Mother’s recovery from childbirth
The period after childbirth is known as the postpartum or postnatal period that lasts for about 6 to 12 weeks. During this period, your body will gradually recover from pregnancy and childbirth. During the first weeks, your new family will get to know each other and you will recover from childbirth. The maternity and child health clinic will book a postpartum check-up appointment with a doctor for you. This appointment will take place 5–12 weeks after childbirth. The purpose of the check-up is to make sure that your body has recovered from childbirth. Birth control will also be discussed during the appointment.
During the postpartum check-up, the doctor will write a certificate that needs to be sent to Kela in order to receive parental allowance.
Your uterus will start to contract immediately after childbirth and you may experience this as postpartum contractions, also known as afterpains. These contractions occur especially during breastfeeding and will start to ease a few days after birth. Postpartum bleeding (lochia) is at first heavier than menstrual bleeding but will gradually decrease and turn brownish. Postpartum bleeding usually lasts for about 2 to 6 weeks after birth. It is important that you take care of good hygiene because there is a risk of uterine infection. The signs of an infection include foul-smelling discharge, pain in the lower abdomen and fever. If such symptoms occur after birth, you should contact the hospital. Sometimes postpartum bleeding has almost stopped but then becomes heavier again. In this situation, you should contact the hospital. Sometimes the amount of bleeding may temporarily increase if you, for example, are physically active. This is harmless if the bleeding is not heavy and starts to decrease a few hours after physical activity.
Sometimes an episiotomy (a cut in the area between the vagina and anus, known as the perineum) is performed during delivery or the mother may have a tear that needs stitches. Cuts in the perineal and vaginal area usually heal rather quickly, within a few weeks. The stitches are absorbable, which means that they do not need to be removed. The cut should be showered every time after going to the toilet. Even after a caesarean section (C-section), mothers usually recover quickly. For about a month, you should avoid strenuous household chores and lifting anything that is heavier than your baby. Staples and stitches will be removed at the maternity and child health clinic about seven days after childbirth. Showering and fresh air will speed up the healing process.
It is normal for your digestive system to slow down after birth. You can help the situation by exercising, drinking water and eating foods that are high in fibre. If necessary, you can take laxatives. Haemorrhoids are a common problem after childbirth and sometimes they may be very painful. The pain can be relieved with a cream or suppositories, and usually the discomfort eases soon after childbirth.
Milk usually comes in about 2 to 5 days after childbirth. At the hospital, you will be instructed to feed your baby frequently, in a baby-led manner, and you should continue to do so at home. Frequent breastfeeding will boost your milk supply and help prevent mastitis (inflammation of the breast). Your nipples may be sore, especially at first. If the pain persists, you should have your breastfeeding position and the baby’s latch checked. As milk comes in, you may feel aching in your breasts and have a temperature. Sometimes the milk ducts get blocked, which is a problem that can be solved through frequent breastfeeding. If there is a red area on the breast, it feels painful and hot and you have a fever, you will need to contact the health centre or the emergency department where they can assess your need for antibiotics. This condition is known as mastitis.
Even though your main focus is on the baby, it is also important for you to take care of your own health and well-being. A balanced diet and regular meals will help you recover from birth and take care of your baby’s nutrition through breastfeeding. According to the Finnish nutritional recommendations, the additional need for energy due to breastfeeding is about 2.0 MJ (600 kcal). If you donate breast milk or breastfeed twins or more children, you need more energy than average.
Once your baby is six months old, the need for energy due to breastfeeding will no longer increase because by then the baby will also be eating other foods and the need for breast milk will begin to decrease. You can meet the average need for additional energy by eating, for example, a couple of potatoes, a fruit, two slices of bread and salad and by drinking a glass of fat-free milk.
Breastfeed supports weight management. Weight management is safe when you lose weight in a controlled manner and pay attention to small changes in your diet, physical activity as part of your daily life and maintaining your exercise habits. If you follow nutritional recommendations, your baby will get all vitamins and minerals they need with the exception of vitamin D. Both breastfeeding mothers and babies should take a daily supplement containing 10 µg (mcg) of vitamin D.
