So...I Just Had a Baby - Now What?

Congratulations! What Comes Next in Your Postpartum Journey?

Congratulations! You did it! You carried and nurtured life for nine months, bringing a brand-new little human into the world. That is nothing short of miraculous! While the focus naturally shifts to your newborn, you might be wondering—what about you? What happens to your body now that pregnancy and childbirth are behind you?

The truth is, your body is still undergoing an incredible transformation. Pregnancy affects nearly every major physiological system—your hormones, cardiovascular function, musculoskeletal structure, digestion, and, of course, your reproductive health. But here’s what many don’t talk about: childbirth is not the end of these changes; it’s the beginning of a whole new chapter—postpartum recovery.

This phase is just as important as pregnancy itself, yet it’s often overlooked. Your body needs time, care, and the right support to heal, adapt, and regain strength. Whether you had a vaginal birth or a C-section, whether this is your first baby or your third, your postpartum journey is unique—and so is what your body needs during this time.

So, what exactly happens next? How can you support your recovery while adjusting to life with a newborn? Let’s dive into what you can expect from your body postpartum and how pelvic floor physical therapy can play a crucial role in your healing process.

Understanding the Postpartum Period

The postpartum period, often referred to as the fourth trimester, extends up to 12 months after birth, with the most dramatic physiological changes occurring within the first six to eight weeks. During this time, your body is in overdrive, working to heal, regulate hormone levels, and adapt to life after pregnancy. Contrary to the common belief that everything “snaps back” to its pre-pregnancy state, the reality is far more complex. Some organs, such as the uterus, gradually shrink back to their pre-pregnancy size (a process called involution), but others, like the abdominal muscles and pelvic floor, may take longer to recover—and sometimes never fully return to their pre-pregnancy form.

Additionally, postpartum recovery is highly individual. Factors like the type of delivery (vaginal vs. C-section), complications during birth, pre-existing health conditions, and even emotional well-being all play a role in how your body heals. Research shows that up to 60% of postpartum women experience some form of pelvic floor dysfunction (such as incontinence, prolapse, or pain), while about 30% still report diastasis recti (abdominal separation) at one year postpartum. This highlights the importance of postpartum care, including pelvic floor physical therapy, core rehabilitation, and overall body awareness.

Rather than striving for a quick return to pre-pregnancy shape, the focus should be on healing, strength, and functionality—ensuring your body recovers in a way that supports your long-term health and well-being.

The Fourth Trimester: A Critical Time for Recovery

The first 12 weeks postpartum, known as the fourth trimester, are a crucial time of recovery for both mother and baby. As your baby adapts to life outside the womb, your body is also undergoing major changes—healing from childbirth, adjusting hormonally, and regaining strength.

Physically, your uterus contracts back to its pre-pregnancy size, while hormonal shifts impact mood, energy, and milk production. Up to 80% of new moms experience the “baby blues,” and 1 in 7 may develop postpartum depression or anxiety, making emotional well-being just as important as physical healing.

This period is also key for bonding with your baby through skin-to-skin contact and responsive feeding. Prioritizing rest, nutrition, and recovery can support your healing, and pelvic floor physical therapy can help address postpartum pain, incontinence, or core weakness.

By recognizing the importance of the fourth trimester, new mothers can approach this time with care and patience, laying the foundation for long-term well-being.

Postpartum Changes & Considerations

The postpartum period brings significant physical and emotional changes as your body heals and adjusts to life after childbirth. Understanding these changes can help you navigate the recovery process with care and patience.

Anatomy & Physiology Adjustments

• Over-Lengthened Abdominal Muscles & Diastasis Recti:

  Your abdominal muscles stretch to make room for the baby, which can lead to over-lengthening and a condition called diastasis recti, where the abdominal muscles separate. This affects about 30-60% of postpartum individuals, making core strength and stability challenging.

• Postural Shifts:

  Pregnancy shifts your body’s center of gravity, causing changes in posture. The added weight in the front often leads to an exaggerated spine curve and pelvic tilt, which can result in back and neck pain.

