Your body in the first weeks after birth

Bleeding from the vagina, cramps while feeding and a sore trip to the toilet can all happen in the first weeks after birth. Some symptoms need prompt medical attention.

Bleeding that gradually settles

The bleeding after birth is called lochia. It can be quite heavy at first, then usually decreases and turns brownish over the following weeks. Use maternity or period pads and change them regularly, washing your hands before and afterwards.

The NHS advises waiting until after your 6-week postnatal check before using tampons. There is still a healing wound where the placenta was attached inside the womb; internal products, including menstrual cups, can increase the chance of infection before it has healed.

Get emergency medical assessment now for sudden or very heavy vaginal bleeding, even if you do not feel faint. Call 999 (UK), 911 (US), or your local emergency number if you cannot get to emergency care safely. Do not 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 with an unpleasant smell also needs prompt assessment. These are reasons to call, rather than measurements you need to reach before asking for help.

Cramps and breast tenderness

Breastfeeding makes the womb contract. You may notice period-like cramps and temporarily redder or heavier bleeding during feeds. Get emergency assessment now for sudden or very heavy blood loss; feeding is not a reason to dismiss it.

At first, your breasts produce colostrum, a yellowish liquid. As milk production starts, they may feel tight and tender. A supportive nursing bra may help with comfort. Speak to your midwife if your breasts are very uncomfortable, and ask about support that fits your feeding plans.

Making toilet trips easier

Drinking water can dilute your pee and make it sting less. Seek urgent medical assessment now if you cannot pee at all or have severe lower tummy pain. Contact your maternity unit (UK), obstetric clinician (US), or local urgent service now; go to emergency care if you cannot be assessed promptly.

Contact your midwife or GP today (UK), your obstetric clinician (US), or your local doctor or midwife if you can pee but it is really difficult, you feel very sore or you notice an unpleasant smell.

For constipation, the NHS suggests plenty of water and foods such as fruit, vegetables and wholegrain cereals. Try not to strain. If you have stitches, opening your bowels is very unlikely to break them; holding a clean tissue pad over the stitches may feel more comfortable. Ask your midwife or GP about constipation that isn’t settling; 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, and a GP can refer you to a physiotherapist if they are not helping. Tell your midwife or GP about leaking poo or losing bowel control too.

Your check is for you

In the UK, your GP surgery should offer a postnatal check at 6 to 8 weeks. You can request it yourself. It can be separate from your baby’s check. You should still receive an invitation if your baby is in hospital or has died.

US guidance from ACOG recommends contact within the first 3 weeks postpartum, followed by care as needed and a comprehensive visit no later than 12 weeks after birth. WHO recommends care for at least 24 hours after a facility birth and a minimum of three additional checkups in the first six weeks. These are schedules for planned care. Don’t wait for an appointment date if you have symptoms that need help.

When to call sooner

Get emergency medical assessment now for sudden or very heavy vaginal bleeding, even if you do not feel faint. Call 999 (UK), 911 (US), or your local emergency number if you cannot get to emergency care safely.

Call 999 now (UK), 911 (US), or your local emergency number for new chest pain or severe breathing difficulty, 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 persistent severe headache or changes in vision.