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Pregnancy

3 Weeks Postpartum: What Should I Expect

Written By
Callai Nagle
Certified Doula and Childbirth Educator

You are now 3 weeks postpartum, halfway between the birth of your baby and the 6 week recovery mark where you will be cleared by your doctor or midwife for most pre-pregnancy activities (we’re talking everything, from jogging to sex). But what can you expect right now in terms of your postpartum recovery?

  • Lochia level
  • Breasts changes
  • Perineal healing
  • C-section care
  • Physical activity
  • Appearance
  • Sexual activity
  • Baby Blues

Lochia level

Whether you gave birth vaginally or via cesarean, you will experience lochia, or vaginal discharge of blood and tissue after your baby’s birth. In the first week postpartum this bleeding is very heavy. The flow gradually tapers off, and by the 3 week mark it will probably be similar to a light day of your period, or even have reduced to brown or yellow-ish discharge. Some people find that lochia has almost completely stopped by 3 weeks postpartum, but it isn’t unusual for it to last up to 6 weeks.

Breast changes


If you are breastfeeding, your breasts are still working on regulating your milk supply during the third week postpartum. It is common to overproduce milk during this period as your body learns how much your baby needs. You might find that your breasts often feel firm and full, and you will probably leak milk between feedings and from the unused side while your baby is nursing.

Look for signs of plugged ducts (a hard and painful lump in the breast) and engorgement (overly hard, swollen breasts), and treat early signs of either condition by using breast massage, warm compresses, and thoroughly draining the breast at each feeding by leaving the baby on one side until he or she falls asleep or pulls off.  

To help with leaking, try using a manual silicone pump like a Haakaa, which uses gentle suction to collect extra milk released from the unoccupied breast during a feeding. You can also keep breast pads on hand to wear between feedings. You can find disposable adhesive nursing pads that stick to the cups of your bra or nursing cami, reusable washable pads that also rest in the cups of your bra, or silicone pads that adhere to your breasts and can be worn without a bra.

You can help your milk regulate and your breasts feel more comfortable by feeding your baby frequently around the clock. Try not to go more than 3 hours between feedings and don’t limit the amount of time your baby spends at the breast.

As your milk supply slowly regulates you might notice that your breasts feel softer or more empty, and that you don’t leak as much. This is a normal part of the regulation process and not something to worry about. It means your body is learning to make exactly the right amount of milk your baby needs without any waste.

Perineal healing


If you received stitches from an episiotomy or tear during delivery, you can expect the stitches to have fully dissolved and the initial healing period to be complete by 3 weeks postpartum, but pain and sensitivity may last for up to 6 months.

It is also common to experience hemorrhoids in the postpartum period. Over the counter treatments are very effective and safe to use, including witch hazel pads (try storing them in the refrigerator for additional cooling) and ointments such as Preparation H. To help hemorrhoids heal, avoid constipation by drinking a lot of water and making sure your diet contains plenty of fiber.

C-section care

If you had a cesarean birth, your body experienced  major surgery and will need additional time to heal, but by the 3 week mark you should be feeling significantly better. The visible stitches in your skin should have healed, but the internal stitches take up to 12 weeks to fully heal, so continue to rest and take it easy.

It is ok to resume most daily activities, such as driving a car, climbing stairs, and doing light housework, but make sure not to push yourself. Err on the side of caution and continue to take it easy until your 6 week postpartum check-up.

Physical activity

By 3 weeks postpartum you are probably starting to feel more like yourself, and your physical healing is well on its way. You may be tempted to take on more activities, but keep in mind that the more you rest, the more quickly your body will fully heal. It’s alright if all you manage to do during this period is feed yourself, feed the baby, change diapers, and sleep.

If you feel ready, light exercises such as walking and stretching are okay. Keep your walks and gentle yoga sessions on the shorter side and pay attention to how your body feels afterward. Overdoing it can set your recovery back. If you find that your lochia flow is increasing or becoming more red in color (versus brown, pink, or yellow) that is a sign to reduce your activity level and refocus on rest and healing.

Appearance

Remember that it took your body 9+ months to grow a baby, and it will take around the same amount of time for your body to heal physically and return to an approximation of your pre-baby state. Don’t rush the healing process, and don’t worry about “bouncing back” and “losing the baby weight” during the initial postpartum period. There will be plenty of time for more intense exercise later, if desired.

At the 3 week postpartum mark, you can expect to still look somewhat pregnant, and will probably be most comfortable in your maternity clothes or other loose outfits. It takes approximately 6 weeks for your abdominal wall to regain muscle tone after giving birth. During the first 2-3 weeks it is still significantly relaxed, contributing to that still-pregnant look. Another contributing factor is your uterus, which is still enlarged and won’t return to its pre-pregnancy size for about three more weeks.

Focus on comfort and nursing accessibility in your clothing choices, and don’t feel frustrated that you aren’t back into your favorite pair of pre-pregnancy jeans yet.

Many new parents find self-care difficult during the first few months of their baby’s life. Do try to make your care a priority by taking time for regular baths and showers. But for those days where personal hygiene has to take a back seat, dry shampoo is a lifesaver. I personally found this dry shampoo from Lush very effective, and I liked that it has a milder scent than many drugstore dry shampoos.

Sexual Activity

Many people do not wait the full recommended 6 weeks to resume sexual activity after giving birth. You know your body best, and if you feel ready you can safely have penetrative sex with your partner as soon as your lochia bleeding has stopped and any stitches have healed. Make sure to take it slow and easy, and stop if it becomes painful or uncomfortable. Hormonal changes from giving birth and breastfeeding cause a reduction in your body’s natural lubrication, so keep extra lubricant on hand to use liberally, and make foreplay a priority.

Baby Blues

After giving birth, your body experiences rapid hormonal changes, which can often lead to the “Baby Blues.” These blues begin during the first week of postpartum, when the hormones are at their lowest levels, and are experienced by upward of 80% of new parents. “Baby Blues” typically make you feel moody, weepy, extra dependent on your support people, unexpectedly sad or anxious, and scatterbrained. As your hormone levels slowly rebalance in the first few weeks postpartum the symptoms of “Baby Blues” begin to lessen, and by the third week of postpartum some new parents are feeling significantly better.

If by the third week postpartum you find that your symptoms of depression and anxiety are not improving, or if they are worsening, you may have a postpartum mood disorder. You should discuss your symptoms with your healthcare provider. You can find a directory of mental health professionals with training in postpartum depression and anxiety here.

Sources:

Recovering from Delivery (Postpartum Recovery)
A Faster Postpartum Recovery
Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety by Soshana Bennett, PhD & Pec Indman, EdD, MFT
Chapter 20