What are the three stages of postpartum?

Postpartum stages can be divided into three stages. The acute stage is the first 24 hours, during which immediate care and management of complications are provided. The subacute phase is from week 2-6, which focuses on physical healing and regulating hormones. The third stage is a late or delayed phase that starts from 6 weeks and can last more than 6 months. It focuses on gradual recovery and returning to the pre-pregnancy state.

What are the 4 T’s of postpartum?

The four T’s of prefertum refer to the Causes of postpartum haemorrhage. Tone, where the uterus fails to contract after birth. Trauma refers to injuries like tears or uterine rupture during childbirth. Tissue refers to when fragments of the placenta remain in the uterus and cause severe bleeding. Thrombin is the enzyme that causes blood to clot.

Ultimate Guide to Safe Early Postpartum: Do’s and Don’ts

Early postpartum is the initial weeks of recovery after childbirth. The mother's body undergoes various changes and healing. This is the time when the body begins to return to a non-pregnant state. Early postpartum also comes with many complications, including infection, haemorrhage, blood clots, and mood swings.

The postpartum period is also referred to as the fourth trimester. It's because, though the baby is delivered and out of your body, your body and brain are still adjusting to demands. During this phase, your hormones shift drastically to support breastfeeding, the body continues to heal internally, and newborns' demands remain high as they are completely dependent on you. Early postoperative care requires rest and support for better healing.

Changes You Should Expect in Early Postpartum

Physical Changes

Lochia and Bleeding: Heavy vaginal bleeding is a part of uterine healing, which decreases as days progress. It starts as a bright red, heavy period and then transitions into a yellowish-white discharge.
Uterine Involution: A watermelon-sized uterus shrinks back to its pre-pregnancy size. During involvement, the pain intensifies in the first 2-4 days and often fades by week 2.
Perineal Soreness: Vaginal and perineal pain peaks during the first 3 days from stretching, tears, and episiotomy. During childbirth, the mechanical stretching may tear the perineum and cause swelling, bruising, and stinging during urination and bowel movements.
Breast Changes: As milk production increases and let-down happens, your breasts may feel full, warm, or tender. Leaking and mild discomfort are common.
Fatigue: Blood loss, sleep disruption, hormonal shifts, and overall demands of healing may cause extreme tiredness.

Hormonal Changes

Oestrogen and Progesterone: Right after placental delivery, oestrogen and progesterone levels drop rapidly, triggering major physical and emotional changes. This rapid hormonal crash mimics sudden menopause and shows symptoms like mood instability, hot flashes, and tissue changes.
Oxytocin and Prolactin: Oxytocin and prolactin surges in early postpartum to support breastfeeding and increase bonding. Oxytocin spikes to help placental expulsion and supports bonding, while prolactin drives milk production.

Emotional and Mental Changes

Baby Blues: Newborns' constant demands deplete mothers' energy, triggering the baby blues, which peak in the first week and are accompanied by tearfulness, irritability, anxiety, and overwhelm. It often resolves within 2 weeks.
Postpartum Depression: When baby blues intensifies with sadness, hopelessness, guilt, detachment, and mood swings, it can lead to postpartum depression. It lasts longer than 2 weeks and requires professional help.
Postpartum Anxiety: Increased worry, racing heart, and intrusive thoughts may indicate postpartum anxiety. This often emerges from hormonal changes and sleep deprivation.

Also read - Baby Blues vs Postpartum Depression: How to Tell the Signs Apart

Safe Things to Do in Early Postpartum

Safe Physical Activities

It's important to do some gentle mobility work right after birth to support later movement, promote circulation, strengthen the pelvic floor, and support emotional well-being. You can do gentle walking, as it is the safest and most recommended movement in the early postpartum period. Short and slow walks support bowel movements and blood circulation, reduce muscle tension and the risk of blood clots.

You can also practice breathing exercises. Deep intentional breathing practice improves oxygen delivery, activates the core, supports pelvic floor recovery, and reduces stress. After week 6, you can comfortably do moderate activities like Pilates, yoga, power walking, and light resistance training.

