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Advice about stitches, piles, bleeding and other physical changes after birth, plus tips to help you make a healthy recovery.
If you've had a caesarean, see recovering from a caesarean.

Stitches

If you've had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection. Have a bath or shower with plain warm water then carefully pat yourself dry.

If your stitches are sore or uncomfortable, tell your midwife.

Painkillers can help. If you're breastfeeding, check with your pharmacist, midwife or GP before you buy over-the-counter painkillers.

Stitches usually dissolve by the time the cut or tear has healed, but sometimes they have to be taken out.

Going to the toilet

At first, the thought of peeing can be a bit frightening - because of the soreness. Drinking lots of water dilutes your urine, which may make it sting less.

Tell your midwife if:

you're finding it really difficult to pee

you feel very sore

you notice an unpleasant smell

You probably won't have a poo for a few days after the birth, but it's important not to let yourself get constipated.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water.

If you've had stitches, it's very unlikely you'll break them, or open up the cut or tear again.

It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain.

Talk to your midwife or GP if you have constipation that won't go away. A gentle laxative may help.

Also tell your midwife or GP if poo is leaking or you're pooing when you don't mean to.

Bladder control

After having a baby, it's quite common to leak a bit of pee if you laugh, cough or move suddenly.

Pelvic floor exercises can help with this but tell your GP at your postnatal check if they aren't. They may refer you to a physiotherapist.

Piles

Piles are very common after birth but usually disappear within a few days.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water. This should make pooing easier and less painful.

Try not to push or strain - this will make the piles worse.

Let your midwife know if you feel very uncomfortable. They can give you a cream to soothe the piles.

Bleeding after birth (lochia)

You'll bleed from your vagina after the birth. It will be quite heavy at first, and you'll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards.

It isn't a good idea to use tampons until after your 6-week postnatal check because they could increase your chance of getting an infection.

See when you can start using tampons after birth.

You may notice the bleeding is redder and heavier when you breastfeed. This happens because breastfeeding makes your womb contract. You may also feel cramps similar to period pains.

The bleeding will carry on for a few weeks. It will gradually turn a brownish colour and decrease until it finally stops.

If you're losing blood in large clots, tell your midwife. You may need some treatment.

When will my periods start again after pregnancy?

It's hard to be exact about when your periods will start again, as everyone is different.

If you bottle feed your baby, or combine bottle feeding with breastfeeding, your first period could start as soon as 5 to 6 weeks after you give birth.

If you fully breastfeed (including at night) without any bottle feeding, your periods may not start again until you start to reduce breastfeeding.

How soon after giving birth can I get pregnant?

You can get pregnant as little as 3 weeks after the birth of your baby, even if you're breastfeeding and your periods have not started again yet.

Find out more about when you can use contraception after having a baby.

How soon can I use tampons after giving birth?

You should not use tampons until you've had your 6-week postnatal check. This is because you'll still have a wound where the placenta joined with the wall of your womb, and you may also have tears or cuts in or around your vagina.

Using internal sanitary products like tampons and menstrual cups before this wound has healed could increase your chance of getting an infection.

Use maternity pads or sanitary towels during this time while your body is still healing.

Breasts

To begin with, your breasts will produce a yellowish liquid called colostrum for your baby.

On the third or fourth day, they may feel tight and tender as they start to produce milk.

Wearing a supportive nursing bra may help. Speak to your midwife if you're very uncomfortable.

Read more about breastfeeding in the first few days.

Tummy

After delivery, your tummy will probably still be a lot bigger than before pregnancy. This is partly because your muscles have stretched.

If you eat a balanced diet and get some exercise, your shape should gradually return.

Breastfeeding helps because it makes your womb contract. You may feel quite painful period-like cramps while you're feeding.

You could also try these gentle postnatal tummy exercises.

Is it something serious?

Tell your midwife, health visitor or GP straight away if you get any of these symptoms.

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Advice about stitches, piles, bleeding and other physical changes after birth, plus tips to help you make a healthy recovery. If you've had a caesarean, see recovering from a caesarean. If you've had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection.

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I am a mother. I am tired, broken and sore. I have lumps, bumps, marks and jiggly bits.

I am a mother. I have created, grown, carried and birthed two gorgeous sons.

I am a mother. I am solely responsible for the lives of two little humans, every single day and night, week in and week out and will be for the rest of my life (and maybe future #number 3 baby).

I am a health professional. I work in an industry which is largely focused on the superficial. The how you look. Not how you feel. Not who you are.

I am a mother.

You too are a mother. You are also tired, exhausted, broken, sore, have lumps, bumps, marks and jiggly bits.

You too live in a world which judges you on how you look. Not how you feel. Not who you really are and what you have sacrificed...and continue to sacrifice.
You are beautiful, you are amazing, you are a mother.
You live in a society that pushes images at you every day of women who have given birth and just "bounced back" - great for them (truly, that is great, Kate Middleton you are amazing!). But this is such a small minority. For most of us, our bodies change, and change a lot. It is scary, it is hard, it can be down right disgusting and upsetting but it is real and normal. Although I am a qualified health professional I am also a mother and my body has also not just 'bounced back'. We are starting to see a shift in the media and online with more women sharing the often hidden and unspoken realities of child birth and the effect on your bodies.

So I have joined in the movement. Here is my #takebackpostpartum body blog. My real body after two children.

On the 17th of January, 2015 at 11.10pm I gave birth to my second son. I fought to conceive him. Put my body through assisted reproductive therapy. I was broken just (ha just!) carrying him to full term. Broken in ways I did not know my body could break ( see previous blogs). Photographs do not tell the full story. I could barely walk. I was induced early just to get my son out as every day he was in me was another day I had to fight to keeping carrying him. Before I had children I would run marathons for fun...yes for fun - just wake up, find an event and run...I could barely walk to the letter box and I could not pick up my 2 year old.
You are beautiful, you are amazing, you are a mother. 24 Hours Postpartum
Regardless of how you birthed your child (aka watermelon), you can still look and feel like you have a watermelon (or two) inside you. It is often sort of lumpy and squishy too. There's only one way that thing is coming down....hello excruciating uterine contractions...may as well go through labour again. I gave birth vaginally (birth story here) and it feels like a truck, not a watermelon, ripped through me. Good thing is I am so high on adrenaline and oxytocin nothing in the world matters except for my precious bundle...2 days later it is a different story.
You are beautiful, you are amazing, you are a mother. 2 Days Postpartum
Have I showered or changed my pjs...cannot confirm. Normally a size A cup, I am giving Kate Upton a run for her money. What's more these puppies are ON FIRE and I still don't know how to bloody use them. Show me that breastfeeding video one last time and I will tear the television from the wall socket - it is not helping. Everything leaks. I mean EVERYTHING. I am a mess of body fluid. I am wearing not one but two enormous maternity pads, inside granny panties to try and contain the postpartum bleeding. Golf ball sized blood clots keep coming out. I have to keep these to be inspected and make sure it is not part of the placenta. Where has my dignity gone?

Sleep...I could count the hours on one hand but am just too beyond exhausted to remember. My body is experiencing a horrendous hormone withdrawal. Is this what drug addicts feel like? Maybe drugs would help right now...My eyes just keep leaking. I am more prepared for this second time around. First time, I just could not understand why I would not stop crying. The cherry on the Sunday is that precious little bundle WONT STOP SCREAMING (don't let the photographs fool you). You want to come and visit? Sure, let's have a tea party while we are at it.
You are beautiful, you are amazing, you are a mother. 1 Week Postpartum
Back at home. Still rocking my pjs. Still got a lumpy, squishy watermelon belly. Still got the granny style undies and thunder pads. I am glad to be home but surely it is illegal to be responsible for two other little humans when in fact you are a walking zombie? And what the HELL do I do with two children? I barely did 1 before??! How do I bath them both? How do I get them both feed at the same time? Boobs out, get baby on one side, express pump on the other and shove a spoon in my toddlers face - that's how... hmmm bringing sexy back to the dinner table alright. Oh yes and somehow I am meant to fit into my pre-pregnancy clothes right (hahaha that's a joke right?).
You are beautiful, you are amazing, you are a mother. 2 Weeks Postpartum
I look a bit more alive...must have had a shower that morning. Tummy still swollen, shrinking but swollen. I am still bleeding, its like the period that never ends. Am out of my pjs, rocking pregnancy clothes instead (see you do get more than one use for those!!). Boobs are like rocks. My poor husband. If he even thinks about going near those knockers he will get a swift slap.

