Doctors often refer to the six weeks after delivery as the "fourth trimester" because your body is continuing to change so much. However, weight fluctuations aren't the only postpartum challenge you'll face. Here's a look at what you can expect.    

By Belle: University Chancellor
Mikhail Tchkheidze/

Your Uterus Shrinks

Minutes after your baby's born, your uterus begins to shrink and contract, causing cramps known as afterpains (these are usually comparable to menstrual cramps). Around the same time, you start shedding the uterine lining that thickened during pregnancy. At first, this bloody discharge (called lochia) will be heavy, but as the days go on, it'll gradually get lighter and lighter. You should use sanitary pads during this time: Tampons increase the risk of infection since you're still healing. After six weeks, your uterus will be close to its pre-pregnancy size and the discharge should stop.

You Have Pain Down There

If you have a vaginal birth, the area between the vagina and anus (called the perineum) might be sore from stretching, tearing, or being cut during an episiotomy. Try ice packs and pain relievers like ibuprofen or acetaminophen to ease swelling and make you more comfortable. If you developed hemorrhoids while pushing during delivery, use cold witch-hazel compresses and over-the-counter anti-inflammatory hemorrhoid creams for relief. Relaxing in a tub filled with a few inches of warm water a few times a day (a sitz bath) also helps.

You Have New Problem Areas

Most women lose about 10 pounds during childbirth, which includes the weight of the baby, the placenta, and the amniotic fluid. But it takes more time and effort to shed the rest of the weight you gained. "Most women are five pounds heavier, if not more, after each pregnancy," says Adelaide Nardone, MD, clinical instructor of obstetrics and gynecology at the Warren Alpert Medical School of Brown University. The more excess weight you put on during pregnancy, the harder it is to lose afterward.

Once you've managed to get back into your old size, don't be surprised if your favorite clothes don't flatter you the way they used to. Your body may have created new curves in certain areas, such as your breasts or hips. And changes in fat deposits and lost muscle tone will also play a role in altering your body shape. To help speed up your weight-loss program, try strength-training exercises to firm up problem areas and regain muscle.

Your Skin Changes

Your belly, breasts, and butt can look like a road map of stretch marks during pregnancy, and, sadly, these purplish-red streaks won't magically disappear after you have your baby. "But over time they'll fade and become less noticeable," says Dr. Nardone. Prescription topical ointments like tretinoin cream can diminish the marks, but they're not safe to use while you're nursing, and they're most effective when used soon after childbirth.

Your Hair Looks Thinner

After nine months of having lush, shiny locks that rival Angelina Jolie's, it can be unsettling to find those gorgeous strands suddenly clogging the shower drain. High estrogen levels during pregnancy kept your hair follicles in a resting phase (as opposed to a growing or a shedding phase), so you lost fewer hairs on a daily basis. About 12 weeks after delivery, as your estrogen levels settle down, follicles begin to grow and shed quickly to make up for all that lost time. Normally, you shed about 100 hairs a day, but in the months following childbirth, you may lose up to twice that amount. Don't worry: This rapid hair loss should ease up after about three to six months. If it doesn't, see your doctor because you could be low on iron.

Watch Out for These Symptoms

Call your doctor immediately if you experience any of the changes on this list during the six weeks after you give birth, since they can signal a health problem.

  • Chills or fever of 100.5 degrees or higher
  • Sudden heavy bleeding (soaking more than one pad an hour) or lots of large clots
  • Foul-smelling vaginal discharge
  • Severe pain or redness surrounding, or discharge from, a c-section incision or an episiotomy
  • Fainting, nausea, or vomiting
  • Frequent urination or burning with urination
  • Constipation that lasts three days or more
  • Swelling, redness (or red streaks), and pain in your breasts, accompanied by fever
  • A tender, swollen, or red area anywhere in your leg or calf
  • Persistent headaches or vision changes
  • Excessive swelling of the face, fingers, or feet
  • Intense sadness or feeling that you can't care for yourself or your baby

Pamper Yourself

Need a little pick-me-up? Try these feel-good tips from other new moms.

I love getting a pedicure to boost my spirits. I'm still dieting to lose my baby weight, and it's nice to have pretty toes when the rest of my body doesn't feel so pretty.-- Sarah S., Lewisville, Texas

I splurged on a really expensive haircut and color. I figured I might as well have great hair while the rest of my body gets back into shape.-- Abbi H. W., Reno, Nevada

When I go to the gym, I feel better about myself and my body. It's amazing how much energy exercise gives you -- even if it's just a 20-minute walk on the treadmill.-- Erin B., Canton, Georgia

Copyright © 2008. Used with permission from the April 2008 issue of Parents magazine.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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