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BASIS

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It's probably fair to say that your mates are not top of your partner's list of priorities when you first have a baby. To be honest, you'd be concerned if they were. But there's no denying that fatherhood affects your friendships. How much time you have for them, what you do, and even who your friends are.

Something in common with other dads

Well, let's face it, becoming a dad is quite a big thing. Possibly the single most ecstatically joyous, utterly terrifying thing you've ever experienced. Suddenly all those parenting conversations at work seem intensely interesting. How long does yours sleep for? You really use reusable nappies?

But remember, not all of your colleagues will be quite so fascinated by the relative merits of different swaddling techniques. After all, not so long ago, neither were you. In any case, you might find work a welcome distraction from the sheer intensity of parenthood. Or maybe you've decided to be the stay-at-home parent.

Whatever your role, the experience of being a first time parent can be overwhelming. Immense tenderness, vulnerability, frustration, pride and confusion - all on very little sleep.

We can all find it hard to talk about our feelings. But the first weeks and months of fatherhood are a great time change that.

"Whatever you're feeling, there's every chance that other new dads are feeling something similar."

"It's a heady mixture of elation, confusion, pride, love, terror and indescribable joy" John, dad to twins, Jennie and Janie, six months and Martha, four years
Many fathers are surprised by just how much having a baby gives them in common with other men. If you and your partner went to NCT classes, keeping up with the men you met can be a great way of talking about the emotional rollercoaster that is being a dad.

"Linking up with the other dads and hearing what they were concerned about was one of the best parts. We set up a WhatsApp group quickly, followed soon by a curry night. Support established." Nate, dad to Mindy, 11 months

Staying in touch

Try to stay in touch not just with your old mates but with your old way of life. Fatherhood can be all-consuming. A lot of men are happy for their new family-focused lifestyle to replace time spent with old friends. It is a new chapter, after all. And that might mean naturally bringing earlier chapters to a close.

But you might find it's worth the effort to keep in touch with non-parent friends, even if you don't see each other quite so often as before. Catching up with old mates for non-baby-related chat or some time on the pitch/court/track/yoga mat can provide important respite.

Just make sure you offer to take over the childcare in return, so your partner gets the same opportunity. Even a sleep-deprived evening out once in a while can be better than nothing - for both parents.

Social life? What social life?

Let's face it, however often you manage to catch up with friends - new or old - your leisure time is going to change. Whether you're the primary caregiver during the week or not, you might have to put regular, time intensive golf playing, music listening, footie watching, gym and gig going on hold.

"I had to give up a lot of the sport I played - golf and football, which was quite hard. But we spent lots of time together as a new family, going out to parks and cafes. There we met other families, which was really nice." Matt, dad to Sandy, five years and Etta, 19 months

If you've been out at work all week, think of the weekend as not only a time to get to know your baby better but to potentially meet other new dads. Whether by going to a local dads group in your area or simply hanging out as a family. Babies equal chats with friendly strangers in playgrounds, soft plays and even supermarkets. New friends needed? Go get 'em.

This page was last reviewed in December 2018.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Changing friendships and parenthood: the dad's perspective | Life as a parent articles & support | NCT

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It's probably fair to say that your mates are not top of your partner's list of priorities when you first have a baby. To be honest, you'd be concerned if they were. But there's no denying that fatherhood affects your friendships. How much time you have for them, what you do, and even who your friends are.

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Your relationship as a couple | Information and support on life as a parent | NCT

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What you need to know about the six-week check

About six weeks after you give birth, your baby should have a check-up with your GP and you should have a postnatal check-up appointment. This is often called the six-week check. Yours and your baby's check-ups might be combined but to allow enough time for you to discuss everything you want to; it's a good idea to book two separate appointments (NHS, 2018a).

In England, our #HiddenHalf campaign won funding for a dedicated six-week postnatal check for mums - so you should be offered a separate appointment to your baby. This is important to allow you the time and space to talk about your mental and physical health.

Your baby's six-week appointment is a chance for your GP to give your baby a check-up to make sure they're well. Your postnatal check-up is to see how you're doing after the birth and how you're feeling as a new mum.

Some GP surgeries don't routinely offer you a postnatal check-up so you might have to request it. If you have any worries or just want to ask a few questions, do give your surgery a call.

What happens at your six-week postnatal check?

What your six-week check involves can vary depending on your GP practice and how long your appointment is. The GP might do a physical examination if they think it's necessary.

Your GP is there to help you, not judge you. So try to remember it's ok to tell them about any worries and concerns you might have.

Unlike when they do your baby's checks, GPs have no set guidelines for what to discuss during your six-week postnatal check.

Here are some of the topics and checks that might be covered...

How you're feeling

You can discuss how you're feeling, any worries and your mental health and wellbeing. Your GP might consider your risk of postnatal depression and anxiety, including whether you've had any mental health concerns before.

Our research shows that half of postnatal mental illness isn't picked up, so if you have any concerns at all about your mental health, please do mention it. The earlier problems can be identified, the better, so try to bring up any worries you have, no matter how small you might think they are.

They might ask about your lifestyle too, such as what support you have at home or how well you're sleeping.

