Postpartum Recovery Tips: Essentials For The Fourth Trimester

During the postpartum period, often referred to as the fourth trimester of pregnancy, an individual may experience as many challenges as they do joyful moments with their baby.

As a new parent, you’ll need to adapt to taking care of your infant and the physical and psychological changes you experience following childbirth. (1) It’s important to take care of yourself and seek appropriate support for your postpartum recovery, ultimately optimizing your long-term health.

We’ll explore postpartum recovery tips you can use to support your overall health after childbirth.

Postpartum recovery timeline

The postpartum period starts after childbirth and continues until your body has nearly returned to its pre-pregnancy state, generally six to eight weeks. (5) Standard maternal care typically involves a single six-week postpartum visit with an obstetrician-gynecologist. (1) 

However, the American College of Obstetrics and Gynecology (ACOG) recommends a more comprehensive 12-week recovery process. Ideally, this includes an in-person or telephone evaluation within three weeks after birth, ongoing care as needed, and a final postpartum visit within 12 weeks. (1) 

How long should you rest after giving birth?

There is no set recommended time to rest after childbirth; your individual needs may vary based on factors such as your health status and mode of delivery. Follow your healthcare practitioner’s guidance about resuming regular daily activities.

Did you know? Many cultures recommend as long as 30 to 40 days of rest, with support for you and your newborn from family and friends. (1)

What to expect postpartum

Individuals may experience various complications following childbirth, such as:

• “Baby blues” (temporary mood changes)
• Breast engorgement (full, firm, tender breasts)
• Changes in bladder and bowel function (e.g., urinary incontinence, constipation)
• Decreased libido (sexual desire)
• Hemorrhoids (swollen blood vessels around the anus)
• Hypertension (high blood pressure)
• Postpartum depression (depression that occurs after childbirth)
• Thyroid disorders (e.g., hypothyroidism, hyperthyroidism)
• Type 2 diabetes (increased risk in women with gestational diabetes)
• Vaginal discharge/bleeding
• Vaginal tears and pain (5)

Postpartum recovery essentials 

Work with your obstetrician-gynecologist or other primary practitioner to develop your individual postpartum recovery care plan. The plan should be developed during your prenatal care, and reviewed and updated after you give birth. (1)

Follow the postpartum recovery tips below to help you on your healing journey.

1. Get plenty of rest

In your first few days at home following birth, you should prioritize your rest and recovery, along with getting to know your new baby. During this time, try to limit visitors and your tasks around the house. (10)

It’s alright if all you can do is eat, sleep, and take care of the baby. Try to sleep or nap when the baby is sleeping. You should ask for and be willing to accept help with tasks such as preparing meals, cleaning, and caring for your baby. (10)

2. Breastfeed if it’s right for you

Breastfeeding is beneficial for both you and your baby. Breastfeeding has been associated with a reduced risk of type 2 diabetes and certain cancers in women. For newborns, it may reduce the risk of gastrointestinal tract infections, atopic eczema, and pediatric cancers. (5)

Breastfeeding or voiding (pumping) breastmilk regularly can help reduce the pain and discomfort of breast engorgement (swelling). Breastfeeding is contraindicated in some situations, and in the end, is a personal choice you should make in consultation with your practitioner. (5)

3. Check your blood pressure

Individuals with hypertension (high blood pressure) during pregnancy have an increased risk of postpartum stroke. (1)(3) It’s essential to get a blood pressure evaluation within seven to 10 days postpartum if you have hypertension, and within 72 hours if you have severe hypertension. (1)

4. Consume a nutritious diet

A healthy diet and exercise will help your body return to a healthy weight postpartum. Focus on consuming nutrient-dense foods and beverages, which provide health-promoting nutrients with limited added sugars, sodium, and saturated fat. (10)(11)

Examples of nutrient-dense foods include:

• Animal proteins (e.g., eggs, lean meats, poultry, seafood)
• Fat-free and low-fat dairy products
• Legumes (e.g., beans, lentils, peas)
• Unsalted nuts and seeds
• Vegetables and fruits
• Whole grains (11)

Keep in mind that individuals who are breastfeeding require approximately 330 to 500 additional daily calories compared to their prepregnancy needs. (5)(8)(11)

5. Stay hydrated and get enough fiber

Consuming enough fiber and staying hydrated are important to your overall health and can help with common postpartum symptoms such as constipation. (10) Water and fiber can also help treat hemorrhoids, which are caused by constipation and pushing during labor. (5)

The Dietary Guidelines for Americans recommend that lactating women aged 19 to 30 get at least 34 g of fiber, and women aged 31 to 50 get 31 g of fiber daily. (11) Women should aim for 91 oz (2.7 L) of water per day. Water may come from beverages, such as herbal tea and carbonated water, and foods, such as fruit and vegetables. (4)