I will be honest I do feel better this time post birth than I did with my first son. Not fighting horrendous mastitis surely will be playing a large part of that (see why I am not exclusively breastfeeding here). The other, is I am kinder to myself, I am not out trying to walk for an hour or more a day like I did first time around. I have basically told friends to come and visit in about 3 months time (I am sorry but I know you understand).

In case you are wondering - that lovely scar down my belly is from some major abdominal surgery I went through as a 21 year old. Was split open 6 times after an appendix operation went wrong. Two pregnancies has morphed and stretched this. Never mind, it just becomes the 'feature piece' of my stretch marks. May have to reconsider my dream job as a bikini model....
You are beautiful, you are amazing, you are a mother. 10 Weeks Postpartum
Now that it has contracted down, my swollen tummy is a bit more of a jiggly tummy, still rocking preggie clothes, and sporting a moon boot from fracturing my ankle - my body so broken from the last few months my leg just snapped like a twig when I rolled off a curb trying to walk an unsettled baby. Where did the last 8 weeks go? In a blur...a blur of feeding, sleeping, pumping, learning to juggle both children and work in among it all. Am exhausted, like bone aching exhausted. I am lucky to have the knowledge I do of good food to nourish from the inside, but I am still human. I do have chocolate, I do have coffee (lots of coffee), and dinners are sometimes baked beans on toast. I don't have time to shower so no I DON'T make my own baked beans.

Sometimes I wonder why the hell did I want this so badly (previous blog from the trenches here), but for the most part I love it, stupidly love it all.
You are beautiful, you are amazing, you are a mother. 14 Weeks Postpartum
Officially out of the newborn phase. Feel less zombie and more human. I am left with the marks of motherhood. A tummy that appears 'flat' but has the stretch marks, the skin, the sunken scar and abs which have not yet healed. It's our best kept secret as mothers. I have just got my first period. I have irregular periods at the best of times so this I see as a true sign my body feels good. I now am ready to do some gentle activity, to help repair and recover. I may never run a marathon again, don't think my pelvic floor would survive, but I will run the parenting marathon day in and day out, my boys are so darn worth it - my god are they worth it!!.

You may be broken, exhausted, sore, have lumps, bumps, marks and jiggly bits.

You may not look like the next Victoria's Secret Underwear model, but focus on how you feel. Be kind to yourself and your body, you will look like how you are meant to when you feel good. It may take some time. It took me a lot longer to feel good following the birth of my first son then this time around. There is no one to compare yourself too. No one is walking in your shoes, deals with what you deal with. You will be judged. I am judged everyday and there will be people judging me right now. Doing what is right for you and your family takes courage, takes strength and as a mother, you have both. Nourish and love from the inside out and do not forget:
You are beautiful, you are amazing, you are a mother. With love, the New Mum's Nutritionist xxx

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My Real Postpartum Body - Dr Julie Bhosale

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I am a mother. I am tired, broken and sore. I have lumps, bumps, marks and jiggly bits. I am a mother. I have created, grown, carried and birthed two gorgeous sons. I am a mother. I am solely responsible ... Read More

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Becoming a parent often puts a strain on relationships, regardless of what they were like before.
Part of the problem is that you're tired and have so much less time to spend with your partner than you did before the baby arrived.

It's a lot harder to go out together and enjoy the things you used to do. Your partner may feel left out, and you may resent what you see as a lack of support.

But the stage when babies and children take up all your physical and emotional energy doesn't last forever.

Make time for each other when you can. Do little things to make each other feel cared for and included.

If you're having your first baby, you may feel lonely and cut off from your old life.

Your partner can't give you everything you used to get from work and friends. You need other people in your life for support, friendship and a shoulder to cry on.

The National Childbirth Trust (NCT) has more information about changes in your relationships after having a baby.

Take time to listen to your partner

However close you were before the baby was born, your partner can't read your mind. Both your lives are changing, and you have to talk about it.

You and your partner need to tell each other what you want and what's bothering you if you're resentful, angry or upset.

Be honest about what you need: do you need a hug or to feel understood?

Ask a friend or relative to babysit so you can have time together, even if it's just for a walk in the park.

Share the housework so you can have more time together.

Share the childcare duties, too.

It's important to talk about how you want to bring up your children. You may find you don't agree on basic matters like discipline and attitudes.

Find a way of dealing with these issues without disagreeing in front of your child.

If you think your relationship is in danger of breaking down, get help.

Where couples can get help and further advice

Help from a trained counsellor or therapist

If you'd like to talk to someone who's not a friend or family, there are lots of ways you can contact a relationship counsellor, some of them for free.

Relate - the charity offers many different types of relationship counselling, including a free, confidential live chat service, as well as services you have to pay for, like counselling by telephone, webcam, email, or face-to-face. For face-to-face counselling, contact your nearest Relate branch.

Click Relationships (previously Couples Connection) - this online relationship support service from the charity OnePlusOne includes the Listening Room, a free live chat service where you can talk to a trained counsellor.

More information online

Relate offers lots of advice on relationships, family life and parenting, including a section for new parents.

Click Relationships also offers extensive relationship advice, including a section on parenting.

Relationships with family and friends

Bringing a baby into your life changes your relationships with family and friends, whether you're part of a couple or single.

Everyone's situation is different. For example, some mothers feel that their own mothers are taking over, whereas others resent the fact their mothers don't help them more.

It's best to be clear about the kind of help you want, rather than going along with what's offered and feeling resentful.

Your relatives are also getting used to a completely new relationship with you. They won't know what to do for the best unless you tell them.

You may find your old friends stop coming to see you, or they seem to expect you to drop everything and go out for the evening.

This can make keeping up with friends difficult, but explain to them how your life has changed. They may not understand the changes you're going through.

Keep in touch and keep some space for them in your life, as the support of friends can be really valuable.

Domestic abuse and how to get help

Domestic violence, also called domestic abuse, includes physical, emotional and sexual abuse in couple relationships or between family members.

Domestic abuse against women often starts in pregnancy. Existing abuse may get worse during pregnancy or after the birth.

Nobody has to put up with domestic abuse. It puts your health and that of your baby at risk.

There are lots of ways you can get help:

Witnessing domestic abuse can have a serious effect on children. Social workers can help you protect your child. If you wish, they can help you take steps to stop the abuse or find refuge.
Find out more about getting help for domestic abuse

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Becoming a parent often puts a strain on relationships, regardless of what they were like before. Part of the problem is that you're tired and have so much less time to spend with your partner than you did before the baby arrived. It's a lot harder to go out together and enjoy the things you used to do.

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Family finances are an important consideration after your child is born. Read about costs related to having a baby including childcare, and about parental benefits and savings.

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All births in England, Wales and Northern Ireland must be registered within 42 days of the child being born.

You should do this at the local register office for the area where the baby was born or at the hospital before the mother leaves. The hospital will tell you if you can register the birth there.

If you cannot register the birth in the area where the baby was born, you can go to another register office and they will send your details to the correct office.

Information you need when registering a birth

When registering the birth, you should know:

place and date of the birth

name, surname and sex of the baby

parents' names, surnames and address

places and dates of parents' birth

date of parents' marriage or civil partnership

parents' jobs

mother's maiden surname

You might not need to give all of this information, depending on who is registering the birth.

What you should take

You should take at least one form of identification when you go to the register office. You can use:

passport

birth certificate

deed poll

driving licence

proof of address (for example, a utility bill)

Council Tax bill

marriage or civil partnership certificate

You should also take your child's personal child health record or 'red book' as some registrars may ask to see it.

If you're going to the register office on your own, you may need proof of paternity from the other parent before you give their details.

After the birth is registered

Once you've registered the birth, you may be able to claim:

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Find out how to register a birth - who can register, birth certificates

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Postnatal care up to 8 weeks after birth | Guidance and guidelines | NICE

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Evidence-based recommendations on the postnatal care of women and their babies up to 8 weeks after birth

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We're here to support you and your unique experience of pregnancy, birth, and early parenthood.

Our vision is that everyone who becomes a parent feels confident, connected, and safe.

We share evidence-based information you can trust

We create opportunities to connect with other parents

We listen to your experiences, amplify all parents' voices and campaign for change

We are strong advocates for improving experiences of pregnancy, birth, infant feeding, and early parenthood, equitably, for all parents.