Bleeding after birth

After birth, you will experience some vaginal bleeding and your GP will normally ask about this. They'll also ask whether you've had a period since the birth. Read more about what you might expect to see in our article about bleeding after birth.

If you had an episiotomy, they might offer to check your stitches or ask how they're feeling (NHS, 2016b). If you have discomfort around your perineum (the part between your bum and vagina), your GP should check to make sure it's healing well (NHS, 2017a).

Your tummy

Your GP might feel your tummy to make sure your uterus has gone back into its old position. If you had a caesarean birth, your GP might offer to check your scar (NHS, 2016b).

Sex and contraception

At this point, it may well be the furthest thing from your mind but you can ask about sex after birth, if you'd like to.

Your GP will also probably ask you what contraception you now plan to use. Yes, you can get pregnant again pretty soon after birth! They can outline your options and give you a prescription if needed (NHS, 2017b).

Going to the toilet

Your GP might ask you about your toilet habits and if you leak any wee when you cough or laugh. Don't be embarrassed or worried if you do; incontinence after childbirth is common (Thom and Rortveit, 2010).

Pelvic floor exercises can really help with incontinence so ask your GP about them if you need information or tips.

Some women also find they fart or poo when they don't mean to after giving birth. Embarrassing as it may feel to talk to the doctor about this if you're experiencing it, do make sure you mention it to them (UCLA Health, 2018).

Your breasts and feeding

Your GP might ask you about how breastfeeding is going and whether you have any symptoms of anything like mastitis. They might be able to give you details about feeding support if you need any and might examine you if there's a problem with pain.

Legs

Your GP might ask about any varicose veins, swelling or any symptoms you're having with your legs that might suggest a blood clot.

Weight

If your BMI is 30 or more, your GP might ask to weigh you. They can advise you on healthy eating and postnatal exercise too.

Medical problems

If you had a medical problem when you were pregnant or if a previous issue got worse, your GP might give you a check-up to see how things are going. For example, your GP will normally check your blood pressure if you had problems during pregnancy or right after the birth (Guy's and St Thomas' NHS Foundation Trust, 2016). They will also do blood tests if needed, for example to check for anaemia

Rescheduling a smear test

If your smear test was due while you were pregnant, it can be rearranged for 12 weeks after you gave birth (NHS, 2018b).

This is your check

The six-week postnatal check is all about you so talk through anything you need to. You might find it useful to jot down some questions or points in advance (NHS, 2016a). That way nothing will slip your (probably sleep-deprived) mind.

Partners are welcome to come too so ask yours along if you'd like them to.
This page was last reviewed in May 2021.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Help us get postnatal mental illness out of hiding with our #HiddenHalf campaign. We're demanding dedicated postnatal check-ups so all new mothers can get the mental health support they need. Email your MP today and help us make this change.

You might also like to try one of our Mother and Baby Yoga courses, which aim to help improve your physical and emotional wellbeing, as well as feel more confident and positive.

Mind, a leading mental health charity, provides information on a range of mental health topics including postnatal depression and has an infoline for support: 0300 123 3393.

#PNDHour is an online peer support group that runs every Wednesday at 8pm via the Twitter account @PNDandMe. Anyone can join in to discuss topics about antenatal and postnatal depression, such as self-care, medication and seeking help. It's run by a mum called Rosey who also blogs about her own experiences with antenatal and postnatal depression, as well as raising awareness of perinatal mental illness, at PND and me.

The charity Tommy's has information about mental health in pregnancy as well as a Wellbeing Plan to help parents talk more openly about how they're feeling.

The Royal College of Psychiatrists has information on mental health in pregnancy.

Effective psychotherapeutic treatments can be found in your area. Check out the British Association for Counselling & Psychotherapy the United Kingdom Council for Psychotherapy (UKCP) and the British Psychoanalytic Council (BPC) for a list of recommended therapists.

Wellbeing Scotland or Niamh (in Northern Ireland) are leading providers of mental health information in their regions, for further information on PND.

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What happens at your 6-week check-up | Life as a parent articles & support | NCT

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You're emerging from the newborn fog and it's time to check in with your GP. Here's what happens in your six-week check.

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The Pregnancy and Post-birth Wellbeing Plan

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The Wellbeing Plan helps you start thinking about how you feel emotionally and what support you might need in your pregnancy and after the birth.

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Managing Your Mental Health during the Pandemic

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Managing Your Mental Health during the Pandemic

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What is sepsis?

Sepsis is a complication of a severe infection. When the immune system fights the infection, sepsis sees the body go too far and start to attack organs and other tissues.

When it occurs in pregnant women or within six weeks after giving birth, it's called maternal or postpartum sepsis (RCOG, 2012). Without quick treatment, sepsis can lead to multiple organ failure and death. It's a leading cause of maternal death in women in the UK (NHS Choices, 2016).

What are the symptoms of sepsis?

Early warning signs to look out for are:

High temperature (over 38.3°C)

Very low temperature (less than 36°C)

Chills and shivering

Fast heartbeat

Fast breathing or breathlessness

Headache

Severe abdominal pain

Extreme sleepiness
(MBRRACE-UK, 2017)

If you develop any of these symptoms, you or your family should seek medical advice or go to a maternity unit quickly (MBRRACE-UK, 2017).