6. Resume exercise slowly

Physical activity postpartum can help improve mood, reduce the symptoms of postpartum depression, and maintain a healthy weight. (11) Your practitioner can advise when it’s safe to start exercising, depending on factors such as the delivery method (cesarean or vaginal birth). (2)

It’s best to avoid strenuous activity in the first two to three weeks after delivery. Start reintroducing exercise with low-impact activities such as walking. (5) You should work up to 150 minutes of moderate-intensity aerobic activity per week. (11)

If you are lactating, consider feeding your baby or voiding (pumping) your breast milk before exercising to avoid the discomfort of engorged breasts. (2)

7. Strengthen your pelvic floor

Pelvic floor exercises, which strengthen the group of muscles across the bottom of the pelvis, can often be initiated early postpartum. (2) Pelvic floor exercises and pelvic floor physical therapy can help address urinary incontinence caused by stretching and injury to the pelvic floor muscles during labor. (5)

Did you know? More than 25% of individuals experience moderate to severe urinary incontinence in the first year following childbirth. (5)

8. Gradually reduce your body weight

It’s recommended to lose weight gradually following childbirth, especially if you are breastfeeding your baby. This helps ensure your milk supply and the baby’s growth are unaffected. (10) Losing a pound and a half per week is considered gradual weight loss. (8)

9. Recognize the baby blues

Following childbirth, you may experience the “baby blues,” a group of symptoms including mood swings, changes in appetite, crying, and feeling anxious, sad, or overwhelmed. These symptoms are caused by factors such as changing hormones, impaired sleep schedule, and concerns about taking care of your baby. (7)

The baby blues aren’t considered severe and don’t require medical treatment. (7) These symptoms should go away within two weeks. Having emotional support and help caring for your  newborn, especially during the first week, can help address the baby blues. (5)

10. Seek care for postpartum depression

Postpartum depression is a more serious condition that can develop in the several years after childbirth. (12) If you experience sadness for longer than two weeks, consult with your healthcare practitioner. (10)

Signs and symptoms of postpartum depression include:

• Changes in appetite and weight
• Difficulty concentrating or remembering
• Difficulty sleeping
• Disinterest in or lack of pleasure from activities such as socializing and sexual intercourse
• Excessive crying
• Excessive worrying about the baby or disinterest in the baby
• Feeling irritable or restless
• Feeling sad, worthless, or guilty
• Low energy
• Pain (e.g., headaches, chest pain)
• Thoughts about harming yourself or your baby (10)

Treatment for postpartum depression may involve antidepressant medication and talk therapy. (7)

Did you know? Individuals in approximately 15% of births experience postpartum depression. (6)

11. Be patient and understanding with yourself

Try setting realistic expectations for yourself during recovery. The postpartum recovery journey looks different for each person, and your body may need more time to heal. 

12. Use a postpartum recovery checklist

You may find it helps to create a postpartum recovery checklist to keep track of key components of your care plan. 

The checklist below is based on suggestions from the ACOG:

• Date, time, and location of postpartum visit(s)
• Infant feeding plan and resources
• Any pregnancy complications, test results, and the recommended follow-up care or treatment
• Reproductive life plan, method of contraception, and instructions for re-initiating intercourse
• Signs and symptoms to recognize mental health changes; recommendations for managing anxiety, depression, and other psychiatric issues
• Recommendations for common postpartum concerns (e.g., pelvic floor exercises for urinary incontinence, lubricant for genital pain during intercourse)
• Treatment plan for any ongoing physical and mental health conditions (1)

Your postpartum recovery checklist should also include the name, address, and contact information for the following individuals:

• Family and friends who will provide support (e.g., help with caring for the infant and other children, household tasks, transportation)
• Primary maternal care provider (e.g., obstetrician-gynecologist, family physician, certified nurse midwife)
• Infant’s health care provider (e.g., pediatrician, family physician, pediatric nurse practitioner)
• Primary care providers who will help manage any chronic conditions and ongoing care after the postpartum period (e.g., family physician, psychiatrist) 
• Other support providers/consultants (e.g., lactation specialist, care coordinator, home visitor nurse) (1)

What should you not do postpartum?

Don’t try to manage your postpartum recovery alone. Lack of postpartum healthcare can impact the management of chronic health conditions and access to effective contraception. (1)

Did you know? An estimated 40% of individuals don’t attend a postpartum visit. (1)

Generally, you should avoid sexual intercourse for four to six weeks following childbirth. It may take about four to six weeks for your perineal area (between the vaginal opening and anus) to fully heal. (5)

You may also need to limit your activity, such as walking, climbing stairs, and exercising. It’s best to follow your practitioner’s guidance on how much activity is safe for you. (9)

The bottom line

The postpartum recovery tips in this article can help you take care of your physical and mental health postpartum. After giving birth, remember to seek the support of your family, friends, and your healthcare team during the healing process to help you achieve optimal well-being for yourself and your baby.