The first week after birth: what to expect for mother and baby
The first seven days after giving birth bring a cascade of physical and emotional changes for both mother and baby. You may feel elated, exhausted, sore, and overwhelmed, sometimes all within the same hour. Knowing what is normal, what the NHS midwifery team will be looking for, and when to ask for urgent help can make those early days feel a little less uncertain.
Your body in the first week: physical recovery
After birth, your body begins the work of returning to its pre-pregnancy state. The uterus, which expanded dramatically over nine months, starts to contract back to its normal size. You may feel these contractions as cramping pains, particularly when breastfeeding, because the hormone oxytocin that drives milk let-down also stimulates the uterus to tighten.
Postnatal vaginal bleeding, known as lochia, begins immediately after birth and is a normal part of the healing process. In the first few days it tends to be heavy and red, containing small clots. Over the following days and weeks it gradually lightens and changes colour from red to pink to yellow or white. This process typically continues for two to six weeks in total.
If you gave birth vaginally, you may have perineal soreness or stitches from a tear or episiotomy. Keeping the area clean, using a peri bottle of warm water when using the toilet, and changing maternity pads regularly all help with comfort and healing. If you had a caesarean section, your abdominal wound will need gentle care: keeping it dry, wearing loose clothing, and watching for any signs of infection are the key priorities.
Breast engorgement, when the breasts become full and firm as milk comes in, typically occurs around days two to four. This can feel uncomfortable but usually eases once feeding is established. Whether you are breastfeeding or formula feeding, your midwife or a feeding specialist can support you with any difficulties during the postnatal visits.
Your newborn in the first week
Newborns arrive with a set of normal characteristics that can look alarming if you are not expecting them. Many babies have a slightly mottled or blotchy skin tone in the first days as their circulation adjusts. It is also common for newborns to lose a small amount of weight in the first few days after birth, which is monitored closely at midwife visits, and most regain this by around 10 to 14 days.
Jaundice is extremely common in newborns, appearing as a yellowing of the skin and whites of the eyes. It is usually mild and clears on its own within two weeks. However, jaundice that appears within the first 24 hours of life, or that is accompanied by other symptoms, needs to be assessed promptly. Your community midwife will check your baby for jaundice at every postnatal visit.
The umbilical cord stump, the small dried remnant where the cord was cut, needs to be kept clean and dry. It will gradually shrivel and fall off on its own within one to three weeks. There is no need to apply any powders or creams. Contact your midwife if the area around the cord becomes red, swollen or smelly, as these can be signs of infection.
Feeding patterns in the first week can feel relentless. Newborns have tiny stomachs and need frequent feeds, whether breastfed or formula fed. Looking for hunger cues such as rooting, sucking movements, and hand-to-mouth gestures, rather than feeding only on a strict schedule, helps ensure your baby gets enough and supports your milk supply if you are breastfeeding.
Emotional wellbeing: the baby blues and beyond
Most new mothers experience a period of emotional fragility in the first week, often described as the baby blues. Tearfulness, mood swings, and feeling overwhelmed are very common in the days after birth and are linked to the sharp drop in pregnancy hormones that follows delivery. These feelings typically peak between days two and five and resolve within a few days without specific treatment.
It is important to distinguish the baby blues from postnatal depression, which is a more persistent condition that does not lift on its own in the same way. If low mood or anxiety continues beyond the first two weeks, or feels severe or unmanageable at any point, it is worth speaking to your midwife, health visitor or GP. The Edinburgh Postnatal Depression Scale, a short questionnaire that your midwife will usually complete with you at one of the early postnatal visits, is one of the tools used to identify mothers who may need more support.
Partners and other family members can also be affected by the emotional weight of the early postnatal period. Acknowledging this and making space for honest conversations about how everyone is coping can help the whole household adjust.
NHS midwifery care in the first ten days
Under NICE guideline NG194 on postnatal care, NHS community midwives are required to offer postnatal visits to all women and their babies in the first ten days after birth. In practice, the number and timing of these visits varies by area and by individual clinical need, but a visit in the first 24 to 48 hours after leaving hospital is standard.
At these visits, your midwife will check a range of things for you: your physical recovery including lochia, any wounds or stitches, blood pressure, and signs of infection. They will also ask about your emotional wellbeing, your feeding experience, and whether you have support at home.
For your baby, the midwife will check weight, feeding, jaundice, the umbilical cord, and general health. If there are concerns, they may arrange additional visits or a referral to another service. Around day five, a blood spot screening test is usually performed: a small blood sample taken from your baby's heel to screen for a range of rare but serious conditions.
Midwifery care transfers to the health visitor at around day ten to fourteen, though some areas offer a final midwife discharge visit before that handover. Your health visitor will continue monitoring your baby's development and your own wellbeing through a schedule of contacts in the weeks and months that follow.
Frequently asked questions
What is lochia and how long does it last?
Lochia is the postnatal vaginal bleeding and discharge that occurs as the uterus sheds its lining after birth. It is heaviest in the first few days and gradually reduces over 2 to 6 weeks, changing from red to pink to brown. Contact your midwife if it becomes very heavy or has an offensive smell.
What are the baby blues?
The baby blues is a period of emotional fragility and tearfulness experienced by most new mothers, typically between days 2 and 5 after birth. It is caused by the rapid hormonal shift after delivery and usually resolves within a few days. It differs from postnatal depression, which is more persistent.
What do community midwives check in the first week?
In the first 10 days after birth, NHS community midwives visit at home to check your physical recovery, your baby feeding and weight, jaundice, umbilical cord, and your emotional wellbeing. The Edinburgh Postnatal Depression Scale is usually completed at one of these visits.
When should I seek urgent help in the first week after birth?
Seek urgent help if your newborn develops jaundice in the first 24 hours, has a temperature above 38 degrees C, is not feeding, or is breathing with difficulty. For the mother, heavy bleeding soaking more than a pad an hour, high fever, or signs of wound infection all need prompt attention.
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