Your body after birth: what to expect in the first six weeks

Newborn · Wellbeing · Reviewed 20 June 2026 · All articles

The first six weeks after birth are a period of significant physical change. Your body is healing from the work of labour and delivery while simultaneously adapting to sustain a new life outside the womb. Many of the changes you will experience are expected and normal, though that does not always make them easy. Knowing what to look for, and what genuinely needs medical attention, can help you recover with more confidence and less unnecessary worry.

Lochia: postpartum bleeding

After delivery, the uterus sheds its lining in a process called lochia. This is different from a menstrual period, though it can look similar in the early days.

In the first two to three days, lochia is bright red and can be heavy, comparable to a heavy period. You may pass small clots. From around day four, the flow typically becomes lighter and shifts to a pinkish-brown colour as the red blood cells are diluted with serous fluid. By weeks three to four, it usually becomes yellowish-white and reduces significantly. Most people stop having lochia by six weeks, though some light discharge can continue a little longer.

A few things are worth monitoring. Sudden increases in flow after it had been reducing, often triggered by doing too much too soon, are common and usually settle with rest. However, soaking a maternity pad within an hour or less, passing clots larger than a plum, or experiencing lochia that smells unusually strong or offensive are all reasons to contact your midwife or doctor promptly.

How long does postpartum bleeding last?

Lochia typically lasts up to six weeks. It begins as bright red bleeding in the first few days, transitions to a pinkish-brown discharge over the following weeks, and eventually becomes a yellowish-white before stopping.

Perineal soreness and healing

If you had a vaginal birth, the perineum (the area between the vagina and the anus) will be sore regardless of whether you had a tear, a graze, or an episiotomy. The degree of discomfort varies considerably.

For minor grazes, pain usually settles within a week or two. Stitches from a tear or episiotomy typically dissolve on their own within two to four weeks, though the area may remain tender for longer. Sitting can be uncomfortable, particularly on hard surfaces. A cushioned ring or a folded towel can help, as can taking pain relief such as paracetamol or ibuprofen at regular intervals rather than waiting until the pain peaks.

Keeping the area clean is important for healing. Pouring warm water over the perineum while urinating helps reduce stinging. Shallow warm salt baths (or plain water baths) two or three times a day can ease discomfort and keep the area clean. Pat dry gently rather than wiping.

Contact your midwife if you notice increasing pain after the first few days rather than decreasing pain, or if the wound looks red, swollen, has a discharge, or has opened. These can be signs of infection or wound breakdown, both of which can be treated effectively when caught early.

Afterpains: the uterus contracting back

After delivery, the uterus begins contracting back to its pre-pregnancy size in a process called involution. These contractions, known as afterpains, can feel like moderate to strong period cramps. They are usually strongest in the first two to three days and reduce as the week progresses.

Afterpains tend to be more noticeable in people who have had previous pregnancies. In a first birth, the uterine muscle tone is often sufficient to maintain contraction without as much cramping. In subsequent births, the muscle needs more repeated contractions to retract effectively, which can make afterpains noticeably stronger.

Breastfeeding also intensifies afterpains. Suckling stimulates the release of oxytocin, which acts directly on the uterus and triggers contractions. This is a normal and useful response: it supports involution and reduces postpartum bleeding. Taking a mild pain reliever such as paracetamol or ibuprofen thirty minutes before a feed can make this more manageable in the first few days.

When do afterpains stop?

Afterpains usually ease within two to four days of birth. They tend to be stronger in second or subsequent pregnancies and can feel more intense during breastfeeding, when oxytocin triggers uterine contractions.

Breast changes: engorgement and milk coming in

Colostrum, the early concentrated milk, is present from birth. The transitional milk usually comes in between days three and five, and when it does, it can arrive dramatically. The breasts become noticeably larger, firmer, and can feel very tender. This is engorgement, and while it is normal, it can be uncomfortable and occasionally makes it harder for a baby to latch because the areola becomes taut.

Feeding frequently and on demand is the most effective way to manage engorgement. Before a feed, a warm compress or a few minutes in a warm shower can help milk flow more easily. After a feed, a cool compress or chilled (not frozen) cabbage leaves placed inside a bra can reduce swelling. Express only enough to relieve pressure rather than to empty the breast, as over-expressing signals the body to produce more.

Mastitis is an inflammation of the breast tissue that can develop when a duct becomes blocked or when bacteria enter through a cracked nipple. Signs include a hard, red, painful area in the breast, often accompanied by flu-like symptoms: fever, aching muscles, and fatigue. Mastitis requires prompt assessment. Treatment usually involves continuing to feed or express from the affected breast, rest, fluids, and sometimes a course of antibiotics. Left untreated, it can progress to a breast abscess.

Hormonal changes: baby blues and postnatal depression

In the days after birth, oestrogen and progesterone levels fall sharply. This drop is among the most rapid hormonal changes a human body can experience in a short period, and it has a direct effect on mood.