Access networks of support and build friendships through our courses and community events.

Use our resources to make informed decisions that feel right for you.

Information for parents

If you're pregnant or a new parent, we know that you will have a number of questions and concerns about coronavirus. In our sections below, we've created a range of articles about how coronavirus might affect your pregnancy, birth and early days as a parent.

Pregnancy

When it comes to your pregnancy, we've got it covered. You'll find everything you need to help you feel confident and reassured over the next nine months right here.
Find out more

Labour & birth

Thinking about how, what happens and where to give birth? We're here to help you feel more confident. We've got information and tips on everything you need to know.
Find out more

Baby & toddler

Your baby's arrived and you've probably got 101 things on your mind. Don't worry, you're not on your own. We're here with information and support as your baby develops.
Find out more

Life as a parent

You've just had a baby and everyone is focused on your little one. But how about you? We're with you on your journey with support and tips from other mums and dads.
Find out more

Courses and workshops

Interactive, engaging and social, our antenatal course is a fun and exciting way to grow your knowledge of birth and early parenthood, and make life-long friends.
View all courses & workshops

Local activities and meet-ups

Our local activities and meet-ups can help you build up a supportive social network around you.

Support NCT Charity by becoming a member

Join NCT and there's great member benefits for you - exclusive live talks, money-saving offers & competitions, digital magazine & quick-read newsletters, plus early entry to every NCT Nearly New Sale - whilst you help fund free support for others.

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The UK's leading charity for parents | NCT

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We are the charity that supports people as they become parents. We're here for you through pregnancy, birth, and early parenthood.

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Volunteer with us

Over 16,000 highly trained volunteers support the delivery of our service. Our volunteers come from a range of backgrounds and find volunteering rewarding, challenging and fun. We have a range of roles in local Citizens Advice and Witness Service, want to find out more?

Our volunteer opportunities

Find your local Citizens Advice

For more information and advice

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Online free advice from Citizens Advice to help you find a way forward, whatever the problem. Our research enables us to campaign on issues affecting people's lives.

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When you take time off because your partner's having a baby, adopting a child or having a baby through a surrogacy arrangement you might be eligible for:

You may not get both leave and pay, and there are rules on how to claim and when your leave can start.

Employment rights when on leave

Your employment rights are protected while on paternity leave. This includes your right to:

pay rises

build up (accrue) holiday

return to work

You can get time off to accompany your partner (or the surrogate mother) to 2 antenatal appointments.

If you're adopting a child, you can get time off to attend 2 adoption appointments after you've been matched with a child.

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Your Statutory Paternity Pay and Leave - what you get, how to claim, eligibility

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Your Statutory Maternity Pay (SMP) and Leave - what you get, how to claim, maternity rights and extra help

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You can get help paying for childcare if it's provided by a:

registered childminder, nanny, playscheme, nursery or club

childminder or nanny with a registered childminder agency or childcare agency

registered school

home care worker working for a registered home care agency

This is known as 'approved childcare'.

The rules about how childcare providers become approved are different depending on where you live.

You can check if a childcare provider is approved or search for one in:

If you want to claim 30 hours free childcare in England, the provider will also need to be on an Early Years Register with Ofsted or with a registered early years childminder agency - ask your provider about this.

Sign in to your childcare account

Sign in to your childcare account if you already get Tax-Free Childcare or 30 hours free childcare.

Childcare at school

You can only get help paying for care that is outside school hours, for example after school clubs or breakfast clubs.

You cannot get help paying for:

your child's compulsory education

private lessons during school time (for example, private music lessons during school hours)

If your child has not started primary school, you can get help paying for childcare provided by a school. This includes nursery school fees.

Childcare provided by relatives

If you live in England or Scotland

You can only get Tax-Free Childcare to help pay for childcare provided by a relative (for example, a grandparent) if they're a registered childminder and care for your child outside your home.

You cannot claim for 30 hours free childcare for childcare provided by a relative (for example, a grandparent).

You cannot get help for childcare provided by your partner. This is not accepted as 'approved childcare'.

If you live in England and get 30 hours free childcare, you can pay the childcare provider using Universal Credit, tax credits, childcare vouchers or Tax-Free Childcare.

If you live in Northern Ireland

You can only get help paying for childcare provided by a relative if all of the following apply:

If you live in Wales

You can only get help paying for childcare provided by a relative if they're a registered childminder and care for your child outside your home.

Foster carers

Childcare provided by a foster carer in England only counts if they're registered as a childcare provider. You can search for a registered childcare provider through Ofsted.

You may be able to claim if a foster carer provides childcare in Wales, provides childcare in Scotland or provides childcare in Northern Ireland.

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Help with the cost of paying for approved childcare - Tax-Free Childcare, 15 and 30 hours childcare, childcare vouchers, tax credits, Learner Support.

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You get Child Benefit if you're responsible for bringing up a child who is:

Only one person can get Child Benefit for a child.

There's no limit to how many children you can claim for.

By claiming Child Benefit, you can get:

an allowance paid to you for each child - you'll usually get it every 4 weeks

National Insurance credits which count towards your State Pension

a National Insurance number for your child without them having to apply for one - they'll usually get the number shortly before they turn 16 years old

If you choose not to get Child Benefit payments, you should still make a claim to get the other advantages.

If your circumstances change

You must report any change of circumstances to the Child Benefit Office.

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Child Benefit - child benefit rates, eligibility, how to claim, child benefit claim form CH2.

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Recovery after a c-section (caesarean section) usually takes longer than after a vaginal delivery because it is major surgery. You will often be able to go home from hospital after a few days. Although c-section recovery week by week is different for everyone, there are lots of things you can do to stay more comfortable.

Find out how long your c-section recovery might take, what you can do to help your c-section scar heal and prevent infection, and how to stop your c-section incision opening. We also have advice on pain relief, breastfeeding, driving, exercise, having sex again and looking after your emotions.

How long will I stay in hospital after my c-section?

You'll probably stay in hospital for three days or four days (NICE 2021, NHS 2019a). If you're recovering well and have no complications, you can go home after about 24 hours, with follow-up care at home (NICE 2021). But you may be asked to stay in hospital for another day or two, with medical staff nearby.

A caesarean is major abdominal surgery, and you will feel some pain or discomfort for a few days or weeks afterwards (NHS 2019a). Even though you'll get pain relief, there will be things you can't do on your own. Just after surgery, you might need help shifting up the bed or sitting up straight. It may hurt your wound to cough or laugh, but supporting it with your hands, or holding a pillow over your tummy, will help.

After surgery, you may find that you suffer from constipation and other digestive problems, such as wind. This is partly because any type of surgery can affect how your bowel works, but also because constipation is common after delivery (Kuronen et al 2021). If you're suffering from constipation, ask for a bulk-forming laxative which you can take in hospital and at home. This creates poo that should be easier to pass. It will be gentle, so don't worry that it will send you running to the toilet.

How will I deal with the pain after a c-section?

You probably had a regional anaesthetic, such as a spinal or an epidural (NICE 2021) for your caesarean. You'll generally get a painkiller by injection into your spine at the same time as the anaesthetic to get you through the hours after surgery (NICE 2021).

With your consent, you will usually also be given a dose of diclofenac, an anti-inflammatory drug. This will be inserted into your rectum while you're still on the operating table, but you won't be given the drug if you're asthmatic.

An epidural can be topped up while you're in the recovery room (NICE 2021). If you had a general anaesthetic, you'll be given pain relief while you're still asleep (NICE 2021).

As you recover, you'll be closely monitored and offered further pain relief as and when you need it (NICE 2021). Having good pain relief will help you move around, and to feed and cuddle your baby.

Pain relief works best if you have it before the pain kicks in, rather than waiting for it to get bad before you use it (NHS 2021). Call for a midwife if you're uncomfortable or if your next dose of pain relief is due (Jarvis 2021, NHS 2021).

Most women experience some pain after a caesarean for at least a few days. For some women this can last several weeks (NHS 2019a). You should be given enough painkillers to take at home, for as long as you need them (NHS 2019a). This will usually be paracetamol and ibuprofen (NICE 2021).

If those aren't giving you enough pain relief, your midwife may offer you stronger alternatives. However, certain pain relief medications aren't suitable if you're breastfeeding, as they can have serious effects on your baby (NICE 2021).

