New mom health: The Optum Store Guide

The week after delivery is especially tough: Your body is recovering from the physical effects of giving birth. The first days of motherhood can also be a roller coaster of emotions. There’s the joy and excitement of meeting your baby, as well as anxiety and fear over your new responsibilities. To top it off, there are significant hormone changes that can trigger major mood swings.

It’s a lot.

What are the “baby blues”?

Estrogen and progesterone levels run high during pregnancy. “With the delivery of the placenta, also called the afterbirth, there’s a tremendous drop in these hormones. That’s what initiates the moodiness, tearfulness and so forth,” says Maureen Whelihan, MD. She’s a board-certified obstetrician-gynecologist in Greenacres, Florida.

The dip in estrogen and progesterone immediately after delivery can contribute to the “baby blues.” This short-lasting condition affects up to 70% of new moms, according to the American Psychiatric Association. Symptoms generally go away on their own after 1 to 2 weeks and may include:

• Crying for no reason
• Irritability
• Restlessness
• Anxiety

What is postpartum vaginal discharge?

After delivery, your body begins to shed blood cells and the mucus membrane that lined the uterus during pregnancy. Typically, the discharge (called lochia) is dark red in color for the first 3 days after you deliver. The discharge eventually turns pinkish and brownish and finally creamy and yellowish. You may notice more discharge in the morning or during physical activity or breastfeeding.

Wear pads, not tampons, to catch the discharge. Nothing should go into your vagina for 6 weeks while you recover, according to the Cleveland Clinic.

You’ll probably go through at least a couple of pads per day. But if you go through more than a pad per hour, you need to call your doctor, says Christine Carlan Greves, MD. She is a board-certified obstetrician-gynecologist at the Winnie Palmer Hospital for Women & Babies in Orlando, Florida.

Don’t be alarmed if you notice a few small blood clots. But call your health care provider if you see large blood clots (larger than a plum) or bright red discharge that continues beyond the third day.

What are postpartum uterine contractions?

Contractions continue after delivery. This is a side effect of your uterus returning to its pre-pregnancy size, according to Dr. Whelihan. It’s normal but can be uncomfortable.

To relieve discomfort, try:

• Lying on your stomach with a pillow under your lower abdomen
• Taking a walk
• Taking pain medication as recommended by your health care provider
• Taking a sitz bath
• Using a heating pad on your abdomen

Things might still feel like a blur, but you should be getting used to your baby’s rhythms. By now, you’re a pro at changing diapers and burping. The intense pain from your episiotomy is easing and feeding feels like second nature. But you should definitely check in on your mood at the 4-week mark. Routine baby blues should be lifting, but if not, you should tell your doctor.

What is postpartum depression?

If you’re feeling sad, anxious or depressed, you might have postpartum depression.

Postpartum depression is more than just the baby blues. It’s a serious but treatable mental illness that carries risks for the mother and child. It gets in the way of daily life and may last for months or more.

Postpartum mood changes can be more pronounced in moms who have an underlying mood disorder. If you received treatment for a mood disorder before you were pregnant, or you think you may need help coping with the emotional challenges of caring for a new baby, talk to your doctor about starting treatment right after delivery.

“When we know someone has a mood disorder, we’re proactive in beginning antidepressants on the day they deliver just to try to counteract some of the mood symptoms associated with the hormone drops,” Dr. Whelihan says.

About 1 in 7 women experience postpartum depression, according to the American College of Obstetricians and Gynecologists. Any new mom can develop it, but women with a history of depression or other mood disorders face a greater risk.

Women who had a traumatic birth experience or don’t have a partner or family to support them are also more likely to struggle with postpartum depression, according to certified therapist Jessica Sorci. She specializes in treating mental health issues in pregnant and postpartum women at Family Tree Wellness in Campbell, California.

