After birth, the uterus immediately begins contracting to return to its pre-pregnancy size. During pregnancy, it has stretched from a small, pear-sized organ to accommodate a full-term baby. This process begins the moment the placenta is delivered. These contractions reduce bleeding and are essential for healing. The postpartum bleeding is called lochia and consists of blood, mucus, and leftover tissue from pregnancy.

In the first hours after birth, the midwife monitors your bleeding closely. It is normal for the bleeding to be heavy at first — similar to a strong menstrual flow — but the amount should gradually decrease. Contractions may feel like afterpains, especially during breastfeeding, because oxytocin is released and strengthens uterine activity.

In the first few days, lochia is bright red to brownish. Over time, it becomes lighter, turning yellowish or whitish after about a week. It may come in waves, especially when you stand up, breastfeed, or move more. This variation is normal as the body clears remaining material.

You should contact healthcare if bleeding suddenly increases, if large clots continue after the first day, if you develop fever, foul-smelling discharge, weakness, or dizziness.

The uterus usually returns to near-normal size within six weeks, although the experience varies from person to person.

Alma’s tips

• A warm pack on the lower abdomen can ease afterpains.

• Paracetamol and ibuprofen are first-line options for postpartum pain relief and can be taken regularly according to recommended dosing.

• Breastfeeding increases contractions — this is normal and supports healing.

• Rest as often as possible; your body is using a great deal of energy to recover.

• Seek medical care if you develop fever, increasing pain, foul-smelling discharge, or heavy bleeding.