Self-Care Practices

Self-care practice focuses on nurturing healing, regulating hormones, and preventing complications like infection. Here are some safe self-care practices you can do in the first 6 weeks of postpartum.

Perineal Care: If you had a vaginal birth, it's essential to care for the perineum area to prevent infection and foster healing. Using a peri bottle, clean the area, pat dry or air-dry, and use witch hazel pads. Change the pads frequently in the first few days due to heavy bleeding.
C-Section Care: If you had a cesarean delivery, monitoring and handling the wound safely is important. Keep the incision clean and dry. Avoid wearing tight and friction-creating clothes. Don't lift heavy things or carry the baby for longer. Support the abdomen with a small pillow when coughing and laughing.
Breast Care: Nurse the baby every 2-3 hours to prevent engorgement. Wear cotton bras without underwear. Try applying a cold compress to soothe soreness and tenderness.
Bathing and Hygiene: Bathing is generally avoided during the early postpartum period to avoid contamination and wetting the wound. However, you can shower instead of taking a full bath, swim, or use a tub.

Nutrition and Hydration

As a new mom, nutrition is the most important factor which supports your healing process. Your body is repairing tissue, regulating hormones, and producing breast milk, all at once, increasing the demand for a highly nutritious, balanced diet and hydration. Make sure your diet includes all necessary macronutrients and micronutrients, such as protein, carbohydrates, fibre, and calcium.

Aim to drink 3-4 litres of water daily. Include fenugreek or chamomile tea, electrolyte drinks, soups, and water-rich fruits and vegetables. Limit caffeine and avoid alcohol, as they easily pass through the milk and delay recovery. Don't restrict any food during these times, as they may slow healing and affect milk supply.

Avoid these Things in Early Postpartum

Strenuous Workout: Don't do high-impact or HIIT workouts for 6 weeks. Crunches, sit-ups, planks, bicycle crunches, Russian twists, and other core-engaging exercises apply pressure to the abdomen and delay the closure of diastasis.
Ignore Body Signs: Postpartum bleeding is normal. However, lochia should reduce as days progress. If you experience excessive or worsening bleeding which passes as large clots and soaks a pad within an hour, you need medical help, as this may indicate postpartum haemorrhage.
Skipping Checkups: Don't skip visiting doctors at the scheduled time. Delaying or skipping may increase the risk of infections, anaemia, high blood pressure and mental health issues.
Sexual Activity: Don't engage in intimate practices in the early postpartum period to prevent infection and avoid unintended pregnancy risks. Intercourse before 6 weeks can reopen tissue and increase the risk of haemorrhage.
Self-Medication: If you experience pain or fatigue, don't rely on over-the-counter medicines or traditional practices. It can hinder your breastfeeding and recovery. Always consult with your doctors before starting and stopping any medications.

Early postpartum is a tender and vulnerable time for mothers. They have to deal with their bodily changes and care for the newborn's constant demands. The best way to find your way through this is to seek and accept support. Taking your partner and family in for childcare and cooking gives you some time to focus on yourself. Use these times to catch up on sleep or do your favourite self-care practices. Remember, while caring for the newborn is important, not losing yourself in the process should also be your priority.

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FAQs on Ultimate Guide to Safe Early Postpartum: What You Should and Shouldn't Do

What are the three stages of postpartum?
Postpartum stages can be divided into three stages. The acute stage is the first 24 hours, during which immediate care and management of complications are provided. The subacute phase is from week 2-6, which focuses on physical healing and regulating hormones. The third stage is a late or delayed phase that starts from 6 weeks and can last more than 6 months. It focuses on gradual recovery and returning to the pre-pregnancy state.
What are the 4 T’s of postpartum?
The four T’s of prefertum refer to the Causes of postpartum haemorrhage. Tone, where the uterus fails to contract after birth. Trauma refers to injuries like tears or uterine rupture during childbirth. Tissue refers to when fragments of the placenta remain in the uterus and cause severe bleeding. Thrombin is the enzyme that causes blood to clot.