From Journal of Midwifery & Women's Health

Motherhood: The Early Days

Posted: 09/18/2009; J Midwifery Womens Health. 2009;5(4):331-332. © 2009 Elsevier Science, Inc.

You prepare for the birth of your baby for many months during pregnancy and then the first months at home after your baby is born can be a quiet, gentle time of getting to know this new person who has come to live in your home. But for most women it is not all quiet or sweet. And for some women it is a very hard time.

What Can I Expect in the First Few Months After the Baby Comes?

New mothers and their families face many challenges in the first few months:

• Your body and your hormones have to get back to normal.
• You and the baby will be learning to breastfeed.
• Babies only sleep a few hours at a time. The whole new family will have a hard time getting enough sleep.
• You and your family need to learn how to parent this new family member.
• If you have a partner, you have to figure out how to stay together as a couple and maybe even start to have sex again.
• You may have to figure out how to keep from getting pregnant again right away.
• You may need to return to work and find day care.

How Long Will It Take for My Body to Get Back to Normal?

Some changes occur quickly. Others will not happen so quickly.

• Your uterus, cervix and vagina will all shrink to their normal, nonpregnant size in about 2 weeks. Your vagina may be tender and dry for a few months—especially if you are breastfeeding.
• If you had stitches or hemorrhoids, your "bottom" will be sore for 2 weeks or more.
• For some women who have problems urinating, it can take several months for you to be able to hold your urine when you cough or sneeze or suddenly pick up something heavy.
• Your breast milk will "come in" 2 to 3 days after the birth of your baby. It will take 6 to 8 weeks for you and the baby to get the hang of breastfeeding and find a pattern. During these first weeks, you can have engorged breasts at times and often leak milk.
• Your stomach and intestines all have to fall back into place. You may have a lot of gas for a few weeks. You may be constipated—especially if you are breastfeeding.
• Your stretched stomach muscles can recover in a few weeks, but for some women it takes longer (6 months to 1 year) to recover.
• If you had a cesarean delivery, you may have pain or numbness around the incision for 6 months or more.
• Losing the weight you gained during pregnancy will probably take 6 months to a year. Patience! It took 40 weeks to get here. Give yourself 40 weeks to get back.

What Can I Expect When My Hormones Change?

About 75% of all women will get the "blues." This usually starts about 3 days after the birth of your baby. You may cry easily and feel very, very tired. A few women become very depressed. If you had a cesarean delivery or your new baby was sick, you are at higher risk for depression.

Call your health care provider right away if you cannot care for yourself or your baby, if you feel very nervous or worried, if you cannot stop crying, or if you are having thoughts of hurting yourself or your baby.

Taking Care of Yourself

While you are still pregnant:

• Talk with your partner and your family about the time ahead. Arrange for someone to help you during the first weeks at home if you can.
• Talk with your health care provider about birth control options and make a plan before the baby comes.
• If you are worried about how to parent a newborn, take parenting classes. You will learn a lot about how babies act and you will make some friends who are going through the same thing at the same time. Most communities have these classes.
• Arrange for someone to help with baby care.
• After the baby comes:
• Ask for help. Let other people do the cooking and cleaning and run the house. Focus on yourself and your baby.
• Sleep whenever you can. Try not to be tempted to "get some things done" when the baby sleeps. This is your time to sleep, too.
• Drink lots of water. You will need at least 6 big glasses of water every day to avoid constipation and make enough breast milk. Every time you sit down to breastfeed, have a big glass of water with you to drink while you are nursing.
• Eat lots of vegetables and fruit. You will need lots of vitamins and fiber to help your body get back to normal. This will also help you avoid constipation.
• Go outside and walk. Babies can go outside even if it is very cold. Fresh air and sunshine will do you both good.
• Keep your nipples clean and dry. Rinse your nipples after each feeding and let them air dry. Use black tea bags placed over the nipples to toughen up the skin.
• Take sitz baths. Put about 6 inches of warm water in your bathtub and sit in there for 15 minutes 2 or 3 times a day. This will help your "bottom" heal more quickly. It will also give you 15 minutes of private time!
• Talk to other mothers. Join a new parents group. Call La Leche League and go to their meetings if you are breastfeeding.

With your partner:

• Keep talking. Share the experience.
• Spend time alone. Even a 30-minute walk can be a date.
• Start a birth control method. You can get pregnant before you even have a period. It is very important to use birth control if you do not want to get pregnant again right away.
• When you have sex, use a lubricant. A lot of lubricant! Take it slow.

The first few months after a baby comes can be a lot like floating in a jar of honey—very sweet and golden, but very sticky too. Take time to enjoy the good parts. Remind yourself that this time will pass. Bon voyage!

For More Information