Fever or rigors

Diarrhoea or vomiting

Rash

Abdominal or pelvic pain and tenderness

Abnormal vaginal discharge

Productive cough

Urinary symptoms

If you recently had an infection or injury and are showing signs of sepsis, seek medical advice urgently from NHS 911. If your symptoms are severe, go straight to A&E or call 999.

What causes sepsis?

It's impossible to know who will suffer from sepsis until it happens but risk factors for maternal and postpartum sepsis can be:

Obesity

Diabetes

Anaemia

Abnormal vaginal discharge

History of pelvic infection

History of group B streptococcal infection

History of invasive procedures

Prolonged length of time between water breaking and baby being born

Streptococcal infection in close contacts or family members

Black or other minority ethnic group origin

How is sepsis diagnosed?

If there is concern that you have sepsis, you'll most likely be given a blood test, but then tests can go further to uncover what type of sepsis you have, where it's located and which bodily functions have been affected. These can include urine or stool samples, a high vaginal swab, wound culture, X-ray and a number of other tests (NHS Choices, 2016).

What is the treatment for sepsis?

Severe sepsis or septic shock is a medical emergency. If sepsis is detected early and hasn't affected vital organs, it may be possible to treat the infection at home with antibiotics, leading to a full recovery.

Treatment will vary depending on the site and cause of the initial infection, the organs affected and the extent of any damage.

After hospital admission, treatment usually involves the 'sepsis six'. They should be started by a medical team within an hour of diagnosis. The sepsis six involve:

Giving fluids intravenously

Giving oxygen if levels are low

Giving antibiotics

Blood culture - to identify the type of bacteria causing sepsis

Blood sample - to assess the severity of sepsis

Monitoring urine output - to assess severity and kidney function
(NHS Choices, 2016)

Can maternal sepsis affect the baby?

Yes, sepsis can pass from the mother to the child before or during the birth, which is another reason to treat it so quickly and efficiently (MedlinePlus, 2018).

Is sepsis the same as septicaemia and blood poisoning?

Not quite. Neither term is entirely accurate because septicaemia (blood poisoning) refers to invasion of bacteria into the bloodstream. This occurs as part of sepsis.

Sepsis is not just limited to the blood and can affect the whole body, including the organs. Sepsis can also be caused by viral or fungal infections, although bacterial infections are by far the most common cause (NHS Choices, 2016).
This page was last reviewed in February 2018
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

If sepsis has affected you or someone close to you, you can contact the UK Sepsis Trust.

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Sepsis is a complication of a severe infection. When the immune system fights the infection, sepsis sees the body go too far and start to attack organs and other tissues. When it occurs in pregnant women or within six weeks after giving birth, it's called maternal or postpartum sepsis (RCOG, 2012).

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For all sorts of reasons, it might take a while to get back to your old sex life after having a baby. One study found that more than half of couples had started to have sex by eight weeks after birth, and more than three quarters of couples by 12 weeks (McDonald and Brown, 2013). Yet for many couples, it's closer to 12 months after their baby's birth that they're having sex as frequently as before the birth (Jawed-Wessel and Sevick, 2017).

So here are a few questions you could ask yourself to see whether you're ready to make that move...

1. Do I feel emotionally ready for sex?

This is pretty important. The timing is very much up to you. And it is common for new parents to find that tiredness and the responsibility of caring for a new baby mean they have less interest in sex.

A decline in sexual interest after the birth of a baby can be related to the drop in oestrogen that new mums experience (Hendrick et al, 1998). In fact, one study suggests this is a way of ensuring new mums do not become pregnant while caring for a new baby (Lorenz et al, 2019).

2. Am I worried that my partner wants to have sex?

If you aren't ready but your partner is, reassure them that you're not pushing them away. This is just a temporary situation while you get your head around the demands of a small human. It can take time for your body to recover from the birth.

Your partner's moves over to your side of the bed are likely because they still love and fancy you and want you to know it. But you should never feel under pressure to do anything you are not 100% ready for.

It might sound like a cliché but communication and a mutual understanding of each other's needs can help keep a loving relationship alive. You might also want to remind your partner that your focus on your baby doesn't take away from your love for them. That you're not pushing them away.

"There's no right or wrong time to start having sex again after you have had a baby. Don't rush into it. If sex hurts, it won't be pleasurable." (NHS, 2018a)

Sex is more likely if you make time to relax together. You're more likely to make love when your minds are on each other, rather than other things (NHS, 2018b).

3. Am I worried about my body?

If you gave birth, you might be thinking 'Will it feel different?' Worries around discomfort or becoming pregnant again are normal.

You might start by gently exploring your vagina to discover whether there is any pain or change (NHS, 2018b). You could then discuss the changes to your body with your partner and how you want to be touched.

Dryness might contribute to sex being painful, and lower oestrogen levels until your periods restart after childbirth are partly to blame (NHS, 2018a). But probably the most important reason for dryness is that you're exhausted and adapting to your post-birth body, so you're not sexually aroused enough to produce lubrication. You could use a lubricant and make sure you are fully aroused before sexual activity, and begin with oral or mutual masturbation (NHS, 2018b).

