🌸 Antenatal Guide — Weeks 1–12 After Birth
Postpartum Health Checklist
The weeks after giving birth matter just as much as antenatal care — for both mother and baby. This guide covers the essential health checks, warning signs, and practical steps for the postpartum period that Nigerian mothers are often not told about.
Key Milestones
🌱 Days 1–7: Immediate postpartum period
The uterus contracts and shrinks (uterine involution). Lochia (postpartum vaginal discharge) is heavy and red initially, becoming lighter and pink over 2–3 weeks. Breastfeeding is established — most challenges arise in the first week. Baby weight typically drops 5–7% in the first few days then rises from day 4–5 with adequate feeding.
🌱 Days 7–14: Wound healing and adjustment
Perineal stitches (episiotomy or tear repair) usually dissolve by 10–14 days. Caesarean wound should be kept dry and inspected for signs of infection. Baby is weighed at 10–14 days to confirm return to birth weight with adequate feeding.
🌱 Weeks 4–6: Six-week postnatal check
The formal postnatal review with your doctor or midwife. Covers: mother's physical recovery, wound healing, blood pressure, anaemia check, emotional wellbeing screening, breastfeeding support, contraception discussion, return to exercise, and baby's development.
🌱 Weeks 8–12: Return of menstrual cycle
In non-breastfeeding women, periods typically return by 6–10 weeks. Breastfeeding delays menstruation in most women — but ovulation can precede the first period, meaning pregnancy is possible before menstruation returns. Contraception should be discussed at the 6-week check.
Essential Tests & Scans
Full Blood Count (FBC)
⏱ 6-week postnatal visit
Anaemia is extremely common after delivery — both from blood loss and the demands of pregnancy on iron stores. An FBC at 6 weeks guides whether oral iron supplementation should continue and whether IV iron or transfusion is needed for severe anaemia.
Blood Pressure Check
⏱ Days 1–5 and at 6-week check
Pre-eclampsia can develop or persist for up to 6 weeks after delivery (postpartum pre-eclampsia). Any headache, visual disturbance, or excessive swelling after delivery warrants immediate BP measurement.
Thyroid Function Test (TSH)
⏱ If symptomatic; or at 3–6 months routinely for women with positive thyroid antibodies
Postpartum thyroiditis — an autoimmune inflammation of the thyroid — affects 5–10% of women in the first year after delivery. It presents as hyperthyroidism (weeks 1–4), then hypothyroidism (weeks 4–8), before usually resolving. New onset of fatigue, palpitations, depression, or weight change in the postpartum period should trigger a TSH test.
Postpartum Depression Screening (Edinburgh Postnatal Depression Scale)
⏱ 2 weeks and 6–8 weeks after birth
A validated 10-question questionnaire administered at 2–6 weeks and again at 3 months. A score above 12 warrants assessment by a mental health professional. Postpartum depression affects 10–15% of Nigerian mothers — it is underdiagnosed and undertreated because of stigma.
Pap Smear (if overdue)
⏱ At or after 12 weeks postpartum if overdue
The postnatal visit is an ideal opportunity to perform overdue cervical screening. Pap smear can be done from 12 weeks after delivery.
Frequently Asked Questions
When can I exercise after giving birth?
For uncomplicated vaginal delivery: gentle walking from day 1–2, and pelvic floor exercises (Kegel exercises) from day 1 are safe and beneficial. More intense exercise (running, gym, swimming) from 6–8 weeks after clearance at your postnatal check. After caesarean section: walking within 24 hours is encouraged, but avoid abdominal exercises, heavy lifting (more than 5 kg), and driving for 6 weeks. Listen to your body — pain or pressure is a signal to reduce intensity.
What is normal postpartum bleeding (lochia)?
Lochia is the postpartum uterine discharge that lasts 4–6 weeks. Days 1–4: heavy, bright red, with possible clots (normal if clots are smaller than a golf ball). Days 4–10: lighter, pinkish-brown. Weeks 2–6: yellowish-white and light. Abnormal: soaking more than one pad per hour for 2+ hours (haemorrhage), large clots, returning to heavy bright red after it was lightening (may indicate retained placental tissue), or foul smell with fever (infection).
Can I breastfeed if I have HIV or Hepatitis B?
HIV: WHO recommends that HIV-positive mothers on ART with undetectable viral load can breastfeed safely, as the risk of transmission is very low. However, this is a complex decision requiring individual discussion with your obstetrician and infectious disease specialist. Hepatitis B: breastfeeding is safe if the baby receives HBV vaccine + HBIG within 12 hours of birth.
When will my body "go back to normal" after birth?
The uterus returns to pre-pregnancy size by 6 weeks. Pregnancy hormones take 6–12 weeks to normalise. Hair loss (telogen effluvium) — dramatic shedding at 3–4 months — is normal and temporary; hair usually returns to pre-pregnancy density by 12 months. Weight: expect slow, gradual loss over 6–12 months; breastfeeding helps but is not a guarantee of rapid weight loss. Emotionally, adjusting to new motherhood is an ongoing process — there is no universal timeline.