What other treatment might I need as a I recover from a c-section

If you have a high risk of developing a blood clot, your obstetrician may recommend that you have low-molecular-weight heparin (LMWH) injections after the birth (RCOG 2015). Depending on your risk, you may need to have injections for 10 days or six weeks (RCOG 2015b).

LMWH is a type of blood-thinner called an anticoagulant (RCOG 2015). The risk of a blood clot developing increases after a caesarean birth and could be serious if it lodges in a vein in your leg or your lung (Jarvis 2021, NHS 2019a).

If you notice any pain in your chest, shortness of breath, or pain, redness or swelling in your calf muscles, get advice from your midwife or GP immediately (NHS 2019a). These symptoms could all be signs of a blood clot. Redness or swelling in your calf muscles can also be a sign of deep vein thrombosis, when a blood clot forms in a deep vein.

Doing some gentle ankle rotations and knee bends while you're in bed, and wearing elastic support stockings, will also improve circulation to your legs and reduce the risk of developing a blood clot (NHS 2019a, NICE 2021).

If you experienced a large amount of blood loss during your caesarean, the hospital will inform your GP, who can arrange for a repeat full blood count after you're discharged, and any follow-up treatment (NICE 2021).

If you lost a lot of blood and weren't prescribed an iron supplement to go home with, make sure you tell your midwife if you experience any shortness of breath. It might mean you have a lower level of healthy red blood cells than normal, and that you are anaemic.

When can I get out of bed after a c-section?

Because of the effect of the epidural, you might be worried about walking again. So it may come as a surprise when your midwife encourages you to get out of bed and move around, usually within 12 hours of your surgery (NHS 2019a). Even if it's the last thing you feel like doing, it's worth the effort. If you feel you might be able to stand, call your midwife to help you. Don't try to stand up by yourself.

The sooner you get going, the better for your circulation. Being mobile also means you can have your bladder catheter removed, although it's usually left in for at least 12 hours after your last epidural top-up (NHS 2019a). Each time you move around it will get easier.

How do I care for my c-section incision as I am recovering?

Air your incision to help the healing process. Your wound dressing will be taken off within 24 hours (NHS 2019a, NICE 2021). It's a good opportunity to take a look at your wound in a mirror, as you need to recognise changes as it heals. If you can't get to a mirror, try taking a picture of it on your phone, or ask your partner to check it for you. You won't need to put another dressing on it, unless your midwife or doctor asks you to.

When you're home, check for signs of infection, such as extra soreness, redness or discharge, or if the wound feels hot to the touch (NICE 2021). Tell your midwife if you spot these signs, if you feel feverish, or if it looks like the c-section incision is opening.

Gently wash and dry your wound daily (NICE 2021, NHS 2019a). It's fine to have a shower or bath after a c-section and to use soap on the wound, as long as you rinse it off. You can use a flannel if it's freshly washed. Pat, rather than rub, the wound and gently pat it dry with a clean, dry towel, or use the cool setting on your hairdryer to air-dry it. If you have non-dissolvable stitches or staples, your midwife will arrange for them to be removed after five to seven days (NHS 2019a).

Some women now have a PICO dressing instead. These small vacuum devices are very good at promoting wound healing. They are portable and painless, and will be removed after seven days by your midwife. It might be the best option for you if you have a higher BMI or have a long-term health condition that might affect wound healing, such as diabetes.

Wear loose, comfortable clothes after your caesarean, including high-waisted cotton pants a size bigger than you normally wear (NHS 2019a, NICE 2021). Tight clothes or lacy knickers could rub and aggravate your wound. You can also buy special caesarean pants made from a stretchy gauze that fit comfortably over your scar.

Other ways to help your recovery and relieve pain after a c-section

Eat and drink as soon as you feel hungry or thirsty (NHS 2019a). It's a good idea to have some snacks handy in hospital to help keep your energy levels up, as you may arrive on the ward between meal rounds.

Move around as soon as you can, drink plenty of water, and eat fibre-rich foods to make your poos softer and help prevent constipation. Some women swear by peppermint tea to soothe the pain of trapped wind which often follows surgery. Chewing gum can also help to get your bowels moving again (Short et al 2015).

Use maternity pads or sanitary pads, not tampons, for any vaginal bleeding (NHS 2019a). Tampons can increase the risk of infection. You will have some bleeding after your c-section from your womb (lochia), just as you would after a vaginal birth, although you should tell your midwife if the bleeding is heavy (NHS 2019a).

If you had an emergency caesarean, your medical team may first have tried ventouse or forceps to deliver your baby. If so, you're likely to have a sore area between your vagina and back passage (perineum) especially if you've had stitches there. Find out how to soothe a sore perineum.
What about breastfeeding during my c-section recovery?

You're just as likely to breastfeed your new baby successfully as if you've had a vaginal birth (NICE 2021). Starting breastfeeding can be more challenging after a caesarean, particularly an emergency caesarean (Hobbs et al 2016). This may be because you'll need time to recover from the operation and because of pain from your wound. Your midwife will help to place your baby on your chest and help them to latch on (NICE 2021).

Skin-to-skin contact with your baby after the birth can help to encourage breastfeeding (NICE 2021). Your medical team should offer to help you have skin-to-skin with your baby as soon as possible after the birth, but it will help to put it in your birth plan and agree it with the theatre team before the operation starts. If you're able to, put your hospital gown on so that it opens at the front.

If you have an emergency caesarean, there may not be time to arrange all of this. But you may still be able to have skin-to-skin soon after your baby's born or your partner may be offered skin-to-skin.

There may be a delay to your milk coming in (Hobbs et al 2016). Feeding frequently should help to get your milk started. In the meantime, your baby can do well on your early milk (colostrum) (NHS 2019c). Ask for help whenever you need it and keep trying different positions until you're comfortable.

In recovery, you're likely to be lying with the bedhead tilted up. So a laid-back breastfeeding position with your baby draped across you, away from your wound, is likely to work well. A midwife or support worker can help you to get comfortable before you start, and then hand your baby to you.

Some hospital beds on the postnatal ward have cots that clip on to the bed so it's easier for you to reach your baby for feeds. Feeding while lying on your side or in a laid-back position may be easier than sitting up to feed. You may also be able to syringe colostrum from your breast and feed it to your baby, if it's hard to get breastfeeding established at first. Your midwife will help you and advise you with this if you need it.

Once you get home you may need to take painkillers such as paracetamol or ibuprofen, which are safe when breastfeeding. Aspirin isn't recommended when breastfeeding (NHS 2019a).

What will my c-section scar look like?

The scar is likely to be between 10 and 20cm long, and will be just below your bikini line. It will look very red at first. But as the weeks and months go by it will gradually fade (NHS 2019a). While your scar heals it may become sensitive and itchy, particularly when your pubic hair re-grows.

Any numbness on or around your scar usually gets better a few months after the operation, though it can carry on for longer (Jarvis 2021, NCT 2018). If your scar becomes very sore, red or inflamed, you may have developed an infection (NICE 2021). Tell your midwife or doctor if this happens.

A couple of years after the operation the scar will probably have faded to a faint, pale line (NHS 2019a). It will always be a slightly different colour from your normal skin tone but may eventually be almost invisible.

Scars usually fade but sometimes scar tissue keeps growing even after the wound has healed. This can lead to keloid scars, which are raised and hard to the touch. They are more common if you have dark skin, are under 30 and someone in your family has them (NHS 2019b).

If you want to see what your scar may look like, take a look at our caesarean scar slideshow for pictures of scars taken days, weeks, months and years after caesarean operations.

What can and can't I do at home after a c-section?

When you're home, you shouldn't lift anything heavier than your baby (NHS 2019a). Unfortunately, this includes your toddler if you have one, so ask for help from family and friends to help your toddler get to you for hugs and cuddles.

Sudden movements are likely to make the pain feel more acute, so take your time. If you need to cough, sneeze or laugh, try leaning forwards and supporting your wound with your hands or a small pillow or towel (POGP 2017).

Movements that involve stretching upwards will be difficult for you for a while, and strenuous jobs around the house are off-limits (NHS 2019a, POGP 2017). Ask people for help whenever you need it.

If you feel unwell in the week or so after surgery, it may be a sign of infection. Although this sounds alarming, it is common, even though you had antibiotics during the operation (NHS 2019a). Your doctor will probably prescribe a course of antibiotics, though some women need to be readmitted to hospital for treatment (Johns Hopkins nd).

