When your baby has been born
Possible experiences or symptoms after birth
Experiences immediately after birth
After you give birth, it is expected that you will experience some things which may be new for you. You may experience pain, some different emotions, or other physical symptoms.
Most women will experience an element of pain or discomfort after giving birth. Even without any injuries, your uterus (womb) needs to contract back to its original shape and size. This is often experienced as a cramping sensation, often described as being similar to period pains. You may also experience pain due to bruising, or injury to your perineum.
Bleeding is normal following birth, and it is called lochia. Normally, the bleeding stops by the time you are 12 weeks postpartum and may be quite heavy at first. However, some women will experience significant bleeding after birth (Post partum haemorrhage), this is usually within the first 24 hours but can be in the weeks following birth. If you are frequently soaking through pads or passing clots it is important to seek help for some advice.
You may feel lots of emotions such as anxiety and may feel exhausted after giving birth. You may also feel anxious or down during the first week. This is normal and it shouldn’t last more than 2 weeks. If it does last longer, this could be a sign of postnatal depression. If you are concerned, it is important that you seek help from your midwife or GP.
Depending upon how your labour has been, you may experience other physical symptoms. One of these symptoms is urinary incontinence. This is where you accidently urinate. This can be because of the birth or a tear. Some women will experience the opposite and find they struggle to voluntarily urinate postpartum. This is more likely if you have had an assisted birth, prolonged labour, or an epidural.
Pelvic floor injuries
Pelvic floor injuries can be quite common following labour. They can be grazes right through to more serious perineal tears involving your anus and rectum.
When there is an injury just to the skin, stitches are not generally needed (1st degree tears).
When there is injury to the perineal muscles, but not the muscles around your anus, stitches will be needed. (2nd degree tears)
The most serious tears are when there is an injury that includes your anus, or your rectum. These will need stitches and antibiotics. (3rd and 4th degree tears)
After a pelvic floor injury, you may experience some symptoms in that area. These may include, pain, a change in sensation, infection and your wound breaking down. If you have an infection, you may require antibiotics.
Some women will also experience bladder and bowel issues. This may involve pain or accidentally urinating or opening your bowels when you didn’t intend to. This may be short lived for some women and they may only temporarily experience this. In women who have sustained the most serious tears (third and fourth degree tears), 60-80 in 100 women have no symptoms 12 months postpartum.
Around 49 per 100 women who experience urinary incontinence after a vaginal birth will still be experiencing this a year later. If required you will be managed by a specialist team of doctors and supported by them, specialist midwives and physiotherapists.
Some women may also have problems with their mental health following a perineal tear. This can be for lots of reasons, even if they don’t experience things such as urinary or faecal incontinence. A tear like this could interfere with a woman’s body image, self-esteem, intimate relationships, and bodily functions. Therefore, feeling emotions related to this can be anticipated and if you would like to receive help for this, please do contact your GP, health visitor or midwife.
Experiences after birth references:
Murphy DJ, Strachan BK, Bahl R, on behalf of the Royal College of Obstetricians Gynaecologists. Assisted Vaginal Birth. BJOG 2020;127:e70–e112.
Intrapartum care. NICE guidelines Published September 29, 2023. Accessed October 18, 2023. https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#planning-place-of-birth
Early days. nhs.uk. Published December 8, 2020. Accessed November 20, 2023. https://www.nhs.uk/pregnancy/labour-and-birth/after-the-birth/early-days/
Urinary retention. NICE. Accessed November 20, 2023. https://www.nice.org.uk/bnf-uk-only
Fernado RJ, Sultan AH, et al on behalf of the Royal College of Obstetricians and Gynaecologists. The Management of Third-and-Fourth-Degree Perineal Tears. BJOG 2015
Pelvic floor injury references:
Intrapartum care. NICE guidelines Published September 29, 2023. Accessed October 18, 2023. https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#planning-place-of-birth
Episiotomy. Royal College of Obstetricians and Gynaecologists. https://www.rcog.org.uk/for-the-public/perineal-tears-and-episiotomies-in-childbirth/episiotomy/
Assisted vaginal birth (ventouse or forceps). Royal College of Obstetricians and Gynaecologists. https://www.rcog.org.uk/for-the-public/browse-our-patient-information/assisted-vaginal-birth-ventouse-or-forceps/
Caesarean birth. NICE guidelines. Published March 31, 2021. Accessed October 20, 2023. https://www.nice.org.uk/guidance/ng192
Urinary retention. NICE. Accessed November 20, 2023. https://www.nice.org.uk/bnf-uk-only
Postnatal care | Guidance | NICE. Published April 20, 2021. Accessed November 24, 2023. https://www.nice.org.uk/guidance/ng194
Pelvic floor dysfunction: prevention and non-surgical management | Guidance | NICE. Published December 9, 2021. Accessed November 24, 2023. https://www.nice.org.uk/guidance/ng210/chapter/Recommendations
Murphy DJ, Strachan BK, Bahl R, on behalf of the Royal College of Obstetricians Gynaecologists. Assisted Vaginal Birth. BJOG 2020;127:e70–e112.
Fernado RJ, Sultan AH, et al on behalf of the Royal College of Obstetricians and Gynaecologists. The Management of Third-and-Fourth-Degree Perineal Tears. BJOG 2015
