The first six weeks after birth
Postnatal care is the medical care and support you receive after your baby is born. Doctors usually count the first six weeks as the postnatal period, though full recovery often takes longer. In this time your uterus shrinks back, bleeding settles, any stitches heal and feeding is established.
In many Indian homes the new mother rests for about 40 days with family help. This support is valuable. It works best alongside medical check-ups, not in place of them, because some serious problems appear only after you have gone home.
What is normal as your body recovers
| Change | What is usual | Tell your doctor if |
|---|---|---|
| Vaginal bleeding | Red at first, then pink or brown, lighter over four to six weeks | It turns heavy again, smells bad or has large clots |
| After-pains | Cramps for a few days, stronger while feeding | Pain is severe or constant |
| Breasts | Full and heavy around day three to five | A red, hot, painful patch or fever |
| Urine and stool | Mild stinging, constipation for some days | You cannot pass urine or you leak stool |
| Tiredness | Common with broken sleep | You feel breathless, dizzy or very pale |
Postnatal check-ups
Before you leave the hospital, staff check your bleeding, blood pressure, wound and the baby's feeding. The World Health Organization advises further contacts around day three, in the second week and at six weeks. Your doctor may ask to see you sooner after a caesarean or a complicated birth.
What happens at the six-week visit
- The doctor asks about bleeding, pain, urine and bowel control, sleep and feeding.
- Your blood pressure and weight are checked, and haemoglobin is tested if you were anaemic.
- The abdomen is examined to see that the uterus has gone back to size.
- Stitches or the caesarean scar are looked at.
- You are asked about your mood and how you are coping.
- Contraception, exercise and return to sex and work are discussed.
- If you had diabetes or high blood pressure in pregnancy, follow-up tests are arranged.
Caring for stitches and wounds
After a vaginal birth
Keep the area clean with plain water after using the toilet and pat it dry. Change pads often. Sitting on a soft cushion and using the pain relief your doctor has prescribed can make the first week easier. Most stitches dissolve on their own. Drink plenty of fluids and eat fibre-rich food so that you do not have to strain while passing stool.
After a caesarean
Keep the wound dry and wear loose cotton clothing. Support your abdomen with a pillow when you cough or laugh. Short walks from the first days help prevent blood clots in the legs. Avoid lifting anything heavier than your baby for several weeks, and ask your doctor when you can drive or climb many stairs.
Feeding your baby
Breastfeeding within the first hour and feeding only breast milk for the first six months is recommended where possible. The early weeks can be hard. Sore nipples usually mean the baby is not latched deeply, and a nurse or lactation counsellor can show you how to correct it. Feed on demand, drink fluids and eat regular meals. If you cannot breastfeed or choose not to, discuss safe alternatives with the baby's doctor without guilt.
Your baby also needs check-ups in these weeks. Weight, feeding, jaundice and the umbilical cord are reviewed, and vaccines are given as per the schedule. Keep the baby warm, wash your hands before handling and limit visitors who are unwell.
Rest, food, mood and family planning
- Sleep when the baby sleeps and let others handle housework.
- Eat a normal balanced diet. There is no medical need to avoid water, fruit or vegetables.
- Continue iron and calcium tablets for as long as advised.
- Start gentle walking early, and pelvic floor exercises once you are comfortable.
- You can become pregnant before your first period returns. Talk about family planning and contraception at or before the six-week visit.
- Resume sex only when bleeding has stopped, you have healed and you feel ready. Dryness is common while breastfeeding, and sexual health counselling can help if pain continues.
Baby blues and postnatal depression
Feeling tearful and irritable in the first two weeks is very common and usually passes. If sadness, anxiety, lack of interest or trouble bonding with the baby lasts beyond two weeks, it may be postnatal depression. This is a medical condition, not a weakness, and it can be treated. Tell your doctor and your family.
Costs and paperwork
Fees for follow-up visits and tests vary by city, hospital and case. Carry your discharge summary to every appointment, because it tells the doctor what happened during the birth.
When to see a gynecologist after delivery
Seek care the same day for any of these warning signs:
- bleeding that soaks a pad in an hour or passes clots bigger than a lemon
- fever, chills or foul-smelling discharge
- redness, swelling, pus or opening of the stitches or scar
- severe headache, blurred vision or fits
- pain, redness or swelling in one calf
- chest pain or difficulty in breathing
- burning or inability to pass urine
- thoughts of harming yourself or your baby
Chest pain, breathlessness, fits and thoughts of self-harm are emergencies. Go to the nearest hospital at once.
This page is general information for readers in India. It is not medical advice. Speak to a qualified gynecologist about your own health.