A REAL Postpartum Recovery Timeline to Follow
It’s no secret that the 6 week postpartum recovery timeline isn’t sufficient. This timeline comes from medical understanding that it takes around 6 weeks for the uterus to shrink back to pre-pregnancy size. However, there is a massive disservice to postpartum women to spread information that ALL recovery is complete by 6 weeks. Based on anatomical changes during pregnancy, significant loss of muscle mass, hormonal changes after birth, and connective tissue healing, a more accurate recovery timeline to discuss is 6-9 months. And quite honestly, the majority of our postpartum clients report finally feeling “more like themselves” after an entire year.
Society encourages new moms to "bounce back" - no matter how pregnancy or birth went - but the truth is that recovery is a longer, more nuanced process dependent on a variety of factors. These factors include prior health and level of activity, type of birth, length of labor, pelvic floor injury, traumatic birth experiences, and postpartum health: including sleep, mental health, nutrition, social support, and ability to rest from job demands. Understanding what to expect at different stages can help you approach recovery with patience and intention.
What to Expect in the First Few Days After Birth
For Post-Vaginal Delivery
The first few days after a vaginal delivery are almost certainly a whirlwind. Expect to experience vaginal bleeding (lochia), uncontrollable shaking/shivers, uterine contractions as your body works to return to its pre-pregnancy state, and general discomfort in your pelvic region. You may also notice soreness or swelling around the perineum if you had any amount of tearing. Difficulty controlling urine or gas can feel alarming, but is common. Heaviness in the vaginal region, a sense of bulging or like a tampon is falling out, is also not uncommon. Rest is crucial during this time. We highly recommend the 5-5-5 rule: 5 days in bed, 5 days around bed and 5 days around the house. Of course, we also recommend seeing the sunshine and not going stir-crazy experiencing groundhog day in your bedroom, so there is a balance. The overarching recommendation is to take it SUPER EASY. Please do not compare yourself to your neighbor or sister in law who was walking down the block the day after she had her baby.
After C-Section
For those who’ve had a c-section, recovery tends to be more intensive due to the nature of a major abdominal surgery. C-section recovery also depends largely on whether the surgery was planned or emergent. Emergency surgeries tend to take longer to recover from, and there is often an element of trauma or processing a changing birth story. The first few days will likely involve significant discomfort around the incision site, as well as general soreness in your abdomen and pelvis. You’ll need extra time to heal from the surgery, and movement, such as standing or walking, will be slower. A key focus in these early days is to rest - similarly to a vaginal birth - and gradually increase mobility to prevent complications like blood clots or infection. Sneezing, coughing, laughing, and having a bowel movement will be uncomfortable at first. Use a pillow over your incision to press in towards your body to manage the pressure coming out towards your abdomen.
Mental Health Status
Regardless of the type of birth, mental health plays a critical role in the early days of recovery. The emotional rollercoaster, combined with sleep deprivation and hormonal shifts, can lead to feelings of overwhelm or sadness. The hormonal shift on the 3rd day postpartum is the most dramatic shift in hormones you will experience in your lifetime. Knowing this ahead of time - and informing your support people to expect this change - can help you ride the waves more smoothly. It’s important to acknowledge any and all feelings that come up, and to know when to seek additional support. Postpartum doulas can help you adjust to life with a newborn, offering not just physical help but emotional support during this vulnerable time. They are a great first line of defense to help you know what’s “normal” for you and baby, and when it may be a good idea to seek extra help from a mental health professional, lactation consultant, pelvic floor therapist, or any other provider. Learn more about how a postpartum doula can support you here.
The First 6 Weeks: Physical and Emotional Recovery
For Post-Vaginal Delivery
During the first six weeks post vaginal birth, people often face the challenge of healing the perineum and adapting to changes in their pelvic floor. You may still experience bleeding, pelvic heaviness, or discomfort when sitting. It’s important to rest as much as possible, avoid lifting heavy objects, and practice gentle diaphragmatic breathing to get your core and pelvic floor back on board. Read more about diaphragmatic breathing here.
