Your Postdelivery Body: What’s Going on and Why

Nothing prepared you for this. Here’s a guide to your first 24 hours with the suddenly foreign organism that is your own postpartum body.
ByJenna McCarthy
Updated
May 2017
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Photo: Getty Images

You look nine months pregnant.

Someone told you that you’d deliver and look four months pregnant? If only. Your uterus has gone from about the size of an orange to the size of a watermelon throughout your pregnancy, and it doesn’t deflate quickly like a balloon. For most moms, it takes at least six weeks for it to contract back to its pre-pregnancy size. And according to Ryan C. McDonald, MD, assistant professor of ob-gyn at the University of Wisconsin School of Medicine and Public Health, once it shrinks you could still have a pooch due to bloating, constipation, fluid retention and a stretched-out abdominal wall. “If you’re out of maternity clothes at six weeks after delivery, you’re in the lucky minority,” he says.

You can’t pee.

Surprise! You finally make it to the bathroom, sit down and… nothing. “Under normal circumstances when your bladder is full, your brain sends a message via your nerves to empty it,” McDonald explains. But if you’ve had a long labor or a c-section, those nerves can be temporarily traumatized. The result: You get the urge but can’t seal the deal —weirdest feeling ever. On top of that, severe swelling around the urethra can actually obstruct the flow of urine. “It’s not uncommon to need a catheter in the first 24 hours after delivery,” McDonald says. Don’t get down in the dumps about this opposite-of-glamorous symptom — it almost always reverses itself quickly and completely.

When you finally do pee, it burns like crazy.

Delivery can cause small abrasions or tears near the urethra that burn when they come into contact with urine, McDonald says. Yowch! That’s why your labor nurse will probably give you a squirt bottle (called a “peri” bottle) to rinse the area after you pee, or a wet washcloth to wipe with afterwards. Also, drink up. “Staying hydrated after delivery will dilute your urine, which will also make it less painful,” says McDonald.

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You never saw so much blood.

“Most women will need the biggest maxi pad they have ever seen for the first day after giving birth,” McDonald says. And it’s because the amount of blood you’re losing would put any heavy flow to shame. Believe it or not, it’s not unusual to pass one or two clots the size of a baseball during this time. “It can be absolutely alarming when this happens, but it’s totally normal,” he says. (Any more than that, tell your doctor.) And your pelvic floor muscles may be worn out from delivery, so you could have some urine leakage as well. McDonald says this can last for up to six weeks without any cause for concern.

Every. Muscle. In your body. Aches.

Delivering a baby is a hugely athletic event that forces you to use muscles in ways you’ve never used them before. Laboring for three hours — and many women, especially first-time moms, go far longer than that — is like running 20 miles, McDonald says. “You’re effectively doing marathon-level work, and most of us don’t have the training for that,” he adds. Pop a pain reliever or two, which will help alleviate a lot of the pain and inflammation.

You’re still having contractions.

You thought you were done with these, but as your uterus shrinks back down to its pre-pregnancy shape and size, you may experience some serious contractions. Some women say these aftershocks hurt more than the contractions they experienced during labor. If you’re breastfeeding, the pain can be particularly intense, since nursing releases hormones that make your uterus contract (and jump-start the shrinking process). The worst of these contractions usually come within the first 48 hours after delivery, and you might experience milder ones for the next several weeks. Hang in there and feel free to breathe the way you learned in Lamaze class.

You’ve got giant hemorrhoids.

You may have had these swollen below-the-belt veins during the end of pregnancy, when your belly was putting pressure on the area. But add in all of that delivery-room straining and pushing, and you might find yourself with some seriously large and uncomfortable ones. The good news? Most hemorrhoids that crop up during pregnancy or delivery go away completely within a few weeks, McDonald says. If yours are painful or itchy, take a nice warm bath (or use the sitz bath your nurse gave you) to get some relief.

You’re terrified of number two.

It’s more common to have some degree of perineal tearing than none, McDonald says. And this can make  the first poop after birth seem scary. You’re wondering, “How much will it hurt? Will I bust my stitches?” Stool softeners can help. But also know that most women — even those who had severe tearing — say their first postpartum BM wasn’t as bad as they had expected. It’s important to go when you get the urge; even though it may be frightening, holding it in will just make it worse.

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