The Postpartum Recovery Milestones Nobody Talks About

You’ve probably heard about the six-week postpartum checkup – the one where you’re cleared to exercise, have sex, and supposedly return to “normal.” But anyone who’s had a baby knows that postpartum recovery goes far beyond the six-week mark. 

In reality, the weeks, months and even years after birth are filled with milestones – some of which no one really prepares you for. From pooping after a c-section to postpartum irritability, there are a lot of physical and mental milestones to overcome. While everyone’s postpartum recovery journey is different, these personal milestones and your experiences matter.

We’re here to debunk the myth that it only takes six weeks to return to “normal” and honor the many postpartum recovery milestones that people experience after both vaginal and c-section births. At Origin, we know that the postpartum journey comes with a variety of challenges. But with each challenge comes an achievement. We’re here to support you mentally and physically, and celebrate each milestone with you, no matter where you are on your postpartum journey. 

The postpartum check-up: What does recovery really look like after 6 weeks?

The 6-week postpartum check-up used to symbolize a return to normal life, but we know now that this timeline does not reflect the true experience. Not only does it not reflect the full healing process, it’s important for people to know that they don’t have to wait six weeks to see their doctor or a pelvic floor physical therapist if they have questions, or if something feels off. 

But if six weeks isn’t the right timeframe, you might be wondering “how long is postpartum recovery supposed to take?” The truth is, it varies. Whether you had a caesarean section or vaginal birth, and to what extent you’re experiencing a number of potential physical and emotional symptoms that can arise after birth will also impact your recovery journey. Hormonal changes, tears or injury to the pelvic floor muscles and surrounding tissue, and complications from birth or C-section surgery can all impact recovery time. You may experience new symptoms like incontinence, pelvic pain or pressure, which can be addressed by a pelvic floor physical therapist. Or, you may feel better than you expected! This is also an option.

However, for many, it can be confusing to be told you are “cleared” to return to “normal life” after six weeks when you know better than anyone that you don’t feel the way you used to. Some may feel like six weeks is too long to wait when something is painful, uncomfortable or concerning. The bottom line is that everyone’s recovery process is different. But whatever you are experiencing, we are here to help at any stage of your recovery.  

We recommend going into your 6-week postpartum check-up prepared with notes about any unusual symptoms you’re experiencing, as well as questions (write them down!) so that you make sure you leave feeling confident and clear about a path forward. 

Differences between vaginal and c-section recovery

Vaginal delivery can often cause perineal tearing, pelvic floor strain, or hemorrhoids. The perineum is that area between the vulva and the rectum. It is a common location for tearing during birth. There can be pain with sitting, discomfort with urinary and bowel movements, and a feeling of pressure or heaviness in the perineal area. You may have also received stitches in this sensitive area that is still healing and requires extra care and attention. 

C-section recovery includes managing a major abdominal incision, post-op precautions, and sometimes scar tissue discomfort. Someone who experienced a c-section has undergone a major surgery, and is healing from incisions across layers of tissue, as well as recovering from the sudden physical and hormonal changes of no longer being pregnant. For many women who have a c-section, there are different emotional responses. While many women are happy and relieved to have had a successful birth, for some women a c-section arises unexpectedly and, occasionally, traumatically. Some have trouble looking at or touching their scar. It can be hard to come to terms with the experience at first. 

Some women have complications during or after a birth. Whether or not you had a tear or an injury can contribute to recovery time. How much help you’re getting, how much you’re able to sleep, whether you’re breastfeeding or not and how quickly you return to work and regular movement  – all of these variables will impact the time it takes to recover, especially how you feel in those first few weeks postpartum. 

Pain, mobility challenges, scar tissue restrictions and bathroom-related challenges can show up in both experiences. Contrary to what many people assume, pelvic organ prolapse, pain with sex, urinary or fecal incontinence and other issues can occur with either a c-section or vaginal birth.

The takeaway? Pelvic floor physical therapy can support both types of recovery by addressing symptoms like core weakness, diastasis recti pelvic pain, bladder and bowel dysfunction, and helping you safely return to movement and hit your own goals, on your own timeline.

What physical symptoms can I expect after birth?