• Fatigue:

  Healing while managing sleepless nights and caring for a newborn can leave you feeling exhausted. This fatigue can affect your physical recovery and energy levels, so it's important to rest when possible.

Immediate Postpartum Considerations

• Tissue Healing:

  It takes 6-8 weeks for tissue healing to progress, including skin regrowth and collagen formation. For C-section deliveries, healing involves both the incision site and deeper abdominal layers.

• Neuromuscular Control:

  After childbirth, your body needs to retrain muscles in the core and pelvic floor to restore stability and function. This process is key to regaining strength and preventing injury.

• Hormonal Changes:

  Hormonal shifts after childbirth impact mood, energy, and tissue recovery. Hormones like relaxin continue to affect joint stability, and breastfeeding influences oxytocin and prolactin, which help with milk production and bonding.

  
  

Postpartum recovery is a gradual process that takes time and patience. Giving your body the care it needs is crucial to healing and rebuilding strength. Take it one step at a time and seek support as you navigate this new phase.

Movement & Posture with Childcare

Good posture is important, but perfection isn’t necessary! The goal is to avoid prolonged taxing positions to minimize discomfort. Here are some simple adjustments:

• Pair “forward” movements with “backward” movements:

  • After diapering/bathing your baby → Perform scapular retractions and cervical retractions.

  • While feeding your baby → Look at your baby, then look up and roll your shoulders.

• Follow seated tasks with hip or spine extensions:

  • After sitting to feed → Stand and gently extend your spine.

• Alternate feeding positions:

  • Sitting, side-lying (with proper pillow/towel support for a neutral spine), or standing with infant carrier support.

  • Use pillows to bring baby to the breast to prevent wrist and neck strain.

• Carry baby and supplies mindfully:

  • Maintain neutral wrist positioning to prevent carpal tunnel symptoms.

Returning to Activity

After childbirth, rebuilding core strength is essential, but it’s important to approach recovery in a progressive, safe manner. The first step is neuromuscular re-education for the core, which focuses on retraining the deep abdominal muscles to engage properly. Start with abdominal bracing exercises, where you gently engage the muscles of the abdomen and pelvic floor while exhaling. This helps restore core stability, which is crucial after the changes pregnancy and childbirth bring to your body.

As you progress, the goal is to engage the deep core muscles with each movement, starting with low-impact exercises before gradually advancing to more challenging ones.

However, before jumping into any core strengthening exercises, it’s important to keep in mind some key precautions. A standard gynecologist clearance at 6 weeks postpartum may not fully address all the nuances of your recovery. The American College of Obstetricians and Gynecologists (ACOG) now recommends a check-up at 3 weeks postpartum, followed by a more comprehensive visit at 12 weeks. Additional visits may also be necessary depending on your individual recovery and any concerns. This ensures you’re strengthening your body safely and addressing any underlying issues. (Source: ACOG)

This gradual approach helps prevent injury and supports a smooth return to fitness while nurturing the body’s recovery process.

Mental Health Matters

Postpartum recovery isn’t just about healing your body; it’s equally about healing your mind and emotions. The hormonal shifts, sleep deprivation, and overwhelming responsibilities of caring for a newborn can take a toll on your mental health. Many new parents experience mood swings, anxiety, or even feelings of sadness. However, if you’re feeling persistently hopeless, overwhelmed, or disconnected for more than 10 days after childbirth, it’s essential to reach out to a healthcare provider. Conditions like postpartum depression (PPD) affect about 1 in 7 new mothers and can be managed with the right support. Emotional well-being is just as important as physical recovery, so don’t hesitate to seek help—your mental health matters just as much as your physical health.

Ready to Prioritize Your Postpartum Recovery?

Pelvic floor physical therapy can help you navigate postpartum changes, regain strength, and prevent long-term dysfunction. At COPE PT, we specialize in postpartum recovery and are here to support you every step of the way.

Schedule your appointment today at www.copept.com!