What happens after I give birth?

Over about six weeks your uterus shrinks back to roughly its pre-pregnancy size, the bleeding tapers off, and your pelvic floor and abdominal wall begin repairing from day one — and your work in that window is walking, breathing, feeding and sleeping, not training hard, but not lying completely still either.

The short version: the first two weeks are for rest, short walks and gentle breathing work; weeks three to six are for more walking and better positioning under everyday loads; the six-week appointment is a medical clearance, not the day recovery starts; and a specific list of warning signs — heavy bleeding, fever, calf pain, a mood you do not recognise — means calling your doctor or midwife the same day, not waiting it out.

What is actually happening in my body in the first two weeks?

A lot, most of it invisible, most of it normal.

• Your uterus contracts down from around a kilogram to about 60 grams over roughly six weeks. Those cramps you feel while feeding — afterpains — are that process, driven by oxytocin, and they are usually stronger with each subsequent baby.
• You bleed. Lochia — the discharge of blood, mucus and uterine lining after birth — is heaviest in the first three to four days, then fades from red to brown to yellow-white.
• Your milk changes. Colostrum for the first few days, then a fuller supply usually arriving somewhere around day two to five, often with breast fullness and tenderness that peaks and settles.
• You swell, then you drain. Fluid retained in pregnancy leaves through urine and sweat, which is why the night sweats in week one can be drenching.
• Your pelvic floor is recovering whether you had a vaginal or a Caesarean birth. Pregnancy itself loads it for nine months.
• Your abdominal wall is long and slack. That is mechanical, not a personal failure.

Day one to day three

Standing up, walking to the bathroom, sleeping when you can. Getting in and out of bed without holding your breath. Breathing into your ribs rather than gripping your stomach. That is the whole programme.

Day four to week two

Short, flat walks — five to ten minutes, twice a day, is a reasonable place to start for most women, and if the bleeding gets heavier afterwards, you did more than your body wanted. Add gentle breath-led core work if it feels like nothing. It should feel like nothing.

How long does the bleeding last?

For most women, four to six weeks, tapering the whole way. It is normal for it to stop and then return briefly after a busier day. It is not normal to soak a pad in under an hour, to pass clots larger than a plum, or for the bleeding to smell foul — those are same-day calls.

Do I have to wait six weeks to move?

No, and the idea that you must is one of the things the industry gets most wrong. The World Health Organization's 2022 postnatal care guideline recommends at least four postnatal contacts in the first six weeks — within the first 24 hours, around day three, between days seven and fourteen, and at six weeks — precisely because recovery is a process that needs checking repeatedly, not once. The American College of Obstetricians and Gynecologists made a similar argument in its 2018 guidance on postpartum care, recommending contact within the first three weeks and a full assessment by twelve weeks.

The six-week check is not a starting gun. It is one appointment inside a recovery that began the hour your baby was born.

What that means practically: walking, breathing, positioning and pelvic floor work start in week one. Loaded strength training waits for clearance. For where the line sits, and what "lifting" means in week one versus week twelve, read how soon you can lift after having a baby.

What is different if I had a Caesarean?

You have all of the above plus a healing abdominal incision through several layers of tissue. Practically:

• Getting out of bed on your side, pushing with your arms, and exhaling as you rise, protects the incision more than any binder does.
• Numbness, itching, pulling and a shelf of tissue above the scar are common for months. Increasing redness, heat, discharge or the wound opening are not — get those looked at.
• Walking still starts early. It reduces clot risk and helps your bowels wake up.
• Scar mobility work is usually appropriate once the wound has fully closed, and a pelvic health physiotherapist is the right person to show you on your own scar.

Will my abdominal separation close on its own?

Often it narrows a great deal, and a gap on its own is not a diagnosis. A Norwegian cohort study published in 2016 followed around 300 first-time mothers and found roughly a third still had a measurable diastasis recti — a widening of the gap between the two halves of the rectus abdominis — at twelve months after birth. What matters more than the width is whether you can generate tension across the midline and manage pressure when you lift, cough or stand up with a baby in your arms. That is trainable, and it is what good postpartum core work is for.

How long joint laxity persists is genuinely uncertain. Hormone levels fall within days, some evidence suggests laxity lingers while breastfeeding, and none of it is strong enough to build a programme around. Load tolerance is a better guide than a hormone chart.

What about eating and breastfeeding?

Exclusive breastfeeding adds roughly 500 calories a day to your requirements, based on standard dietary energy estimates. That is not a licence to under-eat later. In the first six weeks the priorities are protein at every meal, enough fluid that your urine is pale, and iron if you lost significant blood at delivery — ask for a ferritin check if you are exhausted beyond ordinary newborn tiredness.

Deliberate weight loss is not the project of the first six weeks. Milk supply, tissue repair and sleep debt all draw on the same account.

Am I supposed to feel like this?

Some of it, yes. Tearfulness, sensitivity and mood swings in the first two weeks are extremely common and usually settle. Screening studies consistently put postnatal depression at somewhere around one in seven women, and it is under-detected mostly because nobody asks twice. Low mood that persists past two weeks, anxiety that stops you sleeping when the baby sleeps, or intrusive frightening thoughts are medical, treatable and not a character flaw.

What does the six-week check actually cover?

Usually: bleeding, uterine involution, blood pressure, incision or perineal healing, contraception, mood, and whether you are cleared for exercise and intercourse. It is often brief. Go in with your questions written down — leaking urine, pain with sex, heaviness in the vagina, doming of your abdomen, back pain — because these are the things most often left unasked, and most of them respond well to pelvic health physiotherapy.

Stop — when to get help

Call your doctor or midwife the same day, or go to emergency, if you have:

• Bleeding that soaks a pad in an hour or less, or clots bigger than a plum
• A fever over 38°C, or discharge that smells foul
• A severe headache, visual changes or swelling — blood pressure problems can appear for the first time after birth
• Chest pain or breathlessness, or pain, swelling and heat in one calf
• A red, hot, painful area on the breast with fever and body aches
• Incision or perineal wound that opens, leaks pus, or becomes more painful rather than less
• Inability to pass urine, no sensation of needing to, or loss of bowel control
• A feeling of heaviness or something coming down in the vagina
• Thoughts of harming yourself or your baby — this is urgent, today

This is general information, not medical advice for your situation. Your doctor, midwife or pelvic health physiotherapist is the person who can assess you.

Where to start

1. This week: walk. Five to ten minutes, flat, twice a day if bleeding is settling. Build from there.
2. Practise breathing with your ribs and exhaling on effort — standing up, lifting the baby, getting off the sofa. This is your core work for now.
3. Write your six-week questions down as they occur to you, and ask for a pelvic health physiotherapy referral even if nothing feels wrong.
4. Eat protein at every meal and drink to thirst. Leave body composition alone for now.
5. Plan your return to lifting before clearance, not after it, so week seven is not a guess — start with how soon you can lift after having a baby.

If this is a future pregnancy you are thinking about rather than a birth you have just had, the groundwork starts earlier: see lifting weights while pregnant.