What to expect after birth

The physiological and psychological changes that every women experiences after they become a mother

It's wonderful but it can be daunting! Knowing what to expect can decrease anxiety at such a vulnerable time.

For most women, becoming a mother is an life altering experience. However, there are many challenges that come with the postpartum period which are often not talked about. Women go through enormous physical and emotional changes after having a baby which, can be stressful and confronting, compounded with the financial, relationship and social dimensions that come with having a new baby.  Understanding the changes that you will go through during the postpartum period, can help you cope and feel confident through this season.

Physical Changes

Physical changes that occur during the postpartum period include afterbirth pains, pain from a perineal tear, episiotomy or caesarean section, exhaustion, sleep deprivation, hormonal changes, learning to breastfeed and care for her baby, social changes and financial changes.

Women who have had a vaginal or a caesarean birth will both have postpartum bleeding for around 6-8 weeks. This is caused by the uterus clamping down to go back to pre-pregnancy size and heal the placental site. The pain of the uterus clamping down is known as “afterbirth pains” and can be quite painful, especially in subsequent births. Heat packs, paracetamol and your TENS machine can help you with dealing with your after birth pains.

Women will undergo breast changes during pregnancy as well as afterbirth to prepare for breastfeeding. When the baby is first born, they will be getting colostrum (the first milk) for the first few days, and this will slowly transition to ‘breastmilk’. When a woman’s milk ‘comes in’ they may become engorged as the body tries to regulate how much milk is needed for the baby. Engorgement along with any breast tenderness or nipple damage can be uncomfortable and difficult to manage in the first few days. Always seek help from a medical professional or lactation consultant if you are experiencing any of these.

Healing from a perineal tear, episiotomy or caesarean wound can make moving around, sitting and caring for your baby difficult in the early postpartum period. It is essential that you rest as much as you can, slowly increase mobilisation each day, take pain relief as required, ice and keep any wounds clean and dry to aid in healing and recovery.

Fluid changes are common after birth due to no longer needing the increased blood volume required during pregnancy. You might find a slight increase in swelling in your feet and legs in the first few days postpartum as your body is trying to remove this excess fluid. It is essential that you drink lots of water, increase mobilisation each day, elevate your legs/feet when you can and wear any compression socks/tights recommended to you. If you are concerned about your swelling, there is any redness, change in colour or a spot on your leg that is cold to touch it is important to alert your midwife or doctor. Wearing compression garments can help to reduce any swelling and reduce your risk of developing a blood clot.

The exhaustion of caring for a baby for 24 hours a day and attempting to continue maintaining their household duties can lead to burnout and feelings of failure. Preparing for your postpartum period through cooking meals and educating yourself on normal newborn behaviour can help you to set realistic expectations. Make sure that you keep communication open with your partner to share the household tasks and ensure there is enough time for the mother to rest.

Psychological Changes

After birth, parents will undergo a series of emotions from love, joy, shock, stress, worry, relationship changes, feelings of failure, feeling overwhelmed, anxiety and depression. The body undergoes a hormonal shift from pregnancy to postpartum and the hormones required from breastfeeding. This is one of the largest hormonal shifts that a woman will undergo during her life. It often results in what’s known as the Baby Blues, which is a period of crying often for no reason, reduced enjoyment from activities, irritability, difficulty making decision, sleep or appetite disturbances, feeling numb, feeling disconnected from the baby or family members and feeling out of control. The Baby Blues should only last 7-14 days and if these feelings persist longer, you may be developing postpartum depression or anxiety.

Postpartum depression impacts around 1 in 5 Australian mothers and 1 in 10 Australian fathers. It is important that if you think you may be developing postnatal depression or anxiety you seek help from a healthcare professional – see below for resources that may help you.

Parents in the postpartum period also have the burden of worrying if their baby is okay or if they are caring for their baby the right way. Conflicting advice around parenting and comparisons between mothers can exacerbate feelings of failure or confusion about your parenting ability. Remember, you are doing what is best for your baby!!

Where can you get more help or support

If you need more help or information, please visit:

  • The Gidget Foundation
  • Beyond Blue
  • COPE
  • NSW Mental Health Line
  • Your local GP

The transition to parenthood is challenging, however it is also a period where you can better understand yourself, find your new identity, grow, mature and increase your knowledge. It is both physically and emotionally challenging, but remember it is a season, you’re doing an amazing job and it will pass.

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