Your body does a lot of healing in the weeks after birth, whether you had a vaginal birth or a caesarean. Bleeding is heaviest in the first few days and usually fades over 4 to 6 weeks. Afterpains, sore stitches, leaking a little wee and deep tiredness are all common. Most of this settles with time, rest and help at home. A few signs need help straight away, and knowing them in advance makes it easier to act.
What's normal in the first weeks after birth?
| What | What's typical |
|---|---|
| Bleeding (lochia) | Heaviest in the first few days, then lighter over 4 to 6 weeks |
| Afterpains | Period-like cramps, often while feeding |
| Stitches | Sore at first; keep clean and dry |
| Leaking wee | Common when you laugh, cough or move suddenly |
| Tummy muscles | A gap that usually closes by about 8 weeks |
Australia's Pregnancy, Birth and Baby service says bleeding after birth is often bright red, like a heavy period, at first. It then changes to reddish-brown, brown and eventually pinkish before it stops, typically within 4 to 6 weeks. It can be heavier in the morning when you get up, after exercise and after breastfeeding. The NHS guide to your body after the birth suggests super-absorbent pads, changed often, and no tampons until after your 6-week check. It also describes period-like cramps while feeding.
How much bleeding after birth is too much?
Heavy bleeding after birth is called a postpartum haemorrhage. Pregnancy, Birth and Baby says it can be life-threatening and needs urgent medical attention. It most often happens in the first 24 hours, but can happen up to 6 weeks after the birth.
| What you notice | What to do |
|---|---|
| Soaking a pad every hour or two, and within 24 hours of birth | Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) |
| Heavy bleeding with dizziness, clamminess, racing heart or breathlessness | Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) |
| Soaking a pad every hour or two, up to 6 weeks after birth | Go to the emergency department |
| Large clots, a sudden increase, or blood turning bright red again | Contact your midwife or doctor straight away |
| Unsure whether your bleeding is normal | Contact your midwife or doctor straight away |
The CDC's urgent maternal warning signs also include soaking through one or more pads in an hour, passing clots bigger than an egg, and discharge that smells bad.
How do I look after stitches or a caesarean wound?
Stitches or a tear. The NHS suggests bathing stitches every day with plain warm water and patting them dry, to help prevent infection. Tell your midwife if they're sore or uncomfortable. If you're breastfeeding, check with a pharmacist, midwife or GP before buying painkillers.
After a caesarean. The NHS caesarean recovery page suggests:
- Gently clean and dry the wound every day.
- Wear loose clothing and cotton underwear.
- Take regular painkillers as advised. The NHS says paracetamol or ibuprofen are usually suitable, but not aspirin while breastfeeding; follow the label or your doctor's advice.
- Take a gentle walk each day to lower the risk of blood clots, but avoid exercise at first.
- Don't carry anything heavier than your baby yet, and don't drive for a few weeks.
The NHS says getting back to these activities may take about 6 weeks. Contact your midwife or GP if the wound becomes more red, painful or swollen, or oozes pus or foul-smelling fluid. A partner or friend can take on the lifting, driving and shopping; see partner support.
What about weeing and pooing after birth?
Weeing. The NHS suggests drinking plenty of water, which may reduce stinging. Tell your midwife if you're finding it really hard to wee, feel very sore, or notice an unpleasant smell.
Not being able to wee at all is more urgent. Cambridge University Hospitals in the UK says you should normally feel the urge to pass urine within 4 hours of the birth or of a catheter being removed. If you still can't pass a good amount by 6 hours, you may have urinary retention, which can cause pain, long-term bladder damage and incontinence if it isn't treated. Contact your midwife or maternity unit the same day if you can't pass urine or only pass small amounts.
Pooing. The NHS suggests fruit, vegetables, wholegrains and plenty of water, and holding a clean pad over your stitches when you poo. Try not to strain. Talk to your midwife or GP about constipation that won't go away, or poo leaking when you don't mean it to. For sore piles, a pharmacist or midwife can suggest a cream.