You could also grab a chat with your health visitor or GP to go through your questions about post-baby sex. If you experience any pain, see your GP (NHS, 2018a).

4. Am I rushing into post-baby sex because I'm worried I'll lose closeness with my partner?

If that's the case, there are plenty of other ways to maintain that bond. With everything from cuddling up in front of a film to doing anything else you fancy in bed that doesn't involve penetration.

5. How will the type of birth I had affect sex?

The type of birth you had can affect your feelings about sex (McDonald and Brown, 2013).

If you had an uncomplicated vaginal birth, you might feel tired, bruised or have some grazing that may sting, so you may want to take it gently. Your health visitor will probably check in with you about pain or difficulties around sex about two to six weeks after the birth (NICE, 2021a). If you have had stitches in your perineum after the birth, you may feel anxious about discomfort and perhaps find that sensation is different (NHS, 2020a).

If you had a caesarean section, you can resume sex whenever you feel fully recovered from the birth (NICE, 2021b). If your scar is still sensitive, you could explore positions that don't put pressure on it.

6. Will my tear or cut (episiotomy) affect sex?

Let yourself recover first. Your stitches should dissolve after 10 days and by two weeks you should feel like you're healing well. But it can take up to a month to heal (NHS, 2020a). For third and fourth degree tears, wait until you've stopped bleeding and your tear has healed before having sex again (RCOG, 2015).

With stitching, when you're ready to have sex again, you'll want to take things slowly and gently. You could try positions that limit penetration or reduce the pressure on the stitched area. If sex is painful or difficult when you do try, speak to your GP.

7. Will how I am feeding my baby affect sex?

This may seem unrelated but actually, if you're breastfeeding, hormones can cause vaginal dryness and a dip in libido (Riordan, 2005). See our Breastfeeding and sex article for more details.

Your breasts may be less of an erogenous zone than they used to be and you may find that the oxytocin released during breastfeeding means you crave affection less elsewhere. On the other hand, as our bodies are never simple, you may find that breastfeeding actually increases your arousal levels.

Some women feel 'all touched out' by the intensity of being constantly on demand as a parent. This isn't a reason to stop feeding, but might mean you just don't feel like having sex.

8. Have I thought about contraception?

Very important information: you can get pregnant soon after the birth of your baby. This can happen even if you are breastfeeding and your periods haven't reappeared. So make sure you look into your options for contraception and discuss it with your health visitor, midwife, GP or contraception clinic (NHS, 2020b).

9. Am I putting it off as I'm worrying about my baby being in the room?

Such a common one, trust us. Yet your baby won't understand what's going on. Your noises are completely familiar to them from their time in your womb and hearing them from outside will not upset them. Plus they won't care what you're up to.

Just be careful if your baby is in the bed with you or move them into their cot. You might also want to choose a time when your baby is less likely to interrupt things, like after a feed.

10. Am I ready to talk honestly with my partner?

If sex hurts, say it. If you need your partner to be gentler, say it. If you need extra foreplay, say it. If you need to nip to the chemist and buy some lube, say it. If you just want to chill out in front of the TV, say it. See a GP and say it to them if something doesn't feel right.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Hendrick V, Altshuler LL, Suri R. (1998) Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics. 39(2):93-101. Available at: https://www.sciencedirect.com/science/article/pii/S0033318298713556 [Accessed 9th December 2021].

Jawed-Wessel S, Sevick E. (2017) The impact of pregnancy and childbirth on sexual behaviors: A systematic review. J Sex Res. 54(4-5):411-423. http://www.tandfonline.com/doi/abs/10.1080/00224499.2016.1274715 [Accessed 9th December 2021].

Lorenz T, Ramsdell EL, Brock RL. (2019) A close and supportive interparental bond during pregnancy predicts greater decline in sexual activity from pregnancy to postpartum: applying an evolutionary perspective. Front Psychol. 10:2974. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6966960/ [Accessed 9th December 2021].

McDonald EA, Brown SJ. (2013) Does method of birth make a difference to when women resume sex after childbirth? BJOG. 120(7):823-830. Available from: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12166/full [Accessed 9th December 2021].

NICE. (2021a) Postnatal care [NG194]. Available at: https://www.nice.org.uk/guidance/ng194 [Accessed 9th December 2021].

NICE. (2021b) Caesarean birth [NG192]. Available at: https://www.nice.org.uk/guidance/ng192 [Accessed 9th December 2021].

NHS. (2018a) Vaginal changes after childbirth. Available from: https://www.nhs.uk/Livewell/vagina-health/Pages/vagina-after-childbirth.aspx [Accessed 9th December 2021].

NHS. (2018b) Sex and contraception after birth. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/sex-contraception-after-birth/ [Accessed 9th December 2021].

NHS. (2020a) Episiotomy and perineal tears. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/episiotomy-and-perineal-tears/ [Accessed 9th December 2021].

NHS. (2020b) When can I use contraception after having a baby? Available from: https://www.nhs.uk/conditions/contraception/when-contraception-after-baby/ [Accessed 9th December 2021].

