Recovering after birth and the postpartum checkup

No matter how your labor and delivery go, your body needs time to heal after giving birth.¹ Some symptoms may last a few days, while others may last several weeks, and they vary from person to person.¹ This page explains what medical sources describe as typical recovery, how healing after a cesarean differs, and what the postpartum checkup is for.

Expected recovery or a warning sign?

Most of this page is about the ordinary aches and changes of recovery. The American College of Obstetricians and Gynecologists (ACOG) says that while most postpartum discomforts are normal, they should not prevent you from taking care of yourself and your baby, and some symptoms may be a sign of a serious problem.¹ The Centers for Disease Control and Prevention (CDC) lists urgent maternal warning signs for pregnancy and the year after delivery, and says to get medical care immediately if you have any of them.²

For those signs, how much bleeding is too much, and when to call 911, see our guide to urgent warning signs during pregnancy and after birth.

What’s typical in the weeks after birth

ACOG lists these as common postpartum symptoms: vaginal bleeding, cramping, pain in your back, neck, or joints, pain in the perineum (the area between the vagina and anus), pain around a cesarean incision, swollen breasts, bladder problems, bowel problems, and hemorrhoids.¹ ACOG suggests talking with your ob-gyn about options for pain relief before you leave the hospital.¹

Bleeding and discharge

The discharge after birth is called lochia; it is the tissue and blood that lined your uterus during pregnancy.³ The Office on Women’s Health (OWH) says it is heavy and bright red at first, then becomes lighter in flow and color until it goes away after a few weeks.³ MedlinePlus, from the National Library of Medicine, says you may bleed for up to 6 weeks, and that the discharge slowly becomes less red, then pink, then more yellow or white.⁴ It also says an increase in red bleeding around 7 to 14 days after birth is not uncommon, when the scab over the spot where the placenta was attached comes away.⁴

Cramping and pain

After delivery, your uterus contracts as it shrinks back to its normal size, and these “afterpains” may feel like menstrual cramps or even labor contractions.¹ ACOG says afterpains are more common in people who have given birth before and during the first few days of breastfeeding, and that a heating pad on the abdomen can help.¹

Healing after a tear or episiotomy

After a vaginal birth, ACOG says you will likely have a few weeks of swelling and pain in the perineum, and that pain may be worse and healing slower if you had a tear or an episiotomy.¹ Its suggestions include cold packs (most helpful in the first 24 to 72 hours), witch-hazel pads, sitz baths, and sitting on a pillow or cushion.¹ MedlinePlus says most women heal from an episiotomy or tear without problems, though it may take several weeks, and the stitches dissolve on their own.⁴

Breasts and feeding

OWH says breast milk comes in within three to six days after delivery, and that even if you are not breastfeeding, your breasts may leak milk and feel full, tender, or uncomfortable.³ This fullness is called engorgement; ACOG says breastfeeding more often and cold packs can help, and that for people who are breastfeeding, nipple pain is normal and can be improved with good technique.¹

Help is available: ACOG says peer counselors, nurses, doctors, and certified lactation consultants can help you get started and work through problems, and that if you can’t breastfeed or decide not to, that’s OK.⁵ ACOG’s patient FAQ lists the U.S. Department of Agriculture’s WIC breastfeeding program among places to find support.⁵

Bladder and bowel changes

In the first days after a vaginal delivery, you may feel the urge to urinate but not be able to, and urinating may hurt or burn.¹ Bowel movements may be hard for a few days; ACOG suggests fluids, short walks, high-fiber foods, and asking your ob-gyn about a stool softener if needed.¹ Hemorrhoids that developed during pregnancy may get worse after delivery, or appear for the first time because of straining during labor.¹

Tiredness, sleep, and other changes

ACOG describes the weeks after birth, sometimes called the “fourth trimester,” as a time that can bring lack of sleep, fatigue, pain, breastfeeding difficulties, stress, low sexual desire, and urinary incontinence.⁶ OWH encourages resting when you can, limiting visitors, and letting others help with cleaning, laundry, meals, and the baby.³

Some women develop thyroid problems in the first year after birth, called postpartum thyroiditis.³ OWH says these problems are easy to overlook because symptoms such as fatigue, sleep problems, low energy, and weight changes are common after having a baby, and suggests talking to your doctor about symptoms that don’t go away.³

Your feelings after birth

Many new mothers feel sad, weepy, and overwhelmed for a few days after birth, known as the “baby blues.”³ OWH says these feelings usually go away quickly, but if sadness lasts more than two weeks, see your doctor instead of waiting for your postpartum visit.³ It says postpartum depression can happen any time in the first year after birth, and that therapy, medicine, or both can treat it.³

Our guides explain the differences in depth: postpartum depression vs. the baby blues and postpartum anxiety and intrusive thoughts. You can also take the private after-birth self-check.