Breastfeeding increases the need for fluids and you should therefore drink plenty. Water, fat-free milk and buttermilk, tea and low-sugar juices are suitable drinks. Coffee can be consumed in moderation. While breastfeeding, you should not avoid any ingredients to prevent the child from developing allergies. If your baby has allergic symptoms while being breastfed, it is important to find out what is causing the symptoms. The allergy may also be caused by something other than food. You should not randomly and unnecessarily restrict your diet. If it is necessary to eliminate certain ingredients from your diet, you should consult a nutritionist or a doctor.
Physical recovery from pregnancy and childbirth varies from one mother to another. You can and should start going for slow walks with your baby soon after childbirth. However, you should not start doing more intense workouts and especially abdominal muscle exercises until after the postpartum check-up. You can gradually start exercising more, while always listening to your body. Regular exercise to improve physical fitness will not reduce milk supply or affect the quality of breastmilk. Instead, physical activity will help you return to your pre-pregnancy weight and make you feel refreshed and relaxed. It is important for you to consume a sufficient amount of fluids during exercise. You should breastfeed the baby before exercising, as your breasts will then be lighter and exercise will feel more pleasant.
It is a good idea to follow the general recommendation for physical activity:
- Every week, you should do at least 2.5 hours of brisk aerobic physical activity that increases your heart rate and makes you feel a little out of breath OR at least 1 hour and 15 minutes of vigorous aerobic physical activity that clearly increases your heart rate and makes you feel out of breath.
- You should do muscle-strengthening exercises twice a week.
- You should divide aerobic physical activity into at least three days per week.
- You can do aerobic physical activity in short sessions of at least 10 minutes each.
You should start with sports that you are familiar with and at first avoid jumps and quick turns, as hormonal changes cause ligaments to become looser.
Pelvic floor exercises
You should start doing pelvic floor exercises as soon as it does not feel unpleasant. However, keep in mind that recovery takes time. It will take months to strengthen your pelvic floor muscles and as you take care of your baby, you may feel more tired than usual and need more rest. You should also do pelvic floor exercises during pregnancy. Strong pelvic floor muscles help prevent urinary incontinence and various types of prolapse and increase sexual pleasure. Good forms of exercise for pelvic floor muscles include Pilates, belly dance, Latin dance and yoga. You should do pelvic floor exercises regularly. You can find good tips online, for example in the HUS's website Labor
Sleep and rest
A baby will inevitably change the parents’ sleeping rhythm. The baby needs constant care and presence. At first, the baby may not have a daily rhythm, so the mother should rest as much as possible whenever the baby is sleeping. Babies under six months old usually also need to be fed at night, which means that the parents’ sleep is often interrupted. If necessary, the father can for example change the baby’s diaper if the mother needs help. If you are exhausted by lack of sleep as new parents, don’t hesitate to ask your parents, other relatives or friends for help. You can also discuss these issues at the maternity and child health clinic. Even a few hours of uninterrupted sleep does wonders.
Baby blues and postpartum depression
Childbirth involves a variety of emotions and it is absolutely normal for a new mother to feel tearful, tired, and melancholic and experience rapid mood swings. Up to 50–80% of new mothers have these feelings, known as the baby blues. This will help the mother tune in to the baby’s world and subtle messages. These feelings begin soon after childbirth, are mild and do not last very long.
However, approximately 9–16% of new mothers develop postpartum depression. The symptoms of depression include a low mood, inability to enjoy anything, tearfulness and anxiety, changes in appetite, various sleep-related issues, feelings of worthlessness and hopelessness, self-accusations, lack of energy and possibly suicidal thoughts. Mothers can get rid of sleep deprivation and tiredness by resting and sleeping, but depression-related tiredness will not go away just by sleeping. Depression usually occurs within the first three months after childbirth. For this reason, mothers are asked to fill in the EPDS (Edinburgh Postnatal Depression Scale) questionnaire at the maternity and child health clinic when their baby is three months old. The EPDS score may help assess how the mother is doing and identify possible symptoms of depression as early as possible and thus support the entire family.
The depression of a parent affects the entire family. Women may experience symptoms of depression during pregnancy or only after childbirth. Fathers can also have childbirth-related symptoms of depression, most commonly 3–6 months after childbirth. It may be difficult for a depressed mother or father to admit that they need help. They may be ashamed of and feel guilty about their negative feelings. It is important that both mothers and fathers talk about mood-related issues openly at the maternity and child health clinic. The clinic’s staff will then be able to offer the help and support that each family needs. The likelihood of recovering from depression is very high if the mother or father gets the support they need and advice on where to seek treatment.