Riordan J. (2005) Breastfeeding and human lactation. Sudbury, MA: Jones & Bartlett Publishing

RCOG. (2015) A third- or fourth-degree tear during birth (also known as obstetric anal sphincter injury- OASI. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-third--or-fourth-degree-tear-during-birth.pdf [Accessed 9th December 2021].

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Sex after a baby: 10 questions to ask yourself | Life as a parent articles & support | NCT

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Wondering how soon you can have sex after giving birth? Here are some questions you should ask yourself to figure out what's right for you.

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1. Taking care of yourself

With a newborn baby in your life it can be easy to prioritise their needs above your own, but you also need to focus on yourself and get enough rest and support so your body can heal.

Take it easy and ask for help if you need it. Making time to look after yourself is important - having a bath, taking a nap, or going for a short walk can all support emotional wellbeing and physical recovery.

Physical wellbeing - get plenty of rest, don't lift anything heavier than your baby, eat healthily and keep hydrated (NHS, 2019a).

Emotional wellbeing - the postnatal period can trigger lots of different thoughts and emotions, as you reflect on and process your birth experience. If you need emotional support, you could contact a peer support service, or many hospitals offer a birth reflections service. Some independent midwives will also review maternity notes with you to help you understand what happened and why.

2. Organise help (and accept it)

Sometimes it feels difficult to ask for and accept help, but now is the time to draw on the support of your friends and family to help out however you need it.

We are not all fortunate enough to have family or friends living close by, but think about who you could ask for help, so you can focus on resting and recovering from surgery, and bonding with your baby.

If you don't have anyone nearby, you might want to consider hiring a postnatal doula. They're trained to support you after birth and can often provide support with breastfeeding or bottle feeding, if you want it. They can help you with your recovery and answer any questions you might have about your baby. They often have lots of local information and are happy to provide whatever support you need in the home too. A few hours of doula support could be a great gift to a new family!

If planning a caesarean birth, you could consider the tasks your support network could do ahead of time, like freezing meals, and decide who could help with which tasks.

If you don't have a local support network, ask your health visitor or contact your local children's centre to find out if any support is available locally. For example, a charity like Homestart  might be able to offer practical help.

It's also a good idea to contact  your local NCT branch  to see what NCT support and social groups are nearby.

3. Get moving

It's important to be mobile after having a caesarean to help prevent the risk of blood clots or deep vein thrombosis, and aid healthy recovery (NHS 2019a, NHS 2019b; Sheedy et al 2022). You'll be encouraged to get out of bed in hospital as soon as you regain feeling in your legs and feel able to walk (NHS 2019a).

At first it might be painful or uncomfortable getting out of bed. You may find it easier to get out of bed by rolling on your side. You can then put your feet over the edge of the bed and push yourself up to a sitting position. It may be helpful to have a midwife or birth partner close by the first few times you stand up, in case you feel lightheaded and/or wobbly.

When you get home, it's a good idea to get up and start going for gentle walks when you feel up to it. Over time, you'll start to feel better.

Gentle exercise, such as walking, can start as soon as possible, moving on to gentle swimming or yoga from six weeks, depending on how recovery is going (NHS 2019b). Stronger exercise may need to wait longer for internal healing and you can discuss this with your midwife or GP.

4. Attend postnatal check ups

Your midwife or health visitor should give you information about recovering from a caesarean. This may include practical information about how to clean your wound, when to return to your usual activities and when to seek medical advice.

Each hospital trust is different, but most offer contact with a midwife every day for the first few days after a baby has been born. These are good opportunities to discuss recovery, and check the wound is healing well.

You will be offered an appointment after around five days to a week to remove any stitches or staples, if they are not the dissolving kind.

You will be offered midwifery support for at least the first 10 days, before being discharged. Every recovery is different, and the length of time support is offered should be personal to your birth and recovery.

You will also be offered a postnatal check with your GP at six to eight weeks after birth, which is another opportunity to seek guidance and support with recovery.

5. Don't rush back behind the wheel

Wait to get back to driving until you feel up to it. You might have to wait six weeks or longer to get back behind the wheel (NHS 2019a).

It's worth checking with your insurance company if they have a policy on driving after a caesarean.

The DVLA suggests that a doctor should be able to say when a driver is likely to be able to drive again, but in practice, a midwife or GP would say that you can begin driving again when you feel you have recovered from the surgery.  It would be a good idea to wait until you feel physically able and comfortable to perform an emergency stop.

6. Know when to seek medical advice

Although rare, it's important to know the signs of possible infection or deep vein thrombosis following a caesarean birth.

Contact your local maternity assessment centre or your GP immediately if you experience any of the following:

severe pain

pain when weeing

a cough or shortness of breath

pain or swelling in your lower leg

discharge, pus or bad-smelling fluid from the caesarean wound

heavy vaginal bleeding, or large clots

the wound becomes red, swollen and painful

fever, high temperature, or you feel very unwell (NHS 2019a)

If you can't get through to your doctor, call 111 for advice or an emergency appointment.
This page was last reviewed in April 2022
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Find out more about HomeStart - a family support charity that offers practical support to parents.

NICE provides evidence-based recommendations about caesarean.

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Top tips for recovery after a caesarean birth | Labour & birth, Different types of birth articles & support | NCT

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Having a caesarean is a major operation so you'll need to take it easy afterwards. Here we share some caesarean birth recovery tips to help you heal.

