of Placenta

The placenta’s job is done once your baby is born and the cord is cut.  Some recommend you wait a specific amount of time for the placenta to complete pulsing, allowing the baby’s blood volume to increase.  While there is a lot of evidence in favoring that, there is a small chance that your baby may become jaundiced when waiting too long to cut the cord.  Jaundice is usually very easy to treat and isn’t known to cause additional concerns.

Placenta Delivery Time

Placentas detach within 5-20 minutes after your baby is born.  Remember that when the placenta detaches from the uterus, it leaves a wound that will bleed.  Those contractions help to shrink your uterus and will also help the wound to heal.  If your placenta does not detach and deliver on its own there may be medication in addition to fundal massage.  While this is unpleasant and can be a startling realization when necessary, the fundal massage is used to reduce bleeding. Fundal massage can be very uncomfortable, even painful, and its important for expecting parents to know this might occur.

The Golden Hour: The first hour after birth is the most important hour to help regulate the baby in the new environment. 

How long does it take for the uterus to return to normal size after birth?

Your uterus is thick and stretched after you give birth, and it will take about 6 weeks to shrink which means you will continue to feel contractions as this is happening.  These are usually the most intense immediately after birthing and tend to let up over the following few days. 

After birth contractions

You can experience after-birth contractions when breastfeeding because breastfeeding produces the oxytocin necessary for the uterus to contract.

Postpartum Bleeding

Postpartum bleeding will continue for about 6 weeks, slowing and changing color until gone.  You do not want to use tampons or menstrual cups during this time. Please check with your care provider for when best to resume using these products as well as sex. It is recommended that nothing go inside the vagina for 6 weeks after birthing. 

Immediately after birth, it is also common for new parents to have severe or minor shaking, feel weak, unsteady, and exhausted, have sore muscles, as well as swelling and tenderness in the perineum. If you had an episiotomy or tear requiring stitches, you will also be caring for that during your postpartum healing time.

This time immediately following the birth of your baby should be joyful and private.  You also want to remember that you should still be drinking plenty of fluids and eat as soon as you can.  Rest and sleep will be important even on this day.  You will want to start a routing baby sleeping and feeding schedule. Move around, use the restroom, and only invite visitors when you feel ready, regardless of how long that might be!

Postpartum Essentials

The list could go on and on, but there are definitely things you want to have on hand when you fist return home when it comes to post partum recovery:

• Clothes that fit you when you were 5 months pregnant
• Pads or period underwear
• Ice packs, (Peripops) medicated pads (witch hazel), or numbing spray
• Sitz tray
• Per or squirt bottle to rinse after using the bathroom
• Stool softener
• Heating pad
• Belly band

In the next blog, we are going to go into more details on the recovery aspect of postpartum.

The information contained on this site should not be construed as medical advice nor should it replace the advice and individual care of your health care provider.