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A new mother may resume normal daily activities when she feels ready. Eating a healthy diet and exercising regularly can help a new mother return to her prepregnancy weight.

She may resume sexual intercourse as soon as she desires it and it is comfortable. If delivery caused tearing or an episiotomy was done, sexual intercourse should be delayed until the area heals. A new mother may take showers or baths shortly after delivery, unless delivery was by cesarean.

If delivery was cesarean, nothing, including tampons and douches, should be put in the vagina for at least 2 weeks. Strenuous activity and heavy lifting should be avoided for about 6 weeks. Intercourse should also be avoided for 6 weeks. The incision site should be cared for in the same way as other surgical incisions. Showering can typically be resumed 24 hours after surgery. Care should be taken not to scrub the incision site. Baths should be avoided until the wound is completely closed and any staples or sutures have been removed. The incision site should be kept clean and dry. Any evidence of increasing redness or drainage from the incision should be brought to the doctor's attention. Pain around the incision site can last for a few months, and numbness can last even longer.

Abdomen: The uterus, still enlarged, continues to contract for some time, becoming progressively smaller during the next 2 weeks. These contractions are irregular and often painful. Contractions are intensified by breastfeeding. Breastfeeding triggers the production of the hormone oxytocin Some Trade Names
PITOCIN
. Oxytocin Some Trade Names
PITOCIN
stimulates the flow of milk (called the let-down reflex) and uterine contractions.

Normally, after 5 to 7 days, the uterus is firm and no longer tender but is still somewhat enlarged, extending to halfway between the pubic bone and the navel. By 2 weeks after delivery, the uterus returns close to its normal size. However, the new mother's abdomen does not become as flat as it was before the pregnancy for several months, even if she exercises.

Stretch marks do not go away, but they may fade, but sometimes not for a year.

Did You Know... Women can become pregnant as early as 2 weeks after having a baby.

Breastfeeding: Doctors recommend breastfeeding for at least 6 months, but some mothers cannot breastfeed or may not want to for various reasons. Bottle-feeding can be done instead (see Newborns and Infants: Feeding).

Mothers who are breastfeeding need to learn how to position the baby during feeding (see Newborns and Infants: Positioning a Baby to Breastfeed). If the baby is not positioned well, the mother's nipples may become sore and cracked. Sometimes the baby draws in its lower lip and sucks it, irritating the nipple. In such cases, the mother can ease the baby's lip out of its mouth with her thumb. After a feeding, she should let the milk dry naturally on the nipples rather than wipe or wash them. If she wishes, she can dry her nipples with a hair dryer set on low. In very dry climates, hypoallergenic lanolin or ointment can be applied to the nipples.

When a mother breastfeeds, the breasts may leak milk. Pads can be worn to absorb the milk, but plastic bra liners can irritate the nipples and should be not be used.

While breastfeeding, women need to increase their caloric intake by about 500 calories per day. The intake of most vitamins and minerals should also be increased. Most women can accomplish this by eating a well-balanced diet, including adequate dairy and green, leafy vegetables and continuing to take their prenatal vitamin with additional folate (1 milligram). Appropriate fluid intake is needed to ensure adequate milk supply. Vegetarians or women on special diets should consult their physician about the need for other vitamin and mineral supplements, such as B₁₂ for vegetarian mothers.

Family Planning: Use of contraceptives is recommended when intercourse resumes because pregnancy is possible as soon as the mother begins to release an egg from the ovary (ovulate) again. Mothers who are not breastfeeding usually begin to ovulate again about 4 to 6 weeks after delivery, before their first period. However, ovulation can occur earlier. Mothers who are solely breastfeeding tend to start ovulating and menstruating somewhat later, closer to 6 months after delivery. The interval depends on how much food other than breast milk the baby consumes. If more than four fifths of the baby's food is breast milk, ovulation is unlikely to occur. Occasionally, a mother who is breastfeeding ovulates, menstruates, and becomes pregnant as quickly as a mother who is not breastfeeding.

Full recovery after pregnancy takes about 1 to 2 years. So doctors usually advise a new mother to wait at least one year and optimally 18 months before becoming pregnant again (although she may choose not to follow that advice). At her first doctor's appointment after delivery, a new mother can discuss contraceptive options (see Family Planning: Contraception) with her doctor and choose one that suits her situation. Whether a mother is breastfeeding affects the method of contraception used. Oral contraceptives that contain estrogen and progesterone Some Trade Names
CRINONEENDOMETRIN
can interfere with milk production and should not be used until milk production is well established. Progesterone Some Trade Names
CRINONEENDOMETRIN
-only contraceptives can be used, but methods that do not use drugs (such as barrier contraceptives) are even better. A diaphragm can be fitted only after the uterus has returned to normal, usually after about 6 to 8 weeks. Before that, foams, jellies, and condoms can be used. Intrauterine devices can be inserted about 6 weeks after pregnancy.

A new mother (or any woman) who has just been vaccinated against German measles (rubella) must wait at least 1 month before becoming pregnant again to avoid endangering the fetus.

After Delivery: When to Call the Doctor Area Symptoms Possible Cause Discharge If blood soaks a sanitary pad every hour for more than 2 hours If the discharge smells foul If the discharge contains very large clots (larger than a golf ball) Infection of the uterus Temperature If the temperature is 100.4° F (38° C) or higher at any time during the first week Infection Urination If urination hurts (not just stings) If the bladder cannot be emptied completely If urination occurs much more frequently than usual Urinary tract infection Lower abdomen If pain or discomfort is felt in the lower abdomen (above the pubic area) after the first 5 days Infection of the uterus or bladder Back If pain is felt in the back or side just under the rib cage, particularly if fever is also present or urination is painful Kidney infection Breast If a firm lump is felt in the breast after engorgement has subsided A blocked milk duct If the breast is painful, swollen, or red or feels hot or tender Breast infection Mood If a very sad mood with fatigue and lack of energy lasts more than 2 weeks Postpartum depression Incision from a cesarean section If soreness increases If this area turns red or becomes swollen or hard to the touch If there is any discharge from the incision Wound infection Leg or chest If the leg is swollen or painful If a new mother has sudden, sharp chest pain or chest pain that worsens when she inhales If breathing becomes difficult A blood clot in the leg or lungs General If a new mother feels light-headed, faints, or has shortness of breath. A blood clot in the lungs

Last full review/revision November 2008 by Julie S. Moldenhauer, MD