Weeks 6 to 12 postpartum: physical changes and when to seek help

0-3 months · Wellbeing · Reviewed 20 June 2026 · All articles

The six-week mark is often treated as a finish line: the postnatal check, a return to "normal", the point at which the body is assumed to be recovered. In practice, recovery is far more gradual. Weeks 6 to 12 are a period of continued change, and understanding what is expected during this time, and what is not, helps you decide when something needs attention.

What has typically resolved by six weeks

For people who had a straightforward vaginal birth without significant tearing, lochia (the postpartum vaginal discharge) usually stops by four to six weeks. The discharge progresses from bright red in the first days to pink and brown, then fades to a yellowish-white before stopping. If bright red bleeding restarts after appearing to slow, or if it is accompanied by a fever or foul odour, that warrants a call to your midwife or doctor.

Perineal soreness from minor tears or an episiotomy also tends to ease substantially by six weeks for straightforward repairs. Sitting comfortably and returning to light daily activities is usually possible by this point. Deeper or more complex tears, including third- and fourth-degree tears, take longer and benefit from specialist pelvic floor physiotherapy follow-up.

Uterine involution, the process by which the uterus contracts back to close to its pre-pregnancy size, is largely complete by six weeks. The afterpains that many people experience in the first week or two, particularly during breastfeeding, have generally settled well before this point.

What is still changing between weeks 6 and 12

Several body systems remain in active transition during this period, and it is helpful to know that this is normal rather than a sign that recovery has stalled.

Hormones. If you are breastfeeding, oestrogen remains low. This is what causes vaginal dryness, reduced libido, and sometimes discomfort during sex when it resumes. These effects are physiological, not permanent, and tend to improve once breastfeeding frequency reduces or stops. Using a vaginal moisturiser or water-based lubricant is safe and often helpful.

Pelvic floor. The pelvic floor muscles and connective tissue were placed under considerable load during pregnancy and birth. Research consistently shows that meaningful recovery takes three to six months, not six weeks. You may still notice some urgency, leakage with sneezing or jumping, or a feeling of heaviness. None of this is something you simply have to live with: a women's health physiotherapist can assess the pelvic floor directly and guide rehabilitation. Kegel exercises (pelvic floor contractions) are safe to begin as soon as comfortable after birth and are a useful starting point, but they are not the whole picture.

Caesarean scar. If you had a caesarean birth, the external incision closes within a few weeks but the deeper layers of the abdominal wall continue healing for several months. Scar tissue forms and the scar itself may feel numb, tight, or itchy as nerves regenerate. Gentle scar massage, usually introduced from around eight weeks once the wound is fully closed, can help with mobility and sensitivity. Any signs of infection, including redness spreading from the wound, discharge, fever, or increasing pain, need prompt medical review.

Hair loss. Many people notice significant hair shedding beginning around three to four months after birth. This is telogen effluvium: during pregnancy, elevated oestrogen prolongs the growing phase of the hair cycle, so more hairs than usual are retained. After birth, oestrogen falls and those hairs enter the shedding phase simultaneously. The result can feel dramatic but is not a sign of a nutritional deficiency or permanent hair loss in most cases. It typically resolves within six to twelve months.

Libido. A low or absent interest in sex is extremely common at this stage and has multiple overlapping causes: fatigue, low oestrogen if breastfeeding, physical tenderness, the psychological weight of new parenthood, and a shift in how the body feels and is perceived. There is no expected timeline for when libido "should" return. When you do return to penetrative sex, using lubrication and taking time are practical steps. If sex is consistently painful beyond a few attempts, a pelvic floor assessment is worth requesting.

The six-week check: what it covers and what it often misses

The postnatal check at around six weeks is an important appointment, but in many healthcare settings it is brief. It typically covers: wound healing (perineum or caesarean scar), blood pressure, a discussion of contraception, infant feeding, and a screening question or two about mood. What it often does not include is a hands-on pelvic floor assessment, a check for abdominal muscle separation (diastasis recti), or extended discussion of emotional wellbeing.

This means you may need to raise things yourself. If you are experiencing pelvic floor symptoms, it is reasonable to ask for a physiotherapy referral at this appointment. If you have concerns about your scar, mood, or contraception, this is the moment to voice them. Come with a short list if that helps.

It is also worth noting that the six-week check is not the end of postnatal care. If new symptoms arise after the appointment, or if things that seemed fine at six weeks worsen over the following weeks, contacting your GP or midwife is appropriate at any point.

Diastasis recti: abdominal separation

What is diastasis recti and how do I check for it?