Symptoms of postpartum depression can include:

• Feeling sad or depressed
• Changes in appetite
• Trouble sleeping or sleeping too much
• Increased fatigue
• Feeling worthless or guilty
• Thoughts of death or suicide
• Trouble thinking, concentrating or making decisions
• Lack of interest in the baby
• Fear of harming the baby or yourself
• Excessive crying
• Difficulty bonding with the baby
• Intense irritability
• Hopelessness

Postpartum depression is serious. Contact your doctor immediately if you experience several of the symptoms above for more than 2 weeks, you have thoughts of suicide or of hurting your baby, your depression gets worse, or you have trouble with daily tasks or caring for your baby. (Read more about postpartum depression here.)

Many of the problems you’ve experienced over the past 6 weeks will start going away. The vaginal discharge, incontinence and uterine contractions should stop, and the baby blues should be long gone. Six weeks is also about how long it takes to develop a regular routine for you and your baby. Expect things to improve from this point forward.

When will my period come back after I give birth?

If you’re breastfeeding, you may not get your period until after your baby weans from the breast. If you’re bottle-feeding, you’ll likely get your first period 6 to 12 weeks after delivery.

But be aware that you can still get pregnant during this time, so you have to be careful about having unprotected sex. Ask your doctor about birth control options at your 6-week checkup. You’ll want to steer clear of combination birth control pills (these contain estrogen and a progestin) if you’re breastfeeding, Dr. Carlan Greves says. These can reduce your milk supply.

Will I still feel moody?

Hopefully, your baby blues are gone now that your hormones have leveled out. But if you don’t feel like yourself, your doctor can refer you to a mental health professional. Seeing a general therapist, psychologist or social worker can help. You can also seek out a therapist who’s been certified as a perinatal mental health professional by Postpartum Support International (PSI). You might also consider joining a local social support group centered on a new mom’s emotional well-being.

When is it okay to start exercising again?

The 6-week checkup is a good time to ask your doctor about returning to your regular workouts. By now, your abdominal muscles should have healed and returned to their normal size and strength (even if you had a cesarean section), according to Dr. Whelihan. This makes some forms of exercise safer and more doable than before. It may be fine to do light weights, yoga, cycling or other workouts. Just make sure to clear any exercise with your OB-GYN first.

Why is my hair falling out?

High hormone levels during pregnancy cause hair to grow faster than it sheds. This means your hair may have been extra thick while you were expecting. If it seems like you’re losing more hair now, that’s normal. It’s called excessive hair shedding and is caused by a dip in your estrogen levels, says the American Academy of Dermatology. It’s usually temporary. (Read more about female hair loss here.)

This is the point when new moms start to feel like themselves, says Dr. Whelihan. You may have lost some of the weight you gained during pregnancy. Your hair is starting to regrow. And you might even feel interested in having sex again. “There can be vaginal dryness if you’re still breastfeeding, but it’s manageable,” Dr. Whelihan says. As long as you’re healed up, using a lubricating gel during intercourse can help.

And by your baby’s 6-month birthday, you should hit your stride. Your hormone levels will have stabilized, and your hair is growing again. Your baby has personality. And your sex life may be getting back on track. If you’re still having any problems, talk to your doctor.

And take a moment to feel proud of all you’ve accomplished over the past 6 months. Getting your baby used to the world is more than a full-time job. And so is getting used to life as a new mom. You’re doing great.

Christine Carlan Greves, MD, board-certified obstetrician-gynecologist at the Winnie Palmer Hospital for Women & Babies in Orlando, Florida

Jessica Sorci, certified therapist who specializes in treating mental health issues in pregnant and postpartum women, Family Tree Wellness, Campbell, California

Maureen Whelihan, MD, board-certified obstetrician-gynecologist in Greenacres, Florida

Vaginal discharge: Cleveland Clinic (2018). “Pregnancy: Physical Changes After Delivery”
Baby blues statistic: American Psychiatric Association (2020). “What is Postpartum Depression?”
Postpartum depression statistic: American College of Obstetricians and Gynecologists (2018). “Screening for Perinatal Depression”
Stress incontinence: Cleveland Clinic (2020). “Urinary Incontinence”
Postpartum hair loss: American Academy of Dermatology (n.d.). “Hair Loss in New Moms”