If you feel generally unwell, it’s important to get yourself checked out by your midwife or GP, as these symptoms can be signs of infection:

Your body after birth

Pregnancy and delivery are very demanding, and your body can look and feel different straight after the birth, many of these changes are temporary and will recover with time.

To reduce the risk of infection, it is vital that you wash your hands before and after passing urine, opening your bowels or changing your sanitary towel.

Learn more about your body straight after the birth.

Many women have stitches at the time of delivery, your midwife will guide you about how these are healing.

A caesarean is major surgery and recovery can take several weeks, although you will usually start to feel more comfortable after a few days. You should try to stay mobile, but don’t overdo it – your stomach muscles and your wound need time to heal. You should avoid strenuous activity, heavy lifting, driving and sex for around six weeks, but your midwife can give you personalised advice.

You should keep your surgical stockings on for a week to reduce the risk of deep vein thrombosis (DVT). If you have been given a course of injections to take home, it’s important that you complete the course. These are to reduce your risk of developing a DVT also.

Stitches usually dissolve by the time the cut or tear has healed, but non-dissolvable stiches and staples will need to be removed. If you have dissolvable stitches that are not dissolving, tell your midwife. You should wash and carefully dry your wound every day to prevent infection, and seek advice if your wound is red, swollen, painful, oozing or smelly.

Some women experience swelling in their feet and legs after birth, especially if they’ve had a caesarean. This can be uncomfortable, but it’s usually not a problem. Ice packs, foot baths and elevating your feet for a little while can be helpful, and swelling should improve after 1-2 weeks.

However, women are at increased risk of deep vein thrombosis (DVT) for around six weeks after birth. If you experience any of these symptoms you should seek immediate medical advice:

  • Swelling in one leg / foot
  • Redness / heat in your calf
  • Pain or tenderness in your calf or behind your knee
  • Shortness of breath or chest pain

If you have been given compression stockings, you should wear them for as long as you have been advised (usually around a week). Some women will be sent home with a course of injections to prevent blood clots if they are at increased risk – if so, make sure you finish the course. To prevent DVT you should keep mobile, drink lots of water and do ankle exercises (e.g. rotating your feet).

At first, the thought of peeing can be a bit frightening – because of the soreness. Drinking lots of water dilutes your urine, which may make it sting less.

Tell your midwife if:

  • You’re finding it really difficult to pee
  • You feel very sore
  • You notice an unpleasant smell

You probably won’t have a poo for a few days after the birth, but it’s important not to let yourself get constipated.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water.

If you’ve had stitches, it’s very unlikely you’ll break them, or open up the cut or tear again.

It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain.

Talk to your midwife or GP if you have constipation that won’t go away. A gentle laxative may help.

Also tell your midwife or GP if poo is leaking or you’re pooing when you don’t mean to.

Read about going to the toilet following labour and birth on NHS UK

Some women experience leakage from their bladder or bowel following delivery. Pelvic floor muscle activity can help to improve these symptoms. Please do refer yourself to the physiotherapy team if these symptoms do not show improvement.

Some women experience a vaginal bulge which might be a vaginal prolapse which is when one or  more of the vaginal walls or top of the vagina move downwards and cause a bulging or heavy feeling at the vaginal entrance.

It can be very helpful to start pelvic floor exercises and avoid constipation and heavy lifting.

Tell your general practitioner (GP) at your postnatal check if things aren’t getting better. They may refer you to a physiotherapist.

You can self-refer to physiotherapy for these symptoms if the information here does not improve things.

Piles are very common after birth but usually disappear within a few days.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water. This should make pooing easier and less painful.

Try not to push or strain – this will make the piles worse.

Let your midwife know if you feel very uncomfortable. They can give you a cream to soothe the piles.

Read about the affects of piles after labour and birth on NHS UK

You’ll bleed from your vagina after the birth. It will be quite heavy at first, and you’ll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards.

It isn’t a good idea to use tampons until after your 6-week postnatal check because they could increase your chance of getting an infection.

You may notice the bleeding is redder and heavier when you breastfeed. This happens because breastfeeding makes your womb contract. You may also feel cramps similar to period pains.

The bleeding will carry on for a few weeks. It will gradually turn a brownish colour and decrease until it finally stops.

If you’re losing blood in large clots, tell your midwife. You may need some treatment.

Read information about bleeding after labour and birth on NHS UK

To begin with, your breasts will produce a yellowish liquid called colostrum for your baby.

On the third or fourth day, they may feel tight and tender as they start to produce milk.

Wearing a supportive nursing bra may help. Speak to your midwife if you’re very uncomfortable, experiencing an area of redness and/or heat in one breast or if feeding is painful.

Read information about your breasts and the affects of labour and birth on NHS UK

Thrush

A common problem is separation of the two long muscles that run down the stomach – this is called diastasis recti. In most women this is quite mild and resolves itself as you recover from your birth, but women who have a larger gap between those muscles may need some help from a physiotherapist. Find out more about diastasis recti.

It is very common for the tummy muscles to lengthen and move apart during pregnancy. By 8 weeks after delivery most women see this has naturally improved.

There are some gentle exercises that you can start to recover your muscles following pregnancy.

 You can self-refer to physiotherapy if you are concerned things are not improving after the first few months.

You shouldn’t start having sex again until you both feel ready, physically and mentally. For some couples this can take some time, as your birth experience, any injuries or trauma, your hormone levels, emotional wellbeing and sleep-deprivation all impact on your ability or desire to have sex. There is no “normal” timeframe to resume a sexual relationship after birth, it depends on the couple and what you’ve experienced.