How soon can I drive and exercise after a c-section?

You may not feel well enough to drive for up to six weeks after your caesarean (POGP 2017). If you feel able to drive sooner, discuss it with your GP or consultant and contact your insurance company to ensure that your policy covers you in the event of an accident (POGP 2017).

Your midwife will encourage you to start gentle postnatal exercises the day after your operation. This will help speed up your physical recovery (POGP 2017). Take it gently. Most women wait until their six-week check before starting any exercise that is more intense than going for a walk (POGP 2017).

However, it's important to start your pelvic floor exercises as soon as your catheter is out. Your pelvic floor would have been stretched during pregnancy, even if you didn't give birth vaginally. Find out how to do pelvic floor exercises, and how often.

Learn more about exercising after a caesarean.

When can I have sex after a c-section?

There's no fixed time limit, so you can have sex after a c-section whenever you feel physically and emotionally ready. Don't pressure yourself - give your postpartum body a chance to heal. Read more about sex after birth.

What are the signs of infection after a c-section?

Here are the signs of infections to watch out for and what they could mean:

Redness, discharge, a wound that is hot to the touch, worsening pain or separation in your wound may be signs that you have a wound infection (NICE 2021).

Heavy or irregular clots and bleeding, smelly discharge or a fever after the birth may indicate an infection in your womb (NHS 2019a).

Pain low down in your tummy or groin, a high temperature, chills and confusion may be symptoms of a urinary tract infection or uterine infection (NHS 2020).

A cough or shortness of breath, or swelling or pain in your lower leg may be a sign of a blood clot (NHS 2019a).

Contact your midwife or doctor if you feel feverish, or if you have any of the above symptoms.
How will I feel emotionally during my c-section recovery?

Everyone is different. How you will feel depends on what happened before and during your baby's birth. It also depends on what your expectations were (Jarvis 2021).

You may feel delighted if everything went to plan. Or you may be upset and disappointed that you didn't give birth to your baby vaginally, if that's what you were hoping for (Jarvis 2021).

If things changed swiftly during your labour and you had an emergency caesarean, you may feel upset by what you've been through.

It's rare to need care in a high dependency or intensive care unit after a caesarean, but it does happen to around nine in every 1,000 women (NICE 2021). If you spent time in either place after your baby's birth, this may also affect your feelings about what happened. You may have little or no memory of it and feel that you missed out on the first hours or days with your newborn.

It may help your emotional recovery to go over the reasons why your caesarean was necessary with your midwife, your obstetrician or a maternity unit counsellor (Cooper 2015). You should have the chance to talk through what happened and raise any concerns you have about future births.

It may be heartening to know that women who have a caesarean do not have an increased risk of depression or post-traumatic stress (NICE 2021).

While you're recovering in hospital, you should be given the opportunity to discuss why you had a caesarean, if it was unplanned. You should also be given information about future birth options (NICE 2021). Some hospitals run a birth reflection service for mums who want to talk about their experience. Contact your hospital to find out what's available.

On the other hand, you may just be glad the birth is over and grateful that you and your baby are well. Many mums recover quickly and accept their caesarean as a part of their baby's birth story.

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We answer your questions about recovery after a c-section, from how long your c-section scar will take to heal to when you can drive again.

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Get involved and support us

Helping NCT is a great way to get out of the house and become part of our supportive community.

There's loads of ways to join in - you could host a coffee morning once a month, help with the Bumps & Babies social group or hold a fundraiser like a pamper evening or a party.

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Helping NCT is a great way to get out of the house and become part of our supportive community. There's loads of ways to join in - you could host a coffee morning once a month, help with the Bumps & Babies social group or hold a fundraiser like a pamper evening or a party.

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Find out why vitamins are important for the health of your baby or young child, and which vitamin supplements they should take.

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You'll probably be in hospital for 3 or 4 days after a caesarean section, and may need to take things easy for several weeks.

Recovering in hospital

The average stay in hospital after a caesarean is around 3 or 4 days.

You may be able to go home sooner than this if both you and your baby are well.

While in hospital:

you'll be given painkillers to reduce any discomfort

you'll have regular close contact with your baby and can start breastfeeding

you'll be encouraged to get out of bed and move around as soon as possible

you can eat and drink as soon as you feel hungry or thirsty

a thin, flexible tube called a catheter will remain in your bladder for at least 12 hours

your wound will be covered with a dressing for at least 24 hours

When you're well enough to go home, you'll need to arrange for someone to give you a lift as you will not be able to drive for a few weeks.

Looking after your wound

Your midwife should also advise you on how to look after your wound.

You'll usually be advised to:

gently clean and dry the wound every day

wear loose, comfortable clothes and cotton underwear

take a painkiller if the wound is sore - for most women, it's better to take paracetamol or ibuprofen (but not aspirin) while you're breastfeeding

watch out for signs of infection

Non-dissolvable stitches or staples will usually be taken out by your midwife after 5 to 7 days.

Your scar

The wound in your tummy will eventually form a scar.

This will usually be a horizontal scar about 10 to 20cm long, just below your bikini line.

In rare cases, you may have a vertical scar just below your bellybutton.

The scar will probably be red and obvious at first, but should fade with time and will often be hidden by your pubic hair.

On darker skin, the scar tissue may fade to leave a brown or white mark.

Controlling pain and bleeding

Most women experience some discomfort for the first few days after a caesarean, and for some women the pain can last several weeks.

You should be given regular painkillers to take at home for as long as you need them, such as paracetamol or ibuprofen.

Aspirin and the stronger painkiller codeine present in co-codamol is not usually recommended if you're breastfeeding.

Your doctor will be able to advise you on the most suitable painkiller for you to take.

You may also have some vaginal bleeding.

Use sanitary pads rather than tampons to reduce the risk of spreading infection into the vagina, and get medical advice if the bleeding is heavy.

Returning to your normal activities

Try to stay mobile and do gentle activities, such as going for a daily walk, while you're recovering to reduce the risk of blood clots. Be careful not to overexert yourself.

You should be able to hold and carry your baby once you get home.

But you may not be able to do some activities straight away, such as:

driving

exercising

carrying anything heavier than your baby

having sex

Only start to do these things again when you feel able to do so and do not find them uncomfortable. This may not be for 6 weeks or so.

Ask your midwife for advice if you're unsure when it's safe to start returning to your normal activities.

You can also ask a GP at your 6-week postnatal check.

When to get medical advice

Contact your midwife or a GP straight away if you have any of the following symptoms after a caesarean:

severe pain

leaking urine

pain when peeing

heavy vaginal bleeding

your wound becomes more red, painful and swollen

a discharge of pus or foul-smelling fluid from your wound

a cough or shortness of breath

swelling or pain in your lower leg

These symptoms may be the sign of an infection or blood clot, which should be treated as soon as possible.

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You'll probably be in hospital for 3 or 4 days after a caesarean section, and may need to take things easy for several weeks. The average stay in hospital after a caesarean is around 3 or 4 days. You may be able to go home sooner than this if both you and your baby are well.

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Sex and contraception after birth - NHS.UK

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Sex and contraception after having a baby, including advice on how to make sure sex is pleasurable.

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Pain Relief Cushion | Postnatal Cushion | Perineal Pain Relief

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The official website of the VALLEY Cushion. This product is designed to relieve pressure from the 'mid-line' areas around the Perineum....

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This article covers:
Family and friends
Recovering after the birth
Lack of sleep
Feeding your baby
Further information

Although hospitals and birth centres discharge mums and babies more quickly than in the past, they may spend a night or two away from home as a matter of policy, or because your partner requests it.

Hospitals also have different policies on dads visiting. Some have family rooms where dads can visit and some even allow them to stay overnight. In others, a new dad's visits will be confined to visiting hours although you will probably have a bit more time than other visitors. When you are with your baby, get used to holding them and changing their clothes and nappies. Babies seem fragile at this age, but this is part of the bonding experience and will soon become second nature.

The period in the early days after your baby is born can seem like a huge anti-climax, especially if mum and baby don't come home with you. But as a new dad you can use this time to prepare for their homecoming.

Speak to friends and family and tell them the good news, but try and get some rest as well.

After that, get your home ready in preparation for caring for a newborn, making sure sleeping arrangements are organised, and stocking up with food and other supplies. You will need to have a car seat for the baby if you are driving home. Fit it in advance and practise with it as they can be fiddly. If you are taking public transport, you will need a pram or buggy of some sort.

