What Really Happens After Birth
Warning: This is an unfiltered post about body fluids and functions after birth. Kindly move along if it’s TMI for you. No hard feelings!
In Part Two of our Postpartum Series, we’re going down under and exploring everything that happens to your body during the first 72 hours after giving birth. Today is all about what to expect from the waist down. You can find the Series Intro HERE and Part One HERE.
One last note before we dig in-
The point of sharing this isn’t to scare you. Being doulas has taught us that knowledge is power. Our clients know what to anticipate going into labor, delivery, AND recovery. They're not as surprised when things unfold because they already know what to expect.
You just laid eyes on your baby for the first time. You’re in awe, and possibly in shock, about what just happened. You’re soooooo thankful the hard part is over.
Hate to burst your blissful bubble…but you’re not done yet. The placenta needs to exit your body, too. Sometimes placentas are stubborn and they won't come out without a little help. Other times they slip right out. It’s important not to panic and to listen to your doctor and nurses while the placenta is being delivered.
In a vaginal birth, the placenta is delivered between 5-30 minutes after your baby is born. With an effective epidural, your provider might ask you to give a little push as the organ makes its way out- you probably won’t feel much when this happens. If you delivered unmedicated, you’ll still feel some contractions and cramping, along with slight pressure as the placenta is coming out. The placenta is like a jellyfish with no bone structures so it’s MUCH easier to push out.
In a cesarean, your doctor will remove the placenta and make sure every bit of it is out before closing your uterine and abdominal incisions.
A telltale sign that your body is entering the transition phase of labor is uncontrollable shaking. Transition is the most intense part of labor. Your cervix is almost fully dilated, and hormones are blazing throughout your body at full throttle.
During transition, estrogen, progesterone, and adrenaline are rapidly coursing through you. The sudden surge of hormones causes your body to shake uncontrollably. It can also make you chill, sweat, and feel nauseated- like when you have a fever. DOULA TIP: The more you fight the involuntary shaking, the worse it is. When we’re supporting clients through this phase, we’re working hard to help them relax their body and to just go with it. Laboring through transition requires a lot of physical and emotional support from your care team.
So, what’s all this transition talk have to do with what happens right after delivery? A lot! Immediately after the placenta expulsion, the surging hormones that were overwhelming your body during transition and pushing INSTANTLY shut down and return to their pre-pregnancy levels when the placenta detaches from the uterine wall. It’s like a switch is flipped after the placenta is out. The physical reactions caused by the booming hormones you felt during labor can continue after birth. The immediate drop in hormone levels causes the same involuntary shaking, chills, and sweating to happen.
Shaking after birth occurs during vaginal and c-section deliveries. When you feel your body shaking, remember to relax every muscle in your body and go with it instead of fighting against it.
uterus & fundal massage
A massage right after giving birth?!?! YES PLEASE!
Sorry to burst your bubble…fundal massage is the furthest thing from a typical relaxing spa massage but it’s necessary.
Ya know the nurse who helped guide you through your blissful birth just minutes ago? Well, it will feel like she instantly betrays you and goes from being one of your favorite people to your archenemy in a matter of seconds.
She's aggressively kneading your fundus so you won’t hemorrhage, and trust us, she hates it as much as you do.
Expect your abdomen to be pressed on often after delivery. If your uterus isn’t contracted, then fundal massage is performed. We promise- this maneuvering isn’t the most comfortable thing you’ll experience, but it can save your life.
Pitocin is also routinely administered immediately after delivery to help your uterus contract. A spasming uterus causes dangerously excessive blood loss. Your uterus is an exhausted ball of muscle after enduring months of pregnancy followed by labor, and delivery. Sometimes it’s so tired that it inadequately spasms instead of properly contracting. Pitocin helps with this.
bleeding and lochia- stage one
Are you ready for the longest, most discombobulating “period” of your life?? Birth and blood go hand in hand. Expect increased bloody show as labor progresses, and then heavy bleeding after birth. We’ll go over the other two stages of lochia and the whys behind it all in a future post. Today, it’s all about what to expect in the first 72 hours.
