Postpartum – The First Few Weeks After Birth

The first few weeks after childbirth—the postpartum period—are an intense time. Your body is recovering, your life is readjusting, and all of this is happening while you’re getting very little sleep. Be kind to yourself during this phase. You don’t have to “prove” anything or do everything on your own: Your midwife will support you at home, and we’ll see you again for your follow-up visit—or sooner if needed. Here you’ll learn what’s normal during the postpartum period, what we’ll be monitoring, and where you can find support.

How Your Body Recovers

Over the first six weeks or so, many things gradually return to their pre-pregnancy state. The uterus contracts again, which may initially be felt as afterpains—especially while breastfeeding. Over several weeks, lochia (postpartum discharge) flows out, slowly changing color from red to yellowish-white. Any perineal tears or the C-section scar will heal during this time, and about three days after birth, milk production really gets going with the onset of let-down. Your pelvic floor, which was put under a lot of strain during childbirth, also needs time and targeted postpartum exercises to regain its strength. Make sure to get plenty of rest—an afternoon nap is definitely part of that.

The midwife supports you at home

After you’re discharged from the hospital, you’re not on your own: a midwife of your choice will visit you at home. She’ll support you with breastfeeding and caring for your baby, monitor your postpartum recovery and healing, and keep an eye on your well-being. These home visits are covered by your basic health insurance. Take advantage of this support—especially with your first child, the midwife’s advice is worth its weight in gold.

Baby Blues and Postpartum Depression

The days following childbirth are an emotional roller coaster. Around the third to fifth day, many women suddenly feel sad, irritable, or find themselves crying over minor things—this is known as the “baby blues.” It’s related to hormonal changes, is completely normal, and goes away on its own within about two weeks.

The situation is different if the low mood persists longer, becomes more severe, or is accompanied by anxiety, exhaustion, and the feeling that you can’t cope with the situation. In that case, postpartum depression may be the underlying cause. It’s common—about one in seven mothers is affected—it’s not a sign of weakness or failure, and it responds well to treatment. Your midwife will monitor this during the postpartum period (often using a short questionnaire, the Edinburgh Scale), and we are also available to talk to you at any time. Please don’t hesitate to reach out—the sooner you get support, the faster you’ll start feeling better. You and your child deserve it.

Follow-up Visits

About six to eight weeks after giving birth, we’ll see you at the practice for a final checkup. During this visit, we’ll check that your body is recovering well, perform a Pap smear if appropriate, and discuss birth control for the time ahead (more on this → “Birth Control”).

Depending on how your pregnancy progressed, targeted follow-up visits may be scheduled:

• If you had gestational diabetes, we’ll use another oral glucose tolerance test (oGTT) four to twelve weeks after delivery to check whether your blood sugar levels have returned to normal; after that, regular long-term monitoring (SGGG) is recommended (more on this → “Gestational Diabetes”).
• If you had gestational hypertension or preeclampsia, we’ll monitor your blood pressure—it can still fluctuate even after delivery—and ensure you receive the necessary follow-up care.
• In case of anemia: If you lost a lot of blood during childbirth or already had an iron deficiency beforehand, we’ll treat it with iron tablets or, if necessary, an iron infusion.

Breastfeeding—and When Things Don’t Go as Planned

Breast milk is your child’s natural source of nutrition; the WHO recommends exclusive breastfeeding for the first six months or so (WHO). However, breastfeeding takes practice and doesn’t go smoothly for every woman right from the start—sore nipples, engorgement, or simply feeling unsure are all part of the process. Your midwife and, if needed, a lactation consultant can help you with this.

Equally important to us is this: Breastfeeding is not a must. If it doesn’t work out despite support, or if you decide against it, formula (infant milk) is a safe and good alternative—your child will thrive just as well on it. What matters is a well-fed, loved infant and a mother who is doing well. If you’d like to wean your baby, we’ll gently guide you through the process together with your outpatient midwife; if you need your milk supply to dry up quickly, a medication (cabergoline) can stop milk production. This decision is yours to make—without pressure and without feeling guilty.

When You Should Contact Us Immediately

Most issues during the postpartum period are harmless. However, please contact us, your midwife, or the hospital immediately if you notice any of the following signs:

• heavy bleeding or a sudden increase in bleeding, or foul-smelling lochia;
• fever, chills, or a general feeling of illness;
• a red, painful, and warm breast accompanied by a fever (a sign of mastitis);
• severe headaches, vision problems, or upper abdominal pain (preeclampsia is still possible even after childbirth);
• a swollen, painful leg or sudden shortness of breath (a sign of a blood clot).

And if you’re feeling emotionally overwhelmed or have thoughts of harming yourself or your child: Don’t wait—get help immediately—from us, your midwife, or an emergency service. You’re not alone in this.

Be kind to yourself

The postpartum period is not a time when you have to “function” as usual. Seek help, accept support, and give yourself and your baby time to get to know each other. We and your midwife are here for you.