Here is some advice for new dads on the situations you are likely to encounter in the weeks and months after your child is born.

Family and friends

In the first week, it is understandable that family and friends will want to meet your new baby. However, if you or your partner are feeling worn out, try to limit visits and enjoy this special time for your new family. You can always spread visits over a few weeks and people will generally understand that this is a period of adjustment when you are getting used to caring for your baby.

Many dads only have a short time off work, so you should make the most of this time together. Having said that, the early days of parenthood can be exhausting, and you shouldn't be too proud to accept help or ask for it. If somebody offers to do your washing or cook for you, take them up on it.

When people do visit, don't feel that the normal rules of hospitality apply. Ask them to bring a hot meal with them. Nobody will expect the house to be spotless, and visitors can easily find the kettle and make their own tea.

Your partner may find it more helpful to have visitors after you go back to work, at which point she will be on her own. Many new mums find adjusting to a different lifestyle challenging and opportunities for adult company may be very welcome.

Recovering after the birth

If your partner has had a caesarean or other major medical intervention, she will need extra time to recover. This means sleeping whenever the baby sleeps if possible. Staying in bed may be the best way to do this for some, whereas other women will want to be up but need to be encouraged not to do too much. Your partner's milk production may suffer if she is overtired or stressed.

Don't underestimate the level of support your partner needs at this time, both practically, emotionally and psychologically. She is at her most vulnerable and needs to know that you are with her all the way. She may get moody and emotional at times, but don't let this affect you negatively.

Lack of sleep

Sleep deprivation among new parents is quite common. Everybody will have told you how exhausting the early days and weeks can be, but nothing can really prepare you for the lack of sleep after becoming a new dad. You can encourage your partner to have some sleep in the day, and join her if you can. Your partner may be particularly affected if she is breastfeeding and dads can help by soothing babies back to sleep (which can also be a time when dads start bonding with their baby). Do what you can to ease the burden on her. You could change the nappies during the night, if the baby needs changing; bring her a drink or an extra cushion.

Try and spend time with the baby yourself, going for a walk or putting the baby in a sling. This will give you a chance to bond as well as letting mum have some time to relax and sleep. Remember that this is just the beginning of parenthood and that the pace of your life is going to slow considerably.

Feeding your baby

Three quarters of babies are breastfed when they are born. Breastfeeding is a skill that can take time to learn and it's not at all familiar to most new parents - so neither of you will know much about what to expect and what's normal. Breastfeeding can be great for everyone once your partner and your baby get the hang of it. But it can take several weeks for it to become straightforward and for your partner to feel confident and completely comfortable. Babies like to feed frequently and this is quite normal and healthy. In fact, it is vital for establishing a good milk supply, especially in the very early days after your child is born. See our selection of articles on feeding your baby for more information.

There are lots of things you can do to be close to your baby if your partner is breastfeeding, such as holding your baby skin-to-skin on your chest; sharing a bath; going out walking together (using a sling or buggy); nappy changing, singing, rocking and taking turns 'talking'.

Further information on early fatherhood

NCT's helpline offers practical and emotional support in all areas of pregnancy and early parenthood: 0300 330 0700.

You might find attending one of NCT's 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 are happening nearby.

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This article covers: Family and friends Recovering after the birth Lack of sleep Feeding your baby Further information Although hospitals and birth centres discharge mums and babies more quickly than in the past, they may spend a night or two away from home as a matter of policy, or because your partner requests it.

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1. Do I feel ready for sex?

This is pretty important. One study found that 65% of couples had tried to have sex eight weeks after birth, followed by 78% of couples at 12 weeks (McDonald and Brown, 2013). Yet most couples don't go back to their pre-pregnancy sex frequency until closer to 12 months after their baby's birth (Jawed-Wessel and Sevick, 2017). The timing is very much up to you.

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 and letting your body 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. Still, 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.

"If you're tense and worried about sex, your vaginal muscles may not relax, making it painful, difficult and sometimes even impossible (NHS Choices, 2018). Sex is more likely if you make time to relax together" (NHS Choices, 2016).

3. Am I worried about having sex post-baby?

You might be thinking 'Will it feel different?' or 'How will we ever find the energy to do anything more than collapse on this bed?'

You might start by gently exploring for yourself first your vagina to discover whether there is any pain or change (NHS, 2016). You could then discuss the changes to your body with your partner and how you want to be touched. You might want to use a lubricant and make sure you are fully aroused before penetration (NHS, 2016) and try positions that limit penetration.

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, 2016).

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 intercourse.

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

If you had an uncomplicated vaginal birth, you can pick up your sex life whenever you want (NHS, 2016). Although if you feel tired, bruised or have some grazing that may sting, 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, 2006).

If you had a caesarean section, you should wait until you've fully recovered to have intercourse (NICE, 2011). If your scar is still sensitive, you could find some 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 be healing well.

If you had stitches after an episiotomy or a first- or second-degree tear, it can take up to a month to heal (NHS, 2017a). 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. Any initial pain is likely to fade quickly.

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; NHS, 2015). 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.

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, 2017b).

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 be honest?

Dryness may contribute to sex being painful, and oestrogen levels after childbirth are partly to blame (NHS, 2018b). But probably the most important reason for dryness is that you're knackered and adapting to your post-birth body, so you're not sexually aroused enough to produce lubrication.

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.

Jawed-Wessel S, Sevick E (2017) The impact of pregnancy and childbirth on sexual behaviors: A systematic review. The Journal of Sex Research, 54(4-5): 411-423. http://www.tandfonline.com/doi/abs/10.1080/00224499.2016.1274715 [Accessed 1st February 2018].

McDonald EA, Brown SJ (2013) Does method of birth make a difference to when women resume sex after childbirth? BJOG: An International Journal of Obstetrics & Gynaecolog. 120(7): 823-830. Available from: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12166/full [Accessed 1st February 2018].

NICE. (2006) Postnatal care up to 8 weeks after birth: CG37. Available from: https://www.nice.org.uk/guidance/cg37/resources/postnatal-care-up-to-8-weeks-after-birth-pdf-975391596997 [Accessed 1st February 2018].

NICE. (2011). Caesarean section: CG132. NICE. Available from: https://www.nice.org.uk/guidance/cg132/evidence/full-guideline-pdf-184810861 [Accessed 1st February 2018].

NHS. (2015). Vaginal changes after childbirth. Available from: https://www.nhs.uk/Livewell/vagina-health/Pages/vagina-after-childbirth.aspx [Accessed 1st February 2018].

NHS. (2016). Sex and contraception after birth. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/sex-contraception-after-birth/ [Accessed 1st February 2018].

NHS. (2017a). Episiotomy and perineal tears. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/episiotomy/#recovering-from-an-episiotomy [Accessed 1st February 2018].

NHS. (2017b). When can I use contraception after having a baby? Available from: https://www.nhs.uk/conditions/contraception/when-contraception-after-baby/?tabname=methods-of-contraception [Accessed 1st February 2018].

NHS. (2018) Vagina changes after childbirth. Available at: https://www.nhs.uk/Livewell/vagina-health/Pages/vagina-after-childbirth... [last accessed 22nd February 2018].

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

RCOG (Royal College of Obstetricians and Gynaecologists). (2015). A third- or fourth-degree tear during birth (also known as obstetric anal sphincter injury- OASI. RCOG. Available from: https://www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-third--or-fourth-degree-tear-during-birth.pdf [Accessed 1st February 2018].
Further reading
Convery KM, Spatz DL (2009) Sexuality & breastfeeding: what do you know?.

MCN: The American Journal of Maternal/Child Nursing. 34(4):218-223. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19587565 [Accessed 1st February 2018].

Deave T, Johnson D, Ingram J (2008) Transition to parenthood: the needs of parents in pregnancy and early parenthood. BMC Pregnancy and Childbirth. 8:30. doi: 10.1186/1471-2393-8-30. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18664251 [Accessed 1st February 2018].

De Souza A, DwyerPL, Charity M, Thomas E, Ferreira CHJ, Schierlitz L (2015) The effects of mode delivery on postpartum sexual function: a prospective study. BJOG: An International Journal of Obstetrics & Gynaecology. 122(10):1410-1418. Available from: http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13331/full [Accessed 1st February 2018].