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1. Every woman bleeds after they give birth

You will have vaginal bleeding after you've given birth(NHS, 2021). This bleeding is known as lochia. The lochia is a combination of mucous, tissue and blood that your womb sheds as it replaces its lining after you've given birth (UHS NHS Foundation Trust, 2020).

2. Bleeding after birth may last for a while

Bleeding often lasts for around for four to six weeks, but could last up to 12 weeks after your baby's born (RCOG, 2016). If you're worried, you can talk to a health professional.

Bleeding will start off heavy and red to browny red. It will become lighter in colour and flow over time (NHS, 2021).

Here's what you can expect:

Day 1: Fresh red to brownish-red blood. Heavy flow that probably soaks one maternity pad every few hours, with one or two clots or several smaller ones.

Day 2 to 6: Darker brown or pinkish red blood. Moderate flow with 7 cm to 12 cm stains on your maternity pads and smaller blood clots.

Day 7 to 10: Darker brown or pinkish red blood, becoming lighter. Variable but lighter flow, with less than a 7 cm stain on your pads.

Days 11 to 14: Darker brown or pinkish red blood, becoming lighter. Lighter flow, you may have some sanitary towels that are hardly stained.

Week 3 to 4: Paler, possibly a creamy white blood loss. Lighter flow.

Week 5 to 6: Brown, pinkish red, or creamy yellow stains, possibly for several weeks, and possibly only on some days (UHS NHS Foundation Trust, 2020).

3. Don't keep quiet about clots

They're common. Discuss any clots with your midwife as they'll want to keep track of what's happening. Save your maternity pads to show your midwife if possible. Passing a lot of large clots can flag up something more serious (NHS, 2021).

4. If you pass a lot of large blood clots or more than a pint of blood in the first 24 hours, talk to a health professional immediately

Passing lots of large blood clots or more than a pint of blood in the first 24 hours after birth are symptoms of primary postpartum haemorrhage (RCOG, 2016).

Severe postnatal blood loss can make you feel even more exhausted than is normal after giving birth but it can also be life threatening. Getting quick treatment is essential before it becomes a major haemorrhage.

Treatment normally involves helping your uterus to contract through massaging the belly, an injection to contract the uterus, and a catheter into your bladder. The doctors will check to make sure all of the placenta has come out, and may have to do this under general anaesthetic. You will also have a drip in your arm and blood taken for tests.

5. The risk factors for primary postpartum haemorrhage

Before labour, risk factors are:

Previous postpartum haemorrhages

A body mass index (BMI) above 35

A twin or triplet pregnancy

Low-lying placenta (placenta previa)

Placenta coming away early (placental abruption)

Pre-eclampsia or high blood pressure

Growths in or around the womb (e.g. fibroids)

Taking blood-thinning medication

Blood clotting problems.

During labour, risk factors are:

6. Think about postpartum bleeding when you pack your hospital bag

Pack maternity pads rather than menstrual pads as they'll be more absorbant and allow the area between the vagina and anus (perineum) to heal with the least irritation. Describing the number of maternity pads you're using also gives your midwife a clear picture of how much blood loss you're experiencing.

7. Lots of things can affect the amount of blood loss

Breastfeeding makes your body release oxytocin. This makes your womb contract so it releases the lochia blood more quickly (but it will be the same amount of blood overall).

Any sort of gentle exercise - even a quick vacuum of the lounge - could also make bleeding heavier. This is especially true in the first two weeks.

Bleeding will tend to be heavier in the morning too. This is because blood pools when you lay down sleeping.

8. It's important to keep an eye on your blood loss in the weeks after giving birth

It's possible to get secondary postpartum haemorrhage, which is abnormal or heavy bleeding between 24 hours and 12 weeks after giving birth. It's often associated with an infection, and sometimes with part of the placenta remaining in the womb (RCOG, 2016).

Symptoms include:

Feeling shaky, feverish, and generally ill.

Having lochia with an offensive smell.

Heavier than expected bleeding, or bleeding that becomes heavier rather than lighter over time. (UHS NHS Foundation Trust, 2015; RCOG, 2016)

If you have any of these symptoms, you should speak to your GP or health visitor immediately (RCOG, 2016). Treatment for an infection includes antibiotics, so remind the health professional if you are breastfeeding so they can select the most appropriate antibiotic.

Severe pain in the womb in the six weeks after birth could be a sign of a serious infection called sepsis, and should be treated with urgency because it can be life-threatening (RCOG, 2012). Other symptoms of sepsis include a high or low temperature, vomiting, diarrhoea, a rash and offensive discharge (RCOG, 2012). If you are experiencing these symptoms, go straight to the emergency department, say that you have recently given birth, and ask if this could be sepsis.

9. It's important to reduce your risk of infection

Wash your hands thoroughly before and after using the toilet and changing your maternity pad (NICE, 2021).

10. Always speak to your GP or health visitor if anything doesn't feel right

In the end, trust your judgement. If you have any worries about your bleeding after you give birth, talk to a health professional. They're there to help.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Bleeding after birth: 10 things you need to know | Life as a parent articles & support | NCT

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It may be one of the few things you haven't discussed with friends. Here's an honest, clear account of what you can expect with bleeding after birth.

