This blog post is the last in our what to expect from your postpartum body series. We will discuss postpartum recovery week 4 through 8. Below you will find information on:
- How to continue returning to daily activity and exercise safely
- What to look for that may warrant a visit to a pelvic floor PT
- What to expect in a typical postpartum therapy session
Postpartum Recovery Week 4 Through 8
“It’s Already Been 4 Weeks? How Has It Only Been 4 Weeks?!”
Yes, you read that statement right. Once you reach the postpartum recovery 4 week mark, delivery will feel like a lifetime ago. It will also feel like it just happened. There may be days when you feel like you know exactly what you are doing and days when you have no idea what you are doing. You are likely are still trying to figure out your new “normal,” and that can oftentimes be daunting. Let’s ease your mind and help you figure out what the new “normal” should look like for your body. Below are some of the things you should expect in the 4-8 weeks postpartum phase.
Typical Nursing Status
At this point, if you are still nursing or pumping, it should be a bit easier. Your supply should be leveling out. You should not have a much nipple discomfort as you may have had in the beginning. If you are still struggling with:
- Oversupply
- Undersupply
- Frequently clogged milk ducts
- Cracked/bleeding nipples (try dipping a washcloth in warm water for relief!)
A consultation with a lactation consultant might be a good idea. (If you have not met with one already). You will also want to make sure you are well hydrated. Don’t forget to also take in an adequate amount of calories throughout the day. This is one of our favorite water bottles. It helps us drink lots of water!
Fueling Your Nursing Body
Most nursing and pumping moms need anywhere from 300-500 extra calories per day. For some mommas this can be a snack or two, and for others it can be another small meal. Added calories are important for moms exercising. This is because they have a higher energy expenditure. It also will be important to choose nutritionally dense foods. You want the ones that give you the most bang for your buck. This can include:
- Veggies
- Avocados
- Nuts and nut butters
- Fruits
- Yogurt
- Plant based smoothies
- Lean proteins
- Complex carbohydrates like brown rice, whole grain pastas and breads, or sweet potatoes.
This is a great option for a calorie-rich breastfeeding bars. KellyMom has a great resource on proper hydration and caloric intake.
Did You Say Something About Exercise?
Yes, I said exercise. For some of you that might be the last thing on your mind. If you don’t feel like exercising, that’s okay. You shouldn’t feel any pressure from family or friends or partners to “lose the baby weight.” But for others, all they can think about is getting back to their prior level of activity. If you are in the latter group, congratulations! You can gradually start to return to exercise, the key word being GRADUALLY.
At this point, it is safe to return to low intensity activities such as walking. You can even try some gentle core/pelvic floor strengthening exercises. These activities will bring good blood flow to the pelvic region. They will start working your pelvic floor and abdominal muscles without unwanted strain.
Activities to avoid
You should avoid these until around 8 weeks postpartum.
- Elliptical
- Yoga/Pilates
- Swimming
The below should be off limits and will remain off limits until at least 12 weeks postpartum.
- Running
- HIIT classes
- Rowing
- Orange Theory
- Powerlifting
- Crossfit
These activities are not appropriate until 3 months postpartum. Often, it’s even longer than that – up to 6 months postpartum. These higher level activities put a greater demand on our pelvic floor and abdomen. They need a high level of trunk and lower extremity coordination. You also need the ability to have good load transfer from one limb to another. At this point, not enough healing has occurred for these tissues to handle that type of load properly. So, you will have to wait a couple more months for those activities. The lower intensity activities help prepare your muscles for the high level activities. If you’re looking for more, check out this research on return to running guidelines.
The 6 Week Checkup
Right around the 6 week mark is when most women have their first postpartum OB visit. This appointment is a quick screen to:
- Make sure that any perineal tearing or cesarean incision is healing
- Discuss birth control options
- Get the “ok” for sex
Many women do not feel ready for intercourse at this point, and that is ok. You may feel ready in a couple of weeks or you may not feel ready for a few months.
Reasons for vaginal dryness
Vaginal dryness can limit your desire to have intercourse and cause pain during sex. Although this is common, pain with intercourse is not normal. It’s a sign that you should get an evaluation by a pelvic floor PT. Reasons for vaginal dryness are usually:
- Nursing
- Healing tears (try witch hazel to help speed up recovery)
- Fear of pain
- General vaginal/perineal discomfort
Tips For Returning To Sex
- USE ALL THE LUBE. Nursing hormones can make your vulvar and vaginal tissue dry. This can make sex uncomfortable. You can use vitamin E oil or coconut oil daily to help hydrate those tissues. You can also find a water based lubricant to use during intercourse. Slippery Stuff Lubricant is one we use in the clinic. It is water based, has minimal ingredients, and is available on Amazon.
- Make sure you have adequate foreplay to stimulate arousal. Doing so will increase vulvar tissue blood flow and increase your natural lubrication. Plus, who doesn’t love a bit of foreplay??
- If you had any perineal tearing during your delivery, do gentle perineal massage. Only do this once your incision has healed completely. You can do it on your own, or your partner can. Make sure to be very gentle with your pressure as these tissues are still healing.
- If you attempt intercourse and have pain, go ahead and get an evaluation by a pelvic floor PT.
Know What Is Normal And What Is Not
Yes, you are only 8 weeks postpartum and still very much in the healing process. Certain things that are common but not normal may need treatment from a medical provider. These include, but are not limited to:
- Urinary leakage or urgency
- Constipation or straining with bowel movements (try a stool softener if needed)
- Pelvic pain with intercourse
- Hip/low back/Sacroiliac joint pain
- Pelvic pressure or the sensation that something is falling out
- Excessive vulvar and vaginal dryness
- Blood clots larger than a golf ball
Should you be experiencing any of these symptoms, make an appointment with a pelvic floor PT in your area. You can also contact us for an online consultation.
Other very common symptoms include the baby blues, postpartum depression and anxiety. If you have these symptoms or other hormonal/mental symptoms, know that you are not alone. It is normal and good to seek the guidance and treatment of a mental health professional. Medicine is okay, too! IT’S ALL OK! The only way you can recover postpartum is to take care of the whole you: the physical, mental and emotional.
In closing, keep rocking on momma! You’re doing great! 4 weeks down and a wonderful lifetime to go!
______________________________________________________________________________________________________
Are you currently pregnant or planning to conceive? If so, make sure to download my FREE resource — How to Prepare Your Pelvic Floor & Core for Childbirth + 8 Must-Dos for C-Section and Vaginal Deliveries.
______________________________________________________________________________________________________
Some links may be affiliate links. The products we recommend are products we use or recommend to clients.