How the birth went can matter, too. ACOG says a woman may experience a birth as traumatic even if she and her baby are healthy, and that the postpartum visit is a chance to ask questions about labor, birth, and any complications.⁶ Read more: Trauma and PTSD in women.

Recovering after a cesarean birth

A cesarean is major surgery, and ACOG says it will take a few weeks for your abdomen to heal.⁷ ACOG says the hospital stay is usually 2 to 4 days, and that when you go home you should take special care of yourself, limit your activities, and ask for help from your partner, family, and friends.⁷ During recovery, ACOG says you may have mild cramping (especially if breastfeeding), bleeding or discharge for about 4 to 6 weeks, bleeding with clots and cramps, and pain or numbness around the incision.⁷

MedlinePlus says incision pain should ease after 2 or 3 days, but the incision may stay tender for 3 weeks or more; it suggests asking your provider which pain medicines are safe while breastfeeding.⁸ Its going-home instructions say walking helps you heal and can help prevent blood clots, that most regular activities are possible in 4 to 8 weeks, and not to lift anything heavier than your baby for the first 6 to 8 weeks.⁸ ACOG says not to put anything in your vagina, such as tampons, or have sex for a few weeks, and to allow time to heal before strenuous activity.⁷

The postpartum checkup

When ACOG recommends care

ACOG’s guidance for clinicians, Committee Opinion 736 (2018, reaffirmed in 2025), recommends that postpartum care be an ongoing process rather than a single visit.⁶ It says all women should ideally have contact with a maternal care provider within the first 3 weeks after birth, followed by ongoing care as needed and a comprehensive postpartum visit no later than 12 weeks after birth.⁶ That first contact can be in person or by phone.⁶ ACOG says the timing of the full visit should be individualized and should take into account any changes in insurance coverage expected after delivery.⁶

Other sources describe different timing. OWH says your doctor will check your recovery at a postpartum visit about six weeks after birth, and MedlinePlus says you will need a checkup in 4 to 6 weeks.^3,4 The World Health Organization (WHO), in its 2022 global guidelines, recommends at least three postnatal checkups in the first six weeks for healthy women and babies: between 48 and 72 hours, between 7 and 14 days, and during week six.⁹ ACOG suggests that your postpartum care plan include contact information and written instructions about when to get follow-up care.⁶

ACOG also says the comprehensive visit is not an “all-clear” signal: recovery and support may still be needed through 6 weeks after birth and beyond.⁶

What the visit may cover

ACOG says the comprehensive visit should include a full assessment of physical, social, and psychological well-being, covering:⁶

• Mood and emotional well-being, including screening for depression and anxiety
• Infant care and feeding
• Sexuality, contraception, and birth spacing
• Sleep and fatigue
• Physical recovery, including perineal or cesarean incision pain and bladder or bowel control
• Chronic disease management
• Health maintenance, such as vaccines and routine screening

ACOG says the visit is a time to identify which health care provider will take primary responsibility for your care going forward.⁶

If you had complications or health conditions

For people with a high blood pressure disorder of pregnancy, ACOG recommends a blood pressure check no later than 7 to 10 days after birth, and within 72 hours for severe high blood pressure.⁶ ACOG says women whose pregnancies were complicated by preterm birth, gestational diabetes, or a hypertensive disorder should be told these are linked with a higher lifetime risk of heart and metabolic disease.⁶ Read more: Recommended follow-up care after preeclampsia or gestational diabetes.

ACOG also says women with chronic conditions, such as high blood pressure, diabetes, thyroid disorders, or mood disorders, should get timely follow-up with an ob-gyn or primary care provider.⁶ After a miscarriage, stillbirth, or the death of a newborn, ACOG calls follow-up with an obstetric care provider essential.⁶ Read more: Pregnancy loss.

Sex, birth control, and spacing pregnancies

When to have sex again. Sources give different guidance. MedlinePlus says doctors usually recommend waiting four to six weeks after birth.¹⁰ Its discharge instructions say sex can start around 6 weeks after a vaginal delivery if the lochia has stopped, and any time after 6 weeks following a cesarean.^4,8 ACOG’s cesarean FAQ says to wait a few weeks to prevent infection.⁷

MedlinePlus says breastfeeding lowers hormone levels, which can cause lower sex drive, vaginal dryness, and pain with sex; it suggests a lubricant and gentle sex, and talking with your provider if sex is still difficult.⁴ ACOG’s list for the postpartum visit includes guidance on painful sex and resuming intercourse.⁶ Read more: Painful sex and vaginal or vulvar symptoms.