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While you might be one of the lucky ones who's totally relaxed about their post-baby bod, never feel bad if it's not that easy. A lot of women struggle with the changes that happen to them after they go through labour.

Knowing what will happen in advance can make it easier to prepare. Here's what you can expect...

Why do I still look pregnant?

You may feel that way because your muscles have stretched during pregnancy so your tummy won't ping back straight away to how it was before. (NHS Choices, 2015) For a while, it'll be a bit looser.

How can I recover?

You might not know this but breastfeeding can help as it causes contractions that shrink the womb (NHS Choices, 2015). And it burns calories. Postnatal exercise can tone your pelvic floor and tummy muscles and of course resisting that cake and eating healthily will help (NHS Choices, 2015).

Issues to look out for

While you're pregnant, your stomach muscles may become separated. They should return to normal by the time your baby is eight weeks old. If they are still separated, speak to your GP about getting a referral to a physiotherapist. (NHS Choices, 2016a)

To tell whether your stomach muscles are still separated, put one hand on your tummy with your fingers on the midline of your naval. Press your finger down gently and bring your head up (shoulders on the ground) like you're doing a mini-crunch. Feel for the sides of your muscles and see if they are still separated.

Will my pregnancy stretch marks fade?

During pregnancy you might have noticed stretch marks developing on your stomach, breasts and inner thighs. They look like narrow pink or purple lines. After birth these should fade.

How can I recover?

Stretch marks will become less noticeable although they're unlikely to completely disappear. You can buy products aimed at removing stretch marks, but there is little evidence that these work. (Liu et al, 2014; NHS Choices, 2016b) If you are particularly self-conscious about your stretch marks, you can have laser therapy but be warned, it can be pricey.

Is back pain after giving birth normal?

Yes, a lot of women experience back pain after giving birth.

How can I recover?

You should:

Keep your back well supported when breastfeeding.

Kneel or squat (do not bend your back) to do low-level jobs like bathing your baby.

Change nappies on a raised surface.

Keep your back straight and bend your knees when lifting.

Keep your back straight when pushing your pram or buggy, or carry your baby in a well-fitting sling. (NHS Choices, 2016a)

If back pain persists, speak to your GP.

Is fatigue normal?

Yes. It's common to feel incredibly tired after you have given birth. Your body has been through a lot and your baby is likely to wake several times during the night. But it will get better.

How can I recover?

Try early nights and the old but true cliché of resting when your baby's asleep. If you're formula or combi feeding, share the night feeds with your partner. (NHS Choices, 2016c) Find out more about tiredness after birth here.

Issues to look out for

If you are particularly irritable, stressed or down, speak to your health visitor. They might look at other underlying causes like postnatal depression. (NICE, 2006)

Are headaches common after labour?

An estimated 39% of women will experience a headache in the first week after giving birth. (Goldszmidt et al, 2005)

How can I recover?

Drink plenty of water and take paracetamol or ibuprofen.

Issues to look out for

Tell your GP if you have a severe or persistent headache, especially if you had an epidural. It could be a sign of eclampsia (high blood pressure), which might require further treatment. (NICE, 2006)

And lastly, a couple of other post-birth worries...

Caesarean section scar

Keep your wound clean, wear loose comfortable clothing and take painkillers if you need to. See a doctor if you have any sign of infection, such as discharge or an unpleasant smell. Your caesarean section wound will scar, but it will become less noticeable over time and often your pubic hair will hide it. (NHS Choices, 2016d)

Deep vein thrombosis

Pregnant women and women who have had a baby in the past six weeks are at an increased risk of deep vein thrombosis. The symptoms are a swollen, painful leg and/or difficulty breathing.

Deep vein thromboses are caused by a clot developing in the deep veins of your leg. It can be fatal if the clot travels from your legs to your lungs. If you develop a swollen, painful leg or have breathing difficulties after a trip, see your GP urgently or go to the nearest A&E department. (NHS Choices, 2015)
This page was last reviewed in February 2018
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

To prepare yourself more for what happens during and after labour, we offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

You might find attending one of our NCT New Baby courses helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Your post-pregnancy body questions answered | Life as a parent articles & support | NCT

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It's you... but different. Here's how to get your head around the physical changes that pregnancy brings.

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Traumatic birth and post-traumatic stress disorder | Labour & birth articles & support | NCT

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Many people feel unprepared for their birth experience and as many as one in three people report feeling traumatised after giving birth. Read on to find out whether you might have post-traumatic stress disorder and how to get support.

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It's hard to describe to anyone how much having a baby flips your life - and your mind - upside down. Your emotions are likely to be all over the place after you give birth and leap between utter joy and complete despair in the space of two minutes. A whopping 81% of women said they'd experienced a maternal mental health problem after giving birth (RCOG, 2017).

As with all things mental health related, it's great to share your feelings, though that can be daunting. Here's how you could make a start on working through things...

How to lessen the load

Try talking to your partner, friends and family or to other new parents who might be going through the same thing.

Try to open up to your health visitor as well about things and see your GP if you need to. Your six-week postnatal check is a chance to talk about how you are feeling as well as talking about your baby.

