💐 Antenatal Guide — Weeks 1–6 After Birth
Postpartum Care After Delivery
The weeks after giving birth involve physical recovery, hormonal shifts, and the biggest adjustment of your life. Knowing what is normal, what is a warning sign, and how to support yourself makes a significant difference — for both you and your newborn.
Key Milestones
🌱 First 24 hours: Recovery room essentials
After a vaginal birth, you will be monitored for 1–2 hours in a recovery area. Uterus massage to prevent postpartum haemorrhage is done. First breastfeed ideally within 30–60 minutes of birth (colostrum — the first milk — is small in volume but extremely rich in antibodies). After caesarean, mobilisation is encouraged within 6–12 hours to prevent DVT.
🌱 Days 2–5: Home and adjusting
Lochia (postpartum bleeding) is heavy and red. Perineal pain is managed with regular paracetamol and ibuprofen (ibuprofen is safe postpartum unless breastfeeding and baby has specific health issues). Breast engorgement peaks around day 3–4 as mature milk comes in (the emotional "day 3 blues" corresponds with this hormonal shift). Baby jaundice is normal if mild — severe or deepening jaundice needs bilirubin check.
🌱 Weeks 2–4: Recovery milestones
Most perineal stitches dissolve by 10–14 days. Caesarean wound should be checked at 10 days if not healing well. Energy begins to improve but night feeding disrupts sleep significantly — accept all help offered.
🌱 Week 6: Postnatal review
The formal 6-week postnatal check covers mother's physical and emotional recovery, wound healing, BP, anaemia screen, contraception, breastfeeding, and baby's development check. This appointment is crucial — do not skip it.
Essential Tests & Scans
Blood Pressure
⏱ Days 1–5 and 6-week check
Monitored daily for 3–5 days after delivery (postpartum pre-eclampsia risk), and again at 6 weeks.
Full Blood Count
⏱ 6-week postnatal check
Checks for postpartum anaemia from delivery blood loss. Guides iron supplementation — many mothers need higher doses postpartum than during pregnancy.
Thyroid Function (TSH)
⏱ If symptomatic at 4–12 weeks
Postpartum thyroiditis is common and underdiagnosed — screen if the mother has new fatigue, palpitations, weight change, or depression from weeks 4–12 postpartum.
Edinburgh Postnatal Depression Scale (EPDS)
⏱ At 2 weeks and 6 weeks
A 10-question validated screening tool for postpartum depression. A score above 10 warrants further assessment; above 12 indicates likely PPD needing treatment.
Frequently Asked Questions
How long does postpartum bleeding last?
Lochia — postpartum bleeding — typically lasts 4–6 weeks. The pattern is: heavy red for days 1–4, lighter pink-brown from days 4–10, then yellowish-white for weeks 2–6. If heavy red bleeding returns after it has lightened (particularly with fever or large clots), this may indicate retained placental tissue or infection — seek medical review.
When can I start having sex after birth?
Most guidelines recommend waiting until 6 weeks after delivery — and until your postnatal check confirms healing is complete. Earlier return to sex is associated with discomfort, wound breakdown, and infection risk. Perineal sensitivity and lubrication may take several months to normalise — oestrogen-based lubricants or pessaries can help, especially in breastfeeding mothers (whose oestrogen is suppressed). Do not resume sex before you feel physically and emotionally ready.
Is it safe to take paracetamol and ibuprofen while breastfeeding?
Yes — both paracetamol and ibuprofen are safe to take at normal doses while breastfeeding. They are excreted into breast milk in negligible quantities. Ibuprofen is preferred over aspirin for postpartum pain (aspirin may affect neonatal platelet function at high doses). Strong opioid analgesics (morphine, codeine, tramadol) are used short-term if needed and are generally considered compatible with breastfeeding in moderation.
My baby is very yellow — is that normal?
Mild jaundice (yellow skin) appearing on days 2–4 and fading by day 10 is physiological neonatal jaundice — extremely common, caused by breakdown of fetal haemoglobin, and self-limiting. Abnormal jaundice: appears within the first 24 hours (pathological — often blood group incompatibility), persists beyond 2 weeks in a term baby, extends to palms and soles, or is associated with dark urine and pale stools (possible liver disease). Significant jaundice is measured by bilirubin levels and may require phototherapy (blue light treatment).