Diastasis recti is a separation of the two bands of abdominal muscle (the rectus abdominis) that run down the front of the belly. The connective tissue between them, called the linea alba, stretches to accommodate the growing uterus during pregnancy. For many people this gap narrows naturally in the weeks after birth, but for some it remains wide enough to affect core function.

To check, lie on your back with knees bent and feet flat. Place two or three fingers horizontally across the midline just above the navel. Gently lift your head as if doing a small crunch, keeping your shoulders down. Feel for a gap between the two muscle bellies. A gap of more than two finger-widths (approximately 2 cm) may indicate separation worth discussing with a physiotherapist. The depth and firmness of the gap matter as much as the width: a narrow but very soft gap can still affect function, while a wider but firm gap may not.

Self-checking is a starting point, not a diagnosis. If you suspect diastasis recti, a referral to a women's health physiotherapist for a proper assessment is the right next step. Physiotherapists can provide exercises specific to your degree of separation and advise on what to avoid. Certain movements, including traditional crunches and heavy lifting with breath-holding, can worsen the condition if done before adequate rehabilitation.

Returning to exercise

When can I start running after giving birth?

Most guidance recommends waiting at least 3 months before returning to running or high-impact exercise. Starting with low-impact walking and pelvic floor exercises first, then progressing gradually with a women's health physiotherapist if possible.

A staged return to exercise is the evidence-based approach. The general framework looks like this:

These are guidelines, not guarantees. Some people are ready for higher-impact work earlier; others need more time. A women's health physiotherapist can assess your readiness individually, which is particularly useful if you have a specific goal such as returning to running or a sport.

Signs that you are progressing too quickly include pelvic heaviness or pressure during or after exercise, urinary leakage, lower back or pelvic girdle pain, or abdominal coning (a ridge or dome shape along the midline during exertion). If any of these appear, scaling back and seeking assessment is sensible.

Emotional wellbeing beyond the early weeks

The "baby blues", which typically involve tearfulness, mood swings, and emotional sensitivity in the first week or two after birth, resolve on their own as hormone levels stabilise. What does not resolve on its own in the same way is postnatal depression (PND).

PND can begin at any point in the first year after birth, not just in the immediate postpartum period. It is characterised by persistent low mood, loss of interest or pleasure, sleep disruption beyond what is explained by infant waking, difficulty bonding, anxiety, and sometimes intrusive thoughts. It is common, affecting roughly one in seven mothers, and it responds well to treatment including talking therapies and, where appropriate, medication that is compatible with breastfeeding.

If you felt well at six weeks but notice mood changes in weeks 8 to 12 or beyond, that is worth raising with your GP. You do not need to wait until a scheduled appointment: you can call and request to be seen. Postnatal anxiety, which can present without a low mood, is equally important to acknowledge and treat.

Partners and co-parents can also experience postnatal depression. If someone in your household is struggling, the same advice applies: contact a GP.

Cervical screening

Pregnancy and the postpartum period can mean routine health checks get deferred. If a cervical screening (smear test) was due during pregnancy or is overdue, the six-week check or a separate appointment in the weeks after is a good time to schedule it. Most clinicians recommend waiting until at least twelve weeks after birth before taking a smear, as the cervix is still returning to its usual state in the earlier weeks. If you are unsure whether a smear is due, your GP surgery or health visitor can check.

Contraception and fertility after birth

Can I get pregnant again before my period returns?

Yes. Ovulation can occur before the first postpartum period, so pregnancy is possible even without a visible menstrual cycle. Breastfeeding reduces but does not eliminate the chance of ovulation. Contraception is worth discussing at the six-week check if you do not want to conceive again soon.

Breastfeeding does suppress ovulation through the lactational amenorrhoea mechanism (LAM), but for LAM to be reliably effective as a contraceptive method, three conditions must all be met: the baby must be under six months old, periods must not have returned, and the baby must be exclusively breastfed with no long gaps between feeds, including at night. When any of these conditions change, another form of contraception is needed.

Contraceptive options suitable for the postpartum period include:

If contraception was not discussed at the six-week check, or if circumstances have changed since then, it is worth raising with a GP or sexual health clinic.

When to seek medical attention

Most of what happens in weeks 6 to 12 is a continuation of normal recovery. The following are signs that warrant a call to a midwife, GP, or in urgent situations, an emergency service:

This period of recovery, though often quietly demanding, does not have to be managed alone or in silence. Raising concerns at appointments, asking for physiotherapy referrals, and seeking help for mood are all appropriate uses of postnatal care.

Common questions

When does postpartum hair loss start?

Hair loss typically begins around 3 to 4 months after birth, as hair that remained in the growing phase during pregnancy enters the shedding phase together. It usually resolves within 6 to 12 months and does not lead to permanent thinning for most people.

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