To give you an idea of the physical symptoms women experience after birth, here are some findings from a 2022 report that show common (not to be confused with “normal”) physical symptoms, as well as the percentage of women who experience them:

Common postpartum symptoms:

• Sore nipples/breast tenderness – 48%
• Weight control – 45%
• Painful perineum (among vaginal births) – 41%
• Urinary problems – 31%
• Bowel problems – 30%
• Painful intercourse – 27%
• Hemorrhoids – 23%

Symptoms that persisted for 6 months or more:

• Weight control – 29%
• Urinary problems – 11%
• Painful intercourse – 10%
• Sore nipples/breast tenderness – 9%
• Bowel problems – 9%
• Hemorrhoids – 9%
• Painful perineum (vaginal births only) – 7%

As you can see, the physical symptoms are quite common, and many persist beyond the six-week mark. It can be hard to determine the difference between normal and common. Seeing a pelvic floor physical therapist can help you better understand what to expect and how you’re healing. One of our specialized pelvic floor physical therapists can help you be proactive in your postpartum recovery and guide you through ways to take care of yourself postpartum, no matter how many weeks it’s been. And don’t worry – we know it can be hard to peel yourself away from a nursing baby, which is why babies are always welcome during your visit, or you can schedule a virtual visit if that is more convenient. 

Physical postpartum recovery milestones 

You will experience many physical milestones after having a child. Whether you had a vaginal delivery or are navigating postpartum cesarean recovery, the physical healing process is full of changes, and sometimes surprises. While you may have heard about the first postpartum poop, the first time your baby latches to your breast, and the first time you’re intimate again with your partner (take all the time you need!), there are plenty of other physical milestones ahead. 

Here are some significant physical milestones that women in our community have shared:

• The first time you sit without wincing from a tear or hemorrhoids after birth.
• Peeing without fear or leaking after weeks of bladder unpredictability.
• Your first poop after a C-section (yes, it can take days).
• Waking up drenched in night sweats due to shifting hormones.
• The first night you sleep without waking yourself up just to listen to your baby breathing.
• When your belly has shrunk and healed enough that you feel comfortable putting away the maternity clothes.
• When your hair finally starts growing back after postpartum hair loss.
  
  

Joint pain is another under-the-radar symptom, often tied to the lingering effects of relaxin, a pregnancy hormone that sticks around postpartum and can contribute to instability or discomfort. But don’t forget your core muscles have been stretched, which can contribute to core weakness for months after giving birth. 

Whatever your milestones, pelvic floor physical therapy can help you address pelvic pain postpartum, improve bladder and bowel function, and help you rebuild strength so you can feel more like yourself – whether that’s three weeks, three months or a full year after birth.

Emotional and mental postpartum recovery milestones 

We know about the obvious physical changes, but what not everyone talks about is how intensely emotional having a baby can be. I’m talking about months and years, not just those first weeks. While there are feelings of immense joy and love, there can also be tough moments of sadness, loss and anxiety. We’ve all heard of the “baby blues” and postpartum depression, which can occur when hormones are changing and sleep is lacking, but the ups and downs can last longer than you might anticipate. Many parents report a delayed emotional crash, while others navigate postpartum anxiety or irritability. 

Some common emotional symptoms women feel postpartum are: 

• Postpartum irritability, even rage, creeping in unexpectedly.
• A persistent sense of detachment or numbness, especially if sleep deprivation is severe.
• Anxiety and intrusive thoughts or fear about your baby’s safety.
• Anger or resentment towards your partner who isn’t going through the same physical and emotional journey. 

With these emotional challenges can come unexpected milestones. For some, a mental milestone is simply realizing “I’m doing okay.” For others, it’s when you stop Googling symptoms and trust your gut. 

A few of the other mental, emotional and social milestones you might experience include: 

• The first time you laugh – really laugh – again.
• The first morning you wake up feeling rested.
• That feeling you get during your first solo walk as a mom, like you have totally changed but the world is the same.
• The first time you realize that you are beautiful the way you are.
• The first date night where you feel connected with your partner.
• The first self-care session that feels nourishing.
• The first time you touch your C-section scar without fear.
• The first time you realize your body is different and feel at peace with that.
• The first time you feel like a great mother (even just for a moment).
• The feeling of achievement you have at the first workout class or group activity after having a baby.
• The first time you meet a mom-friend who just gets it.
• The first cry when you let out every emotion. 
• The first time you do something other than caring for your baby that reminds you of who you are. 
• The moment you stop waiting to “go back” to who you were and start embracing who you are now
• The day you realize that you’re doing better than you think

While being emotional and feeling a lot is very common postpartum, trust your instincts if something doesn’t feel quite right. If you’re feeling unusually down, anxious or irritable, or if you’re just worried that you’re not feeling like yourself, know that help is available and you deserve support. Organizations like Mavida and Seven Starling focus on helping new moms with their mental health. They accept insurance and can connect you with caring providers who can help support you during your recovery.

Your postpartum recovery timeline is personal

All of these physical and mental milestones are examples of how the postpartum recovery period doesn’t have an exact timeline. Recovery isn’t one-size-fits-all. Your journey will never be exactly the same as someone else’s. While there are many experiences that are similar and bond us, there are also unique milestones that mean something more personal to you. 

Whatever your postpartum physical and emotional milestones, we’re here to support you. Schedule your first visit with one of our pelvic floor physical therapists today.