You can get pregnant before your period returns. ACOG says that if you are not breastfeeding, ovulation may happen within a few weeks of childbirth; if you are breastfeeding, it may be delayed but usually returns by about 6 months.¹¹ Because ovulation usually happens about 2 weeks before a period, ACOG says you can get pregnant even if you haven’t had a period yet.¹¹ ACOG’s guidance for clinicians says pregnancy is unlikely only when periods haven’t returned, the baby is under 6 months old, and the baby is fully or nearly fully breastfed with no gap of more than 4 to 6 hours between feedings.⁶

ACOG says all birth control methods are safe while breastfeeding (a few are not recommended in the first weeks), and many can be started right after birth, some before you leave the hospital.¹¹

How long to wait before another pregnancy. Organizations frame this differently:

• ACOG’s patient FAQ says experts recommend waiting 18 months after giving birth before getting pregnant again, for the best health outcomes for you and your next baby.¹¹
• ACOG’s clinician guidance says to avoid a gap shorter than 6 months between a birth and the next pregnancy, and to discuss the risks and benefits of getting pregnant again sooner than 18 months.⁶
• WHO, based on a 2005 expert consultation, recommends waiting at least 24 months after a live birth before trying to get pregnant again.¹² That report says the experts split between 18 and 27 months and agreed on 24 months as a compromise, while unanimously agreeing that gaps shorter than 18 months should be avoided.¹²

Returning to exercise

ACOG says that after a healthy pregnancy and a normal vaginal delivery, it is usually safe to start exercising a few days after birth, or as soon as you feel ready.¹³ If you had a cesarean or complications, ACOG says to ask your ob-gyn when it is safe.¹³ It suggests starting with 20 to 30 minutes a day of simple exercises for the abdominal and back muscles, adding moderate exercise gradually, and stopping if you feel pain.¹³ ACOG’s goal for after birth is at least 150 minutes a week of moderate aerobic activity, such as brisk walking, which can be split into 10-minute sessions.¹³

On high-intensity exercise, sources differ: ACOG says people who exercised vigorously before pregnancy may be able to return to regular workouts soon after birth after talking with an ob-gyn, while MedlinePlus’s discharge instructions after a vaginal delivery say to wait 6 weeks before impact exercise such as jogging, dancing, or lifting weights.^4,13 Your own clinician can tell you what fits your recovery.

Bladder leaks and the pelvic floor

The pelvic floor is a group of muscles that forms a sling across the bottom of the pelvis and holds the pelvic organs in place.¹⁴ Pelvic floor disorders happen when these muscles and tissues weaken or are injured, and include urine leakage, bowel control problems, and pelvic organ prolapse.¹⁴ The National Institute of Child Health and Human Development (NICHD) says childbirth is being studied as a risk factor, but the connection is not clear; in some studies risk rose with the number of births, risk may be greater with forceps or vacuum delivery, and a cesarean reduces but does not eliminate it.¹⁵

ACOG says leaking urine when you cough, laugh, sneeze, or exercise is called stress urinary incontinence, and that most cases of urinary incontinence can be cured or greatly improved with treatment.¹⁶ ACOG says Kegel exercises can help strengthen the pelvic muscles, and that some people are referred to a physical therapist who specializes in pelvic health.¹⁶ ACOG’s postpartum visit guidance includes checking bladder and bowel control, with referral to physical therapy or a specialist as needed.⁶

Going back to work

ACOG notes that many employed women return to work within weeks of giving birth, which is one reason it says the timing of the comprehensive postpartum visit should be individualized.⁶ Its list of what postpartum care should cover includes guidance on your legal rights to express milk if you return to work or school.⁶ If you plan to pump at work, our guide to pregnant and nursing workers’ rights explains federal protections for break time and a private space.

What we don’t know yet

• Timing advice varies. ACOG’s 2018 guidance moved away from a single “6-week check,” but some patient pages still describe a visit at about six weeks or 4 to 6 weeks, and WHO recommends a different schedule of checkups.^3,4,6,9 We show each organization’s advice rather than choosing one.
• Birth spacing recommendations differ, and WHO’s recommendation rests on a 2005 consultation in which experts disagreed on how to read the evidence.¹²
• The link between childbirth and pelvic floor problems is not fully understood, according to NICHD, whose page on causes was last reviewed in 2020.¹⁵
• Some patient pages are older. ACOG’s postpartum pain FAQ was last reviewed in August 2022.¹ Guidance can change as research does.

Questions to ask your doctor

• When and how will you contact me in the first few weeks after birth? Who do I call with questions, including after hours?
• When should my comprehensive postpartum visit be, and will my insurance coverage change after I give birth?
• How much bleeding should I expect, and for how long?
• What can I do for pain, and what is safe to take while breastfeeding?
• When can I start exercising, lifting, driving, and having sex again, given how my birth went?
• Which birth control methods fit my plans, and can I start one before I leave the hospital?
• Will you screen me for depression and anxiety?
• Did I have any complications that affect my long-term health or a future pregnancy? What follow-up do I need?
• I’m leaking urine or having trouble with bowel control. Could pelvic floor physical therapy help?
• Who will be my main health care provider after the postpartum period?

This article summarizes published research and official health information. It has not been reviewed by a clinician and is not medical advice. How we source.

Back to top