Your body undergoes so many changes during pregnancy, and it can take 6 months to 1 year for you to really feel back to yourself. The changes happen slowly but surely, starting about 24 hours after delivery and continuing for up to 1 year. The most important thing is to listen to your body, and try to make time for yourself and your recovery.
24–72 Hours (Immediate Postpartum)
- Uterus starts contracting back to normal size (can feel like cramps, especially during breastfeeding).
- Lochia (bleeding) begins – similar to a heavy period.
- Perineum soreness or incision pain (vaginal tear, episiotomy, or C-section).
- Swelling, constipation, and fatigue are common.
- Rest is so important, the wound from your placenta is large and requires lots of rest for healing
- Hydration and proper eating habits are crucial for supporting your body and your breastmilk production
Weeks 1–2
- Bleeding gradually lightens
- Vaginal soreness, stitches, or C-section incision continue healing.
- Hormonal crash may lead to emotional changes “baby blues” (mood swings, crying, irritability).
- Sleep deprivation and night sweats are common.
- Being to work on gentle restorative exercise. See our blog post “Day One to Week Six – Pelvic Floor Exercises for Postpartum” for more information
Weeks 3–4
- Bleeding may taper off or become light spotting
- Swelling reduces; incision and perineal area continue healing.
- Energy starts returning, though fatigue remains common.
Weeks 5–6
- Many are cleared for light exercise and sex at the 6-week postpartum checkup.
- Core and pelvic floor are still healing.
- Lochia typically stops.
- Hormonal fluctuations may persist, especially while breastfeeding.
6 Weeks – 3 Months
- Gradual return to regular physical activities with professional guidance.
- Pelvic floor physical therapy is recommended at this time. Core weakness, pelvic floor muscle weakness, urinary incontinence, diastasis rectus abdominis, hip tightness, painful intercourse, sand low back pain are all common reasons to seek out pelvic floor physical therapy
- C-section scars may be fully closed but remain sensitive. Begin gentle massage in the area surrounding and slowly work your way towards scar mobilization. A pelvic floor physical therapist can help with scar mobilization techniques.
- Safe to begin core rehab (diastasis recti-safe exercises).
- Respiratory system changes from pregnancy typically return to normal by 6-8 weeks
3 – 6 Months
- Many begin to feel physically and emotionally more stable.
- Hormonal changes continue, particularly if breastfeeding.
- Menstrual cycles may return.
- Avoid high-impact workouts until core and pelvic floor are well-recovered. A pelvic health physical therapist will be helpful in determining your readiness for high-impact workouts
6 – 12 Months
- Full recovery for most, though some may experience ongoing symptoms (e.g., fatigue, leaking, pelvic discomfort).
- If you have persistent symptoms including urinary incontinence, back pain, pelvic heaviness/discomfort, scar pain, etc. please seek help from a pelvic floor physical therapist
- Hormones, energy levels, and muscle strength typically normalize.
- Emotional wellness and identity adjustments are still ongoing.
When to Seek Medical Help
- Fever, foul-smelling vaginal discharge, or severe abdominal/pelvic pain
- Bleeding that soaks a pad in under an hour
- Symptoms of postpartum depression (persistent sadness, hopelessness, withdrawal)
- Pain during sex several months postpartum
- Ongoing bladder leakage, pelvic heaviness, or organ prolapse symptoms
Looking to optimize your postpartum healing with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected].