Welcoming a new baby is one of life’s most transformative experiences—physically, emotionally, and mentally. While every postpartum journey is unique, there are some common bodily changes that many new mothers experience. It’s important to recognize that these changes are normal and often temporary, though they can vary depending on whether you had a vaginal delivery or a Cesarean section (C-section).
Below, we explore what you might expect based on your mode of delivery.
Postpartum Body Changes After a Vaginal Delivery
1. Vaginal Soreness and Swelling
It’s common to experience soreness, bruising, or swelling around the vaginal area, especially if there was tearing or an episiotomy. This typically improves within a few weeks.
2. Lochia (Postpartum Bleeding)
You’ll have vaginal bleeding and discharge (called lochia) for about 4–6 weeks as your uterus sheds its lining. It starts off heavy and bright red, then fades to pink, brown, and finally yellow-white.
3. Pelvic Floor Changes
Vaginal delivery stretches the pelvic floor muscles, which can lead to:
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Urinary incontinence (especially when laughing or sneezing)
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A feeling of heaviness or pressure in the vagina
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Reduced vaginal tone (which may affect intimacy initially)
Pelvic floor exercises (like Kegels) can help restore muscle strength. Your pelvic floor physical therapist will test your pelvic floor muscle strength, assess for pelvic organ prolapse, and check your muscle tone to identify any areas you may need help and create a plan to improve it!
4. Hemorrhoids and Constipation
Straining during labor can cause hemorrhoids or worsen them. Constipation is also common due to hormonal changes, iron supplements, or dehydration.
5. Perineal Healing
If you had a tear or episiotomy, the perineum (the area between your vagina and anus) will need time to heal. Sitz baths and pain relief methods (like cold packs) can help.
- Once you are cleared for intercourse, you can also have an internal pelvic floor evaluation. If you experienced any tearing, it is important to undergo physical therapy evaluation and treatment to prevent pain, weakness, and tightness from tearing or episiotomy.
Postpartum Body Changes After a C-Section Delivery
1. Incision Site Healing
The most immediate change is the surgical incision—usually a horizontal cut just above the pubic area. Healing can take 6–8 weeks. Expect:
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Tenderness and numbness at the incision site
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Mild swelling and bruising
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A scar that fades over time but may remain visible
- Once the scar is well healed, it is crucial to initiate scar tissue mobilization techniques. A pelvic floor physical therapist can assist with these techniques.
2. Abdominal Weakness
The abdominal muscles are separated during surgery, which can lead to:
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Core weakness
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A “pooch” or bulge around the incision
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Challenges with posture and mobility early on
Gentle core strengthening exercises (once cleared by your provider) can help. A pelvic floor physical therapist can teach you all the techniques for strengthening your deep core. It is more than just your Rectus Abdominis!
3. Delayed Mobility
C-section recovery typically involves more physical restrictions in the early weeks. You’ll be advised to avoid lifting, bending, and intense activity to protect the incision.
4. Gas Pain and Constipation
Surgery and pain medications can slow digestion, causing bloating, gas pain (especially in the shoulders), and constipation.
5. Postpartum Bleeding
Yes—you still experience lochia even after a C-section, as the uterus still needs to shed its lining. The bleeding may be lighter compared to vaginal delivery but can last several weeks.
Changes Common to Both Deliveries
Regardless of delivery method, many postpartum changes are shared:
- Diastasis Rectus Abdominis: Many moms experience DRA, which is a seperation of the rectus abdominis muscles at the linea alba. Your doctor and physical therapist should both be evaluating you for a DRA. If your medical provider identifies DRA, you should be referred for physical therapy evaluation and treatment.
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Breast Changes: Engorgement, leaking, and nipple soreness, especially if breastfeeding.
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Hair Loss: Temporary shedding peaks around 3–4 months postpartum.
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Night Sweats: Hormonal shifts can lead to profuse sweating, especially at night.
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Emotional Changes: Mood swings, irritability, and fatigue are common. Be alert for signs of postpartum depression or anxiety.
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Uterine Contractions: Known as “afterpains,” these cramps help the uterus shrink back to its pre-pregnancy size.
Final Thoughts
Your postpartum body tells the story of strength, resilience, and transformation. Whether you delivered vaginally or by C-section, recovery is not a one-size-fits-all process. Give yourself grace, allow time for healing, and don’t hesitate to seek support. A pelvic floor physical therapist can help you identify and create a plan of care to improve many postpartum changes.
Need help?
If you’re struggling with any pregnancy or postpartum concerns and want a personalized evaluation and treatment plan, make an appointment with one of the Pelvic Floor Physical Therapists at The Pelvic Health Center in Madison, NJ.