Baby blues affect the majority of new mothers. The typical pattern is a wave of tearfulness, emotional sensitivity, and low mood that arrives around days three to five, often coinciding with the milk coming in. Feelings can seem out of proportion to events: you may cry without a clear reason, feel overwhelmed, or find it hard to feel the connection to your baby that you expected. These feelings usually lift within two weeks without specific treatment, with rest, reassurance, and practical support making a significant difference.

Postnatal depression is different. It affects roughly one in seven new mothers and can begin at any point in the first year. The low mood does not lift after two weeks, may worsen over time, and starts to interfere with daily functioning: difficulty sleeping even when the baby sleeps, persistent anxiety, inability to enjoy things, and sometimes intrusive thoughts. Postnatal depression responds well to treatment, which may include talking therapies, medication, or both. If you are not sure whether what you are experiencing is baby blues or something more, speak to your midwife or health visitor. They will not judge you, and raising it is one of the most useful things you can do.

What are the signs of postnatal depression versus baby blues?

Baby blues typically peak around days three to five after birth and resolve on their own within two weeks. Postnatal depression persists beyond two weeks, affects your ability to function day to day, and requires professional support. If low mood, anxiety, or feelings of hopelessness continue past the two-week mark, speak with your midwife or doctor.

Hair loss from three to four months

Many new mothers notice significant hair shedding starting around three to four months after birth. This is called telogen effluvium. During pregnancy, elevated oestrogen levels keep hair in the growth phase longer than usual, meaning less falls out and the hair feels thicker. After birth, oestrogen levels drop and a large proportion of hairs shift into the resting and shedding phase simultaneously, which is when the loss becomes noticeable.

The shedding typically peaks around month four and resolves by twelve months. It is not a sign of nutritional deficiency in most cases, and it does not lead to permanent hair loss. Hair density usually returns to its pre-pregnancy baseline, though the texture may change slightly for some people.

Night sweats

Night sweats in the first weeks after birth are common and are driven by hormonal changes. As oestrogen levels fall and the body sheds the extra fluid retained during pregnancy, night sweating is one of the mechanisms the body uses to restore fluid balance. Waking to find the sheets damp is normal and usually settles within a few weeks. Keeping the bedroom cool, using moisture-wicking bedding, and staying well hydrated during the day can help manage the discomfort.

Urinary changes and pelvic floor recovery

Urinary frequency and urgency are common in the days after birth as the body excretes retained pregnancy fluid. Some mothers also notice urinary leakage, particularly when coughing, sneezing, or laughing. This is stress urinary incontinence and reflects the strain placed on the pelvic floor during pregnancy and delivery.

Pelvic floor exercises (Kegel exercises) can begin as soon as you feel comfortable, even while still in hospital. To perform them, contract the muscles you would use to stop the flow of urine, hold for five to ten seconds, then release fully. Aim for three sets of eight to twelve repetitions each day. Consistency over weeks and months makes the difference, and improvements are usually noticeable within six to twelve weeks.

If leakage is significant or you are also experiencing difficulty emptying the bladder fully, mention this at your six-week check. A referral to a pelvic floor physiotherapist can be very effective and is underused.

The six-week check

Most new mothers have a postnatal check with their GP or doctor at around six weeks. This is an opportunity to discuss how your physical and emotional recovery is progressing. Topics that are typically covered include wound healing, lochia, contraception, pelvic floor function, bladder and bowel changes, mood, feeding, and any questions you have accumulated.

Come with a list. The appointment is often short and it is easy to forget things in the moment. If any of the topics mentioned in this article are still concerning you, this is the right time to raise them. Do not leave with unasked questions because you felt you were taking up too much time.

When to seek emergency help

Most of what you will experience in the first six weeks is expected and manageable. The following, however, require prompt or emergency attention and should not be waited out.

• Heavy bleeding: soaking a maternity pad in an hour or less, or passing clots larger than a plum. This may indicate a postpartum haemorrhage.
• Fever above 38C: combined with pelvic pain or offensive-smelling lochia, this can indicate a uterine infection (endometritis).
• Wound infection: increasing redness, swelling, warmth, pus, or worsening pain at a perineal wound or caesarean scar, particularly if accompanied by fever.
• Leg pain or swelling: calf pain, redness, or swelling in one leg can be a sign of deep vein thrombosis. New mothers are at elevated risk of blood clots for up to twelve weeks after birth.
• Breathing difficulty or chest pain: seek emergency care immediately, as these can indicate a pulmonary embolism.
• Severe headache with visual disturbance: in the context of high blood pressure, this requires urgent assessment for postpartum pre-eclampsia.

If in doubt, contact your midwife, call your maternity triage line, or go to A&E. A&E staff are trained to assess postpartum emergencies, and coming in when you are not sure is always the right call.

When should I go to A&E after giving birth?

Seek emergency care if you are soaking a maternity pad in an hour or less, passing clots larger than a plum, have a temperature above 38C, or notice signs of wound infection such as increasing redness, swelling, pus, or worsening pain. These can be signs of postpartum haemorrhage or infection and need prompt assessment.