Bleeding after birth happens in a vaginal AND cesarean delivery. The discharge has nothing to do with the way your baby was delivered. The lining of your uterus, the organ that housed your baby and placenta for many months, is layered with placenta tissue, fetal membranes, cells, blood, and vernix. Your uterus works hard post-delivery by continuing to contract to seal off blood vessels and expel its afterbirth contents.
Remember the placenta? It plays a role here too! It doesn’t just float around haphazardly inside the amniotic sac with your baby. Instead, it’s firmly attached to the uterine wall during pregnancy. Once it detaches after the baby is delivered- remember that’s when the estrogen, progesterone and adrenaline levels rapidly drop- it leaves behind an open wound. If you’ve seen the size of a placenta before, then you know the raw area left behind on your uterine wall is substantial. Postpartum bleeding is part of your body’s natural healing process.
Lochia Rubra (stage one):
Expect to see- dark red blood, heavy flow, blood clots and fragments
Expect to feel- afterpains, cramping, and gushing sensations
vaginal and abdomen pain
Regardless of how your baby came out, you will be sore. There’s no way around it.
Pushing, tearing, episiotomy, and a human being coming out of you will cause discomfort after it’s all over. Swelling is common and ice pads/ice diapers will become your best friends. If you have stitches, expect some sharp pings of pain that quickly come and go, along with itching as the area heals and stitches begin to dissolve.
Abdominal Incision Pain
We want to put his out there…a cesarean is NOT the easy way out! There’s a reason c-section patients are kept in the hospital longer. It’s MAJOR surgery!
You’ll experience the same uterine after-pains as vaginal birth, plus incision discomfort. Your anesthesiologist will administer short and long-acting medications that decrease your pain significantly and you will have access to different symptom management medications while in the hospital and at home.
Vaginal AND Abdominal Recovery
Sometimes, women will have to recover from BOTH due to complications during the pushing stage of birth. When a vaginal birth is no longer safe, a cesarean is the best option for mom and baby. In this case, you can experience vaginal swelling and tissue trauma from pushing, along with everything that comes with recovery from a c-section.
No matter how your baby is born, you don’t have to white-knuckle it if you’re having discomfort. Be honest with your nurses and doctors if your pain isn’t controlled. It’s always better to proactive than reactive and staying on top of your pain is key during postpartum recovery.
Sitting, standing and walking after giving birth is a big event! Since your legs will feel like jello, your nurse will stand beside you the first couple of times you get up. Don’t try it by yourself! If you’ve had an epidural or spinal, your legs will feel heavy for a while so you won’t be able to move around your room until you have full feeling back in your lower extremities. After you’ve been up and about a couple of times, you’ll be able to ambulate on your own as often as you want to.
Your body just underwent a major transformation, especially downtown. The intense maneuvers your abdomen, vagina and rectum went through to bring your baby into the world is astonishing. Remember this in the early days when you’re going to the bathroom.
Have you heard how horrific the first bowel movement will be after birth? Of course, you have. Here’s the deal- the more fearful and tense your body is, the worse it will be. Take deep breaths, take as much time as you need, and if nothing happens, try again later. We promise it’s not as bad as you think.
Talk to your doctor and nurse about medication that can help with avoiding constipation, especially if you’re taking narcotics. Stay hydrated and eat a balanced diet with added fiber, too.
Urinating can also be a challenge. Your pelvic floor muscles, nerves, and ligaments have been stretched to the max. Also, it takes time for your bladder to wake up and for urine to travel down and out of your urethra after a cesarean and/or after a catheter is removed. Be patient. Warm water helps, too.
Remember our doula tip about the relaxing your body during the crazy intense transition phase of labor and how tensing up and fighting your body’s involuntary shaking makes it worse? The same thing applies here on the toilet.
Bottom line- sit back, relax your mind and body, and go with the flow during the first couple of days after birth.
See what we did there?
Okay, so this is a ton of information being thrown your way, right?! If you’ve never had a baby, you’re probably feeling a tad overwhelmed and wondering why in the world are we telling you all of this! Well, ask any person who has given birth and they will tell you they wished they would’ve known the nitty-gritty ahead of time. Remember what we said…knowledge is power.
And here at Indiana Birth & Parenting, we’re all about empowering moms.
Join us next week as we dive into what to expect post-delivery from the waist up.