Your body in the first weeks after birth

Bleeding from the vagina, cramps while feeding and painful trips to the toilet can all happen in the first weeks after birth. Some symptoms need medical help quickly.

Bleeding that gradually settles

The bleeding after birth is called lochia. It can be quite heavy at first. Then it usually gets lighter and turns brownish over the next few weeks. Use maternity or period pads and change them often, washing your hands before and after.

The NHS advises waiting until after your 6-week postnatal check before using tampons. There’s still a healing wound inside the womb where the placenta was attached. Anything you put inside, including menstrual cups, can raise the chance of infection before it has healed.

Get emergency medical help now for sudden or very heavy vaginal bleeding, even if you don’t feel faint. Call 999 (UK), 911 (US), or your local emergency number if you can’t get to emergency care safely. Don’t wait to see whether another pad fills. CDC warning signs include soaking through one or more pads in an hour, passing clots bigger than an egg, or passing tissue. Discharge that smells bad also needs checking soon. These are reasons to call. You don’t need to reach them before asking for help.

Cramps and breast tenderness

Breastfeeding makes the womb tighten (contract). During feeds, you may notice cramps like period pain, and bleeding that is redder or heavier for a while. Get emergency help now for sudden or very heavy blood loss. Feeding isn’t a reason to ignore it.

At first, your breasts make colostrum, a yellowish liquid. As your milk comes in, they may feel tight and tender. A supportive nursing bra may help you feel more comfortable. Talk to your midwife if your breasts are very sore, and ask about support that fits your feeding plans.

Making toilet trips easier

Drinking water can make your pee weaker so it stings less. Get urgent medical help now if you can’t pee at all or have severe pain low in your tummy. Contact your maternity unit (UK), obstetric clinician (US), or local urgent service now. Go to emergency care if you can’t be seen quickly.

Contact your midwife or GP today (UK), your obstetric clinician (US), or your local doctor or midwife if you can pee but it’s really hard, you feel very sore or you notice a bad smell.

For constipation, the NHS suggests drinking plenty of water and eating foods such as fruit, vegetables and wholegrain cereals. Try not to strain. If you have stitches, having a poo is very unlikely to break them. Holding a clean pad of tissue over the stitches may feel more comfortable. Ask your midwife or GP about constipation that isn’t getting better. A pharmacist or doctor can advise about suitable treatments.

Leaking a little pee when you cough, laugh or move suddenly is common. Pelvic floor exercises can help. If they don’t, a GP can refer you to a physiotherapist. Tell your midwife or GP if you leak poo or lose control of your bowels too.

Your check is for you

In the UK, your GP surgery should offer you a postnatal check 6 to 8 weeks after birth. You can ask for it yourself. It can be separate from your baby’s check. You should still be invited if your baby is in hospital or has died.

US guidance from ACOG recommends contact with your care team in the first 3 weeks after birth. This is followed by care as needed and a full check-up no later than 12 weeks after birth. WHO recommends care for at least 24 hours after giving birth in a hospital or clinic, and at least three more check-ups in the first six weeks. These are plans for routine care. Don’t wait for an appointment if you have symptoms that need help.

When to call sooner

Get emergency medical help now for sudden or very heavy vaginal bleeding, even if you don’t feel faint. Call 999 (UK), 911 (US), or your local emergency number if you can’t get to emergency care safely.

Call 999 now (UK), 911 (US), or your local emergency number for new chest pain or severe difficulty breathing, even without leg symptoms.

Contact your maternity unit or GP now (UK), your obstetric clinician (US), or your local doctor or midwife for new breathlessness, pain, swelling or redness in one leg, a high temperature, a sore and tender tummy, a severe headache that won’t go away, or changes to your eyesight.