The good thing is that treatment does help, with 82% of women treated for mental health problems after their babies were born saying treatment had helped (NCT, 2017). So don't delay asking for help.

Emotions you might be experiencing

The baby blues

No matter how much you love or are grateful for your baby, the baby blues can affect you. The baby blues usually arrive in the first week after you give birth (NHS, 2018a).

A lot of new mums find themselves feeling weepy and irritable and not knowing why. But if it happens to you, don't worry, most new mums go through it (NICE, 2014). The baby blues is not an illness and you should see the back of it without any medical treatment. This'll probably happen by the time your baby is around 10 days old (MIND, 2018).

If you're still feeling low after this, speak to your GP or midwife as it might be something more serious. Read more about the baby blues here.

Postnatal depression (PND)

Depression can affect both mums and dads in the weeks and months after birth, so it's something to be aware of and look out for (NHS, 2018a).

No single answer tells us why some new parents are affected and not others (NHS, 2018a). However, emotional and stressful events can bring on depression, and having a baby can definitely be both of those things.

If you are concerned that you or your partner may have PND, speak to your GP or health visitor. The recovery from PND is gradual but with help and support you can get better (NHS, 2018a). Read more about PND here.

Postpartum or puerperal psychosis

Postpartum psychosis (also known as puerperal psychosis) is a serious mental illness that will require psychiatric treatment and a stay in hospital. This condition is rare, affecting only one or two mums in every 1,000. It most commonly occurs in the first month after having a baby (NICE, 2014).

The main symptoms of puerperal psychosis are delusions, hallucinations, confused thoughts and a lack of self-awareness (NHS, 2017). In very severe cases, a woman may try to harm her baby and/or herself. If you are, or know someone who may be, suffering from puerperal psychosis, you should get medical help from your GP, midwife or health visitor immediately.

How to help someone who is low or depressed

You might find living with your partner or seeing your family member who's depressed hard, sad and frustrating (MIND, 2018). Try to never blame them or be judgemental though: instead, try to support them and listen. That way you understand a bit more what they're going through.

Perhaps the most important thing to recognise is that someone suffering from depression may need encouragement to seek help, and support to get it (MIND, 2018). You can also reassure them that they will feel better, in time.

Helping yourself feel better

Share your feelings with people you trust. It's important to feel understood and supported so speak to a friend or family member, or a counsellor or health visitor, who you know will listen and won't judge.

Talking to other mums and dads can be super reassuring and make you feel a lot less alone and isolated.

Try and get help with the childcare and grab a bit of you time, even if it's just an hour here or there.

It's a cliché but a true one: exercise really does help, so head out for a brisk walk with the baby in the pram or go for a swim. You'll notice a mood improvement when the endorphins kick in.

Try as much as you can not to grab cake as a short-term fix: eating badly or skipping meals can make you feel tired and irritable, so try to eat simple and nutritious meals. Foods rich in omega 3 oils (oily fish, seeds and nuts) might help with depression. Though we're not ruling out the occasional chocolate brownie.

Learn to say yes to all offers of help and support. Whether offers involve whizzing a vacuum around, walking your dog or arriving with a home-cooked pie (never say no to pie) - just say yes please.

Give yourself time to adjust. Parenthood is a huge change in your life so go easy on yourself and be patient while you go through the transition.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

You might also like to try one of our NCT Yoga for Pregnancy classes, which aim to help improve your physical and emotional wellbeing, as well as feel more confident and positive.

Mind, a leading mental health charity, provides information on a range of mental health topics including postnatal depression and has an infoline for support: 0300 123 3393.

#PNDHour is an online peer support group that runs every Wednesday at 8pm via the Twitter account @PNDandMe. Anyone can join in to discuss topics about antenatal and postnatal depression, such as self-care, medication and seeking help. It's run by a mum called Rosey who also blogs about her own experiences with antenatal and postnatal depression, as well as raising awareness of perinatal mental illness, at PND and me.

We are grateful to Dr Andrew Mayers, a psychologist specialising in child and family mental health (particularly perinatal mental illness) and sleep (especially children), for his help in reviewing the information on this page.

The Association for Postnatal Illness is a charity that provides support to mothers suffering from postnatal illness and increases public awareness of the illness.

NHS Choices has information on postnatal depression.

The Royal College of Psychiatrists has information on postnatal depression.

Effective psychotherapeutic treatments may be found in your area. Check out the British Association for Counselling & Psychotherapy, the United Kingdom Council for Psychotherapy (UKCP) and the British Psychoanalytic Council (BPC) for a list of recommended therapists. Well Scotland or Niamh (in Northern Ireland), leading providers of mental health information in their regions, for further information on PND.

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Postnatal depression, baby blues and emotions after giving birth | Life as a parent articles & support | NCT

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Weeping at the TV and euphoria when they smile - having a baby is a huge emotional rollercoaster. Here are the moods you might expect after you give birth...

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Postnatal depression (PND) is a type of depression that many parents experience after having a baby. It can affect any parent, regardless of whether they've suffered from a mental health condition before. Postnatal depression is linked directly to giving birth and is a common problem, affecting 1 in 10 women within a year of giving birth.