After C-Section
For those recovering from a c-section, the first six weeks are mainly focused on incision healing. As much as you’re able to limit lifting to just your baby will help prevent any undue strain or injuring your incision. C-section recovery can also bring challenges like tenderness, numbness, or itching around the scar, digestive issues, and general fatigue as your body works to heal. Bending and twisting, especially with nursing, can be challenging and require modifications.
Mental Health Status
The first six weeks can be an emotional whirlwind, with the stresses of adjusting to life with a newborn, possible feeding challenges, and sleep deprivation. It’s important to have realistic expectations and give yourself grace. Mental health struggles, including postpartum depression or anxiety - for you and your partner - can arise during this time. If you’re struggling, don’t hesitate to reach out for professional support.
3 Months Postpartum: Adjusting to New Rhythms
For Post-Vaginal Delivery
At three months postpartum, you may start to feel more like yourself physically as your pelvic floor and perineum continue to heal. You may also begin gentle exercises or activities like walking or light yoga. Your body is transitioning into a new rhythm, and while you may still feel some fatigue, it’s a good time to check in with your physical therapist for a postpartum checkup and to begin the process of gradually returning to more strenuous activities, like running or strength training.
After C-Section
For c-section mothers, three months postpartum is a significant milestone for healing. Your incision will likely be much less tender, but you’ll still need to be mindful of your scar and abdominal muscles. It’s a great time to check in with your physical therapist for a comprehensive assessment of your core and pelvic floor strength. This will ensure that you’re ready to move forward with gentle exercises that promote healing and strength rebuilding.
Mental Health Status
By three months postpartum, you may start to feel more emotionally balanced as you adjust to the rhythm of motherhood. However, it’s still a time to watch for any lingering signs of postpartum depression or anxiety. Having supportive friends, family, and mental health professionals is key.
6 Months Postpartum: Rebuilding Strength and Balance
For Post-Vaginal Delivery
Six months postpartum is a time of rebuilding strength, particularly in the pelvic floor and core muscles. You may begin strengthening exercises such as pelvic floor rehabilitation and core work, which should be done under the guidance of your physical therapist. You might also be ready to return to higher-impact activities, such as running or strength training, but only once you’ve received approval.
After C-Section
For those recovering from a c-section, six months postpartum can bring substantial improvement in abdominal strength and mobility. With the guidance of your therapist, you may be ready to increase the intensity of your workout routine and begin rebuilding your strength, including core-focused exercises. Focus on proper scar tissue management and strengthening the muscles around your abdomen.
Mental Health Status
At six months postpartum, you may feel more settled in your motherhood journey. However, it’s still important to check in with yourself emotionally. Your identity and life might have shifted dramatically, and managing your well-being is just as crucial as physical recovery. Consider therapy, support groups, or talking to loved ones to stay mentally healthy.
1 Year Postpartum: Long-Term Healing and Wellness
For Post-Vaginal Delivery
At one year postpartum, many women experience complete physical recovery, especially if they have been diligent about pelvic floor therapy and exercises. You may feel confident in your body again and even return to high-impact sports, but be mindful of any lingering issues like incontinence or pelvic pain.
After C-Section
For c-section mothers, one year postpartum is typically when full recovery can be achieved. If you’ve worked with a physical therapist throughout the process, you’ll likely have strengthened your abdominal muscles, and any discomfort around your scar should be minimal. However, long-term recovery may require continued maintenance of your core and pelvic floor health.
Mental Health Status
By one year postpartum, many women report feeling more emotionally grounded. However, it’s important to remember that each woman’s journey is different, and it’s normal to experience ups and downs. It’s okay if you don’t feel “back to normal” after a year—healing is a lifelong process.
Embracing Your Unique Postpartum Recovery Timeline
The postpartum recovery timeline isn’t one-size-fits-all. Your experience will be unique to your body, your delivery, and your mental health. While it’s easy to compare yourself to others, the key to healing is to honor your own pace. Whether you’ve had a vaginal delivery or a c-section, focus on your recovery with patience and self-compassion. Remember, the journey doesn’t end at 6 weeks or 12 months—it’s a continuous process that deserves attention and care for as long as you need it.