Polomeno V (1999) Sex and breastfeeding: An educational perspective. The Journal of perinatal education, 8(1), 30. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3431754/ [Accessed 1st February 2018].

Robinson, M. (2008). Child development 0-8: A journey through the early years. Berkshire: Open University Press.

von Sydow, K. (1999). Sexuality during pregnancy and after childbirth: A metacontent analysis of 59 studies. Journal of Psychosomatic Research, 47(1), 27-49: Available from: http://psycnet.apa.org/record/1999-11060-003 [Accessed 1st February 2018].

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Sex after a baby: 10 questions to ask yourself

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This is pretty important. One study found that 65% of couples had tried to have sex eight weeks after birth, followed by 78% of couples at 12 weeks (McDonald and Brown, 2013). Yet most couples don't go back to their pre-pregnancy sex frequency until closer to 12 months after their baby's birth (Jawed-Wessel and Sevick, 2017).

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Tips and exercises to help you get back into shape after birth. Includes advice on diastasis recti (separated stomach muscles), how to ease back pain and safe exercises for the pelvic floor and stomach.

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Keeping fit and healthy with a baby - NHS.UK

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Exercising and healthy eating after giving birth, including ideas for staying fit with a baby and easy ways for new parents to eat more healthily. Also, tips for parents on stopping smoking.

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Although the last thing on your mind may be sex after giving birth, your body could be fertile within 21 days. Many couples take some time before they are ready to have sex, although some women feel more sexual after the birth.

Even if you don't plan on having sex for a while after having a baby, knowing about your options, thinking about what you want and discussing it with your partner puts you in a good place when the time comes.

How soon can you get pregnant after giving birth?

In the first 21 days after giving birth, you are extremely unlikely to get pregnant, so you don't need contraception. After this, you can become pregnant, even before you have your first period. This is because ovulation (when the ovary releases an egg) occurs before you get your period.

Your body will change after giving birth and, if you were using contraception before you became pregnant, it may no longer be right for you. Also, there are other considerations you may need to take into account, particularly if you are breastfeeding, which are outlined below.

According to the National Institute for Health and Clinical Excellence (NICE), contraception should be discussed within one week of giving birth, with either your healthcare practitioner or midwife as some methods of contraception need to have been in use for three to four weeks to be effective. All the reliable birth control methods are for women except for condoms and male sterilisation.

Contraceptive choices after pregnancy
Barrier methods

Male and female condoms - you can use condoms any time after giving birth.

Diaphragm or cap - if you have been using a cap or diaphragm, you will need to wait until your vaginal area and cervix has fully recovered after you have had your baby. This is normally by about 6 weeks. As vaginal birth can alter your size you will need to be refitted to check what size or type of diaphragm or cap is right for you. A spermicide is recommended with the diaphragm or cap for it to be effective.

Intrauterine device (IUD) - this can be fitted within 48 hours of the birth. If it is not fitted at this time, it will need to be fitted from four weeks after you had your baby, whether you had a vaginal birth or acaesarean section.
Exclusively breastfeeding
Breastfeeding can be a very effective method of contraception, sometimes called the Lactational Amenorrhoea Method (LAM). It works because the hormone required to stimulate milk production prevents the release of the hormone that triggers ovulation. It is more than 98% effective in preventing pregnancy so long as:

You are breastfeeding exclusively and haven't introduced formula milk, drinks or solids, with no long gaps between feeds.

Your period hasn't returned, even light spotting counts.

Your baby is less than six months old.

You need to be aware: 'exclusively breastfeeding' in this case means a minimum of six long breastfeeds per 24 hours. And if you wish to relyon LAM as a method of contraception then you need to ensure that there are no gaps of longer than fourhours from the start of one feed to the next during the day and no longer than sixhours at night.

Once you are giving your baby solid foods or formula milk and no longer exclusively breastfeeding then LAM will become less effective and other means of contraception will need to be considered if you want to avoid pregnancy.
Hormonal methods Progestogen-only
Although the World Health Organisation (WHO) recommends that progestogen-only methods should not be used in the first six weeks after having a baby, it is common practice in the UK to do so as no evidence has been found which suggests that it affects your milk supply or baby during this period. These methods, listed below, include:

Progestogen-only pill (mini-pill).

Progestogen-only injection - if you want to use the contraceptive injection, GPs recommend that you wait until six weeks after birth because then you are less likely to have heavy and irregular bleeding if you are breastfeeding. If you have decided to formula feed your baby you can have the injection as soon as you wish, but you may get heavy and irregular bleeding as a result.

Progestogen-only implant - You can have an implant put in three weeks (21 days) after you have a baby. In this case it is an effective contraceptive straightaway. If the implant is put in more than 3 weeks after your baby is born, it will not be effective as a contraceptive for the first seven days.

Hormonal intrauterine system (IUS). Usually fitted anytime from four weeks after a vaginal or caesarean birth.

You can also use emergency contraception if you are breastfeeding.

Breastfeeding women are recommended to avoid any contraceptive method which contains oestrogen, as this has been shown to reduce the milk supply. Contraceptive methods that use oestrogen include:

Combined oral contraceptive pill.

Vaginal contraceptive ring.
Making a decision
You can choose whatever method you feel is best suited to you. But don't forget, your body has changed and what suited you before may no longer be right for you now. If you are bottle or mixed feeding, then your periods will return around four to six weeks after the birth or later.

The combined pill is can be prescribed from six months after birth for women who are breastfeeding. It does not appear to affect either the quantity or the quality of breastmilk after this time, although some women prefer not to go down this route.

What about natural family planning?

Natural family planning is possible though it can be more difficult to learn and use just after you have had a baby. If you used this method before your pregnancy, ask your natural family planning teacher for advice.

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 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.

NHS choices has a comprehensive list of contraception available in the UK.

The Family Planning Association has an interactive tool you can use to help you decide what the most appropriate method of contraception for yourself would be.

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Choosing contraception after giving birth

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Although the last thing on your mind may be sex after giving birth, your body could be fertile within 21 days. Many couples take some time before they are ready to have sex, although some women feel more sexual after the birth.

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Being a new dad: fathers and breastfeeding support

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Although breastfeeding is a natural process, it can take time for new mums to learn this new skill and feel comfortable with breastfeeding their baby. A woman is more likely to choose to breastfeed if she's sure her partner is positive about it and the support of fathers has been shown to be an important factor in enabling mums to breastfeed for longer.

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NHS services for new parents

Registering your baby with a GP

Register your baby with your GP as early as possible in case you need their help. You can use the pink card you'll be given when you register your baby's birth. Sign the card and take or post it to your GP.

You can contact your GP at any time, whether it's for you or your child. Some GPs will see small babies at the beginning of surgery hours or without an appointment, but be prepared to wait. Some will give advice over the phone. Most GPs have regular child health clinics.

If you want the GP to see your baby before you've registered the birth, you can go to the surgery and fill in a registration form there. If you move, register with a new doctor close to you as soon as possible.

Find out how to change your GP.

Find a GP in your area.

How your health visitor can help

A health visitor will usually visit you at home for the first time around 10 days after your baby is born. Until then you'll be under the care of your local midwives.

A health visitor is a qualified nurse who has had extra training. They're there to help you, your family and your new baby stay healthy.

Your health visitor can visit you at home, or you can see them at your child health clinic, GP surgery or health centre, depending on where they're based. They will make sure you've got their phone number.

If you're bringing up a child on your own or struggling for any reason, your health visitor can offer you extra support.

Talk to your health visitor if you feel anxious, depressed or worried. They can give you advice and suggest where to find help. They may also be able to put you in touch with groups where you can meet other mothers.

Child health clinics

Child health clinics are run by health visitors and GPs. They offer regular baby health and development reviews and vaccinations.

You can also talk about any problems to do with your child, but if your child is ill and likely to need treatment, it's best to see your GP.

Some child health clinics also run mother and baby, parent and toddler, breastfeeding, and peer support groups.

Local authority services

Sure Start Children's Centres

Children's centres are linked to maternity services.

They provide family health and support services, early learning, and full-day or temporary care for children from birth to five years.

They also provide advice and information for parents on a range of issues, from parenting to training and employment opportunities. Some have special services for young parents.

Find your local Sure Start Children's Centre.

Family Information Service

Your local Family Information Service (FIS) aims to help you support your children by providing a range of information specifically for parents.