How do I do pelvic floor exercises after birth?
Leaking a little wee when you laugh, cough or move suddenly is common after birth, and the NHS says pelvic floor exercises can help. The NHS guide to your post-pregnancy body describes them:
- Squeeze and lift the muscles around your bottom, bladder and vagina.
- Keep breathing normally.
- Do long squeezes, holding for up to 10 seconds.
- Then do short, quick squeezes until the muscles tire.
- Build up to 10 of each, at least 3 times a day.
- Do them after you've finished on the toilet, not while you're weeing.
The same page says the gap between the tummy muscles usually closes by the time your baby is 8 weeks old. Avoid sit-ups, planks, high-impact exercise and heavy lifting at first. If the gap is still obvious after 8 weeks, or leaking isn't improving, see your GP, who can refer you to a physiotherapist.
Which warning signs after birth need urgent help?
These can happen any time in the weeks after birth. The CDC's list of warning signs covers the whole year after delivery, and it suggests telling any health professional that you've recently had a baby.
Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) or go to emergency now if you have:
- heavy bleeding, as described in the table above
- chest or upper back pain, severe difficulty breathing, a very fast heartbeat, or you faint; the NHS pulmonary embolism page lists these as reasons to call an ambulance
- pain, swelling or redness in the calf of one leg, which can be a blood clot; the CDC's urgent maternal warning signs say to get medical care immediately, and the NHS deep vein thrombosis page says the risk of a clot is higher if you've had a baby in the past 6 weeks
- signs of sepsis, such as a fever with difficulty breathing, or feeling confused or very drowsy; Pregnancy, Birth and Baby's sepsis page advises urgent care, the emergency department or an ambulance
If you have thoughts of harming yourself or your baby, call a crisis line (Lifeline on 13 11 14 in Australia, Samaritans on 116 123 in the UK, 988 in the US) or your local emergency number (000 in Australia, 999 in the UK, 911 in the US) now.
Contact your midwife, maternity unit or GP straight away (the same day) if you have:
- severe pain, or tummy pain that keeps getting worse or won't go away
- a temperature of 38°C (100.4°F) or more, or a sore, tender tummy
- a wound that's red, swollen, more painful or oozing
- a headache that won't go away, changes in your vision, or vomiting, which can be signs of pre-eclampsia
- extreme swelling of your hands or face
- pain when weeing, or you can't pass urine
- discharge that smells bad, or large clots
If you can't reach anyone quickly, or a symptom is severe, go to the emergency department or call your local emergency number (000 in Australia, 999 in the UK, 911 in the US). If you're unsure whether something is normal, your maternity unit or midwife can advise by phone.
Raise at your postnatal check, or sooner if it's bothering you: leaking wee or poo, constipation that won't settle, painful sex, sore piles, or a tummy gap after 8 weeks.
What happens at the 6-week postnatal check?
The NHS postnatal check page says your own check should happen 6 to 8 weeks after the birth. You'll be asked how you're feeling, about contraception, and whether you're still bleeding or have had a period. You may be offered an examination of your stitches or caesarean wound. Your blood pressure is checked if you had problems in pregnancy or soon after the birth.
It's a good time to mention trouble holding in wind, wee or poo, painful sex, or pain between your vagina and bottom. If cervical screening was due while you were pregnant, the NHS says it should be rescheduled for 12 weeks after the birth. You don't have to wait for the check if something is worrying you.
How you're feeling matters as much as how you're healing. If low mood or anxiety lasts more than 2 weeks, see postnatal depression and anxiety. For coping with broken nights, see sleep deprivation.
What's useful to note down?
A few quick notes can help when you call: how often you're changing pads and whether the bleeding is getting lighter, your temperature if you feel unwell, and when any pain started. Write down questions for your postnatal check as they come up. Never wait to finish notes before getting help for a warning sign.