If you do want to have sex, it’s best to wait at least a few weeks to allow yourself to heal, whether you’ve had a vaginal birth or a caesarean. The risk of infection is higher in the weeks following the birth, as your cervix may not be fully closed, and your uterus will still be healing where the placenta has detached. Ask your midwife for advice on this based on your own circumstances. You may need to use extra lubrication to make things more comfortable, especially if you are breastfeeding or pumping as this affects your hormone levels.

If you do have sex, it’s extremely important to use contraception – you can become pregnant again within a few weeks of giving birth, you will be fertile before your first period arrives. Some people think that breastfeeding prevents ovulation but this is not always the case.

It’s a good idea to think about what sort of contraception you’d like to use – talk to your GP about your options, as not all contraceptives can be used while breastfeeding. Until you’ve arranged contraception, make sure you use condoms to prevent an unplanned pregnancy.

Being active after pregnancy is great for your physical health and emotional wellbeing.

Some of the benefits include helping to control weight and return to pre-pregnancy weight, improving tummy muscle tone and strength, improving sleep, improving mood and reducing worry and depression. It can also give you time for yourself.

It is safe to be active following childbirth, but it’s important not to do too much too soon. Priority should be given to rest, recovery and bonding in the early days before gradually introducing activity.

If you were active before or during your pregnancy, gradually re-introduce activities but start off with adaptations. If you were not active before your pregnancy, start gradually and build up your activity levels over time.

You can be active while breastfeeding. Being active when breastfeeding is safe and does not impact on breast milk quality or infant growth.

If you’ve had a straightforward birth, you can start gentle activity as soon as you feel up to it, such as walking, gentle stretches, taking the stairs, and being active with your baby.

Start pelvic floor exercises as soon as you can and continue daily.

After the 6-8 week postnatal check and depending on how you feel, moderate intensity activities can gradually resume. After 3 months, in the absence of any issues, you can resume high-impact activities like running and jumping.

If you have had a caesarean, your recovery time will be longer and timings can vary from person to person. Try to stay mobile and do gentle activities, such as going for a daily walk while you’re recovering to reduce the risk of blood clots.

It is still safe to undertake daily pelvic floor and gentle core exercises soon after birth as long as you haven’t suffered any complications.

Only increase your activity levels when you feel able to do so and do not find it uncomfortable. You can ask your midwife or GP for advice if you are unsure.

Over time, gradually build up to aiming for 150 minutes of moderate intensity physical activity spread throughout the week. You don’t need to do it in big chunks – every active minute counts!

Activities can include walking, exercise classes, taking the stairs, swimming, gardening, housework or any activity that makes you breathe faster whilst still being able to hold a conversation. It is recommended to wait seven days after post-natal bleeding has stopped before taking part in water activities to avoid risk of infection.

When you do start to exercise, it’s important to pay attention to your body – you should stop if it’s painful, when you are tired or if you feel unwell.

Gradually build up to including muscle strengthening activities twice a week, such as walking uphill, taking the stairs, carrying shopping bags, and pregnancy yoga.

In the first few months after birth, avoid activities that involve rapid twisting or lifting, or that place too much strain on the pelvic floor, stomach or back muscles. This will help avoid injury as your ligaments and joints are more supple and pliable following childbirth and your back and core muscles may be weaker than they used to be.

Only after you have built up your activity levels to a moderate intensity, (typically over a three-month period), and in the absence of any symptoms of incontinence, pelvic pain, needing to go to the toilet urgently, or heaviness or pressure in the pelvic area, should you introduce more intense activities. As you do, continue to increase your activity gradually, for example, return to running using a Couch to 5k programme.

For more guidance on specific activities including how to make adaptations post pregnancy and build up your activity levels gradually, take a look at the Find Your Active resources on the Active Pregnancy Foundation website. The series of guides cover a range of specific activities including running, dancing, resistance training and many more.

If you would like support to increase your activity or are unsure about where to start, LiveWell Dorset can help. LiveWell Dorset is a free healthy lifestyle service for adults living in Dorset offering support and coaching to get active, lose weight, stop smoking and reduce alcohol intake. Visit the LiveWell Dorset website to find more information.

If you have had a caesarean, as soon as you’re able to get out of bed gentle walking will help you recover from your surgery. It is still safe to undertake daily pelvic floor and gentle core exercises soon after birth as long as you haven’t suffered any complications. Once you no longer have any pain, it is usually safe to start low-impact exercises, such as swimming, pilates, yoga, gentle jogging and low resistance gym work. Wait until you’ve had your 6-8 week postnatal check with your GP before returning to your pre-pregnancy levels of exercise.

Eventually aim for 150 minutes of moderate intensity physical activity spread throughout the week. You need not do it all at once – every active minute counts!

Activities can include walking, exercise classes, taking the stairs, swimming, gardening, housework or any activity that makes you breathe faster whilst still being able to hold a conversation.

Start pelvic floor exercises as soon as you can and continue daily.

Build back up to muscle strengthening activities twice a week e.g. walking uphill, taking the stairs, carrying shopping bags, and pregnancy yoga.

You can be active while breastfeeding.

Physical activity for women after childbirth.

When you do start to exercise, it’s important to pay attention to your body – you should stop if it’s painful, when you are tired or if you feel unwell.

You should see your obstetrician, midwife or GP before starting to increase their physical activity if you have any symptoms of new excessive shortness of breath, chest pain, palpitations, dizziness or fainting/near fainting, both during exertion or at rest.

For guided activity videos that you can follow at home – This Mum Moves website.

Infections can lead to sepsis, which is a life-threatening condition. You should call 999 if you feel unwell and have any of the following symptoms:

• Mottled or discoloured skin
• Extreme shivering
• Rapid heartbeat and / or breathing
• Slurred speech and / or confusion
• Severe muscle pain
• Not passing any urine
• Breathlessness

Find out more from Sepsis Trust

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