Each FIS has close links with children's centres, Jobcentre Plus, schools, careers advisers, youth clubs, and libraries.

They offer information about local childcare services and availability, and can help you if you need childcare for a child with a disability or special needs.

Find your local Family Information Service.

Local advice centres

Advice centres are non-profit agencies that give advice on issues such as benefits and housing.

They include Citizens Advice, community law centres, welfare rights offices, housing aid centres, neighbourhood centres, and community projects.

Look for them under these names in your phone book or under the name of your local authority.

To help you get the most out of services, remember:

Before you go, think about what you want to talk about and what information you can give that'll be helpful. Maybe jot these ideas down.

Unless your child needs to be with you, try to get a friend or neighbour to look after them so you can concentrate.

If a problem is making life difficult or really worrying you, keep going until you get some kind of answer, if not a solution.

If you don't understand, say so. Go back over what they said to make sure you understand. It may help if they write it down for you.

If English isn't your first language, you may be able to get help from a link worker or health advocate. Ask your health visitor or staff at your local Sure Start Children's Centre if there's a link worker or health advocate in your area.

Websites, helplines and support groups for parents

Contact a Family

Support, advice and information for parents with disabled children.

Family Lives

An organisation providing immediate help from volunteer parent support workers 24 hours a day, seven days a week.

Family Rights Group

Support for parents and other family members whose children are involved with or need social care services.

Gingerbread: single parents, equal families

Help and advice on the issues that matter to lone parents.

Parent and baby groups

To find out about local groups:

ask your health visitor or GP

look on noticeboards and for leaflets at your local child health clinic, health centre, GP's waiting room, children's centre, library, advice centre, supermarket, newsagent, or toy shop

In some areas, there are groups that offer support to parents who share the same background and culture. Many of these are women's or mothers' groups.

Lots of children's centres also run fathers' groups and groups for teenage parents. Your health visitor may know whether there are any groups like these near you.

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Register your baby with your GP as early as possible in case you need their help. You can use the pink card you'll be given when you register your baby's birth. Sign the card and take or post it to your GP. You can contact your GP at any time, whether it's for you or your child.

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If you are wondering how long after giving birth you can exercise: seeking advice from your GP, physiotherapist or midwife before starting an exercise programme is a good idea. It's generally advisable to wait for your six-week postnatal check-up before you start to exercise seriously again.

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1. Urinary incontinence: what it is

Urinary incontinence is weeing or leaking urine without meaning to (NHS, 2016a). Pregnant women sometimes can't stop themselves from leaking wee when they cough, laugh, sneeze, move suddenly, do exercise or just get up from a sitting position (NHS, 2018).

2. What causes urinary urgency or incontinence in pregnancy?

The most common cause of pregnancy-related urinary incontinence or urgency is weak pelvic floor muscles (the muscles around the bladder) (CSP, 2017). This might be temporary as the pelvic floor muscles relax to prepare for labour (CSP, 2017).

Pelvic floor muscles support the uterus and help control the bladder and bowel. The weight of your baby can weaken these muscles.

3. What causes urinary urgency or incontinence after childbirth?

Another thing that weakens your pelvic floor muscles is, of course, giving birth. The pressure inside your bladder becomes greater than the strength of your urethra to stay closed and any sudden extra pressure sees wee leak out (NHS, 2016a).

Your urethra might not be able to stay closed if your pelvic floor muscles are weak or damaged. Alternatively, the muscle that keeps the urethra closed might be damaged. These problems may be caused by damage during vaginal births (NHS, 2016a).

4. Epidurals and spinal blocks may affect urinary incontinence

If you had an epidural or a spinal block, for a few days after birth you may not be able to tell when you need to wee. If you had an epidural, the catheter that was inserted into your bladder might make it harder for you to control when you wee too (NHS, 2017a). But this should get better within a few days.

5. Urinary incontinence is super common

In the three months after childbirth, a third of women suffer from incontinence (Thom and Rortveit, 2010). Yet a third of those women were embarrassed about mentioning it to their partners and almost half with friends (NCT, 2016).

Even more worrying? Almost 38% of women said they were self-conscious speaking about the problem with a healthcare professional (NCT, 2016).

"Incontinence is curable but only if you get help from a midwife, GP or health visitor (NHS, 2018)."

6. Pelvic floor exercises are key

If you're pregnant or planning to get pregnant, you should start doing pelvic floor exercises straight away (NHS, 2017c). This will lower your risk of experiencing incontinence after you have your baby (BAUS, 2017; CSP, 2017; NHS, 2017b).

Do your pelvic floor exercises even if you haven't had any leaks or dashes to the loo as they will improve your bladder control (NHS, 2017b). Find out how to do them here.

As long as the birth was straightforward, start the exercises again as soon as you feel up to it (NHS, 2016c). If you had stitches, start lying down and work your way up to doing them while sitting. Start with gentle, short, pelvic floor muscle squeezes.

If you had ventouse, forceps or a caesarean, start your pelvic floor muscle exercises once any urinary catheter has been removed and you are weeing normally.

Don't assume you don't have to do these exercises if you've had a caesarean. Being pregnant in itself can weaken your pelvic floor muscles so you're still at risk of bladder and bowel problems (sorry...).

As you feel more comfortable, squeeze a little harder and add in your long squeezes again. Gradually build up how many squeezes you do, and how long you hold. Try to do this four to five times per day. Once your baby is feeding well, put your favourite Netflix show on and you'll find this is the perfect time for your exercises.

7. There are other ways to help your bladder

As well as doing your pelvic floor exercises:

cut down on caffeine

avoid spicy and acidic foods

drink six to eight glasses of fluid a day but no more (many people with urinary incontinence avoid drinking fluids but this worsens it by reducing your bladder capacity)

be a healthy weight

quit smoking

avoid lifting.

8. There is specialist treatment available

If you have any concerns, ask your GP for a referral to a women's health physiotherapist. You should receive at least three months of supervised pelvic floor muscle training, for starters (CSP, 2017).

9. Consider the possibility of a urinary tract infection (UTI)

Sometimes, having no control over when you wee is caused by a urinary tract infection (UTI) (NHS, 2017d). UTIs can affect different parts of your urinary tract, including your bladder (cystitis), urethra (urethritis) or kidneys (kidney infection). Most UTIs can be easily treated with antibiotics (NHS, 2017d).

Symptoms of a UTI include:

needing to wee suddenly or more often than usual

blood in your wee

pain in your lower tummy

feeling tired and unwell

pain or a burning sensation when you wee

cloudy wee

unpleasant-smelling wee

fever.

Contact your doctor or midwife immediately if you have any of these symptoms because you might need antibiotics (NHS, 2017d).

10. It's crucial to break the taboo

Many women who get incontinence issues after they have a baby keep it quiet because they are embarrassed (CSP, 2017). Yet the condition is so common. It's certainly nothing to be embarrassed about.

Not seeking help can leave you feeling lonely, affect relationships and careers, and can stop you exercising or having sex. So take a deep breath and speak to friends, midwives and partners about what's happening to you. You'll feel relieved, supported and then you can start to get help and move on too.

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.

The Chartered Society of Physiotherapy (CSP) has lots of useful information about pregnancy-related incontinence.

You can also use the CSP's Physio2U service to find a local practitioner or contact the Pelvic Obstetric and Gynaecological Physiotherapy group.

Read more about the evidence around incontinence.

NHS Choices has helpful information about urinary incontinence including symptoms and treatment.

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10 truths: leaking urine in pregnancy and after birth | Life as a parent articles & support | NCT

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Urinary incontinence is weeing or leaking urine without meaning to (NHS, 2016a). Pregnant women sometimes can't stop themselves from leaking wee when they cough, laugh, sneeze, move suddenly, do exercise or just get up from a sitting position (NHS, 2018).

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Postnatal exercise: how soon can I start again after a baby? | Life as a parent articles & support | NCT

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If you’re keen to get back to your fitness routine but are not sure how safe it is, here’s what you need to know.

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Find out about the postnatal check that happens around six weeks after the birth, where you can discuss issues, including contraception.

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If you and your partner are both going back to work, you will need to consider childcare options. Some families accept help from their relatives or work at different times so one parent is always available to stay with their child.

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Sussex Family Grapevine | Crawley & Horsham

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Sussex Family Grapevine | Crawley & Horsham

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Our magazine and website offer local families a constantly updated source of information through our Family Directory, What's On Guide & Blogs

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