Postpartum: Navigating the Fourth Trimester

December 13, 2022 | Tags: Healthy Outlooks

A lot happens to a mother’s body and hormones after birth, and many women don’t know what to expect. While each birth experience is unique, Dr. Fares Alqara, Assistant Medical Director at Medical Mutual, is sharing some things for moms to keep in mind as their body adjusts and heals.

What to Expect Immediately After Birth

Regardless of whether a woman goes through a vaginal delivery or C-section, doctors spend the 24 hours immediately afterward closely monitoring her. They’re assessing her bleeding, checking labs, inspecting any incisions, and, of course, checking blood pressure and vital signs.

While still in the hospital, moms also will meet with a lactation consultant to discuss feeding their baby breast milk. These consultants can be a resource for as long as a year postpartum, Alqara said. He recommends getting the lactation consultant’s contact information before heading home.

Once mom is discharged from the hospital, she should monitor herself for symptoms such as vaginal discharge, fever, and abdominal or breast pain, all of which can indicate an infection. Moms who are feeding their babies breast milk should be aware of severe tenderness, pain, red streaks or rashes on the breast. Ongoing bleeding warrants a call to the doctor as well.

Pregnancy also causes constipation and gas pain, so as new mothers settle in, they should prioritize consuming fluids and fiber. 

Hormonal Changes and Baby Blues

In those first few weeks of motherhood, there are also significant changes in a woman’s hormones.

“As quickly as a mother’s hormones change when they become pregnant, they change again after delivery,” Alqara said. “A drop in estrogen and progesterone causes a lot of emotions that they experience in the first couple of days to up to four weeks.”

This drop in hormones can cause hair loss for three to six months, as well as vaginal bleeding and contractions. The fast drop in hormones, stress and lack of sleep can also result in the postpartum blues.

“We call them postpartum blues for a reason, Alqara said. “And in the first four weeks it is normal.” 

While the postpartum blues are normal, feelings of helplessness or a desire to harm yourself or your baby are serious. Mothers experiencing these more severe feelings should contact their doctor immediately.

Postpartum Appointments

At six weeks, mothers generally hit a turning point and their hormones begin returning to normal, Alqara said.

Postpartum care is an ongoing process, and moms and their OB-GYNs should connect within three weeks of delivery. That initial check-in should be followed by a complete postpartum visit no more than 12 weeks after baby arrives.

“Your postpartum visit is critical, because that’s when your doctor will examine you, guide you through what needs to be done and address any issues,” Alqara said. “Even if you’re feeling great, attend your postpartum visit.”

The postpartum visit is the perfect time to bring up any concerns. For the best care, women should get comfortable being honest with their OB-GYN, he said. Then continue to see your doctor for ongoing well visits. 

When It’s More Than the Baby Blues

One common complaint? Lingering postpartum blues. Alqara said that if these emotions continue past four to six weeks — or are more severe than just the blues — mothers should talk to their doctors immediately about being treated for postpartum depression. Women with postpartum depression often describe feelings of hopelessness and exhaustion. They could experience changes in appetite, excessive crying and withdraw from family and friends.  In some extreme cases, they might think about harming themselves or their child.

Moms shouldn’t fear stigma along with a postpartum depression diagnosis, he said. It’s a common health issue, and your medical team is ready to help.

Medications and working with a therapist are used to treat postpartum depression.  Alqara reassures mothers that the medications are non-addictive and are safe while breastfeeding. Some individuals may need treatment for six months, a year or two years — it all depends on the unique situation. 

How Long Does It Take to Recover After Birth?

After delivery, it ultimately takes about a year for new mothers to fully recover. That’s why doctors recommend waiting 12 to 18 months before getting pregnant again.

“When new moms get pregnant again right away, they can get diabetes, struggle with weight loss and experience more complications because their body never fully went back to normal.”

Alqara adds that moms should spend their time healing in whatever way is best for them. Mothers can find support from their OB-GYN, in new mother groups and, of course, from friends and family. He encourages them to accept help, head out of the house for some fresh air, and to get some alone time.

Looking for Pregnancy and Postpartum Support?

The MedMutual Maternity App also supports mothers and their growing families, beginning with ovulation tracking, throughout pregnancy and into postpartum. New mothers can find various health trackers and a library of postpartum resources on the app, including postpartum recovery, postpartum support, mental health and information for partners. Find more information and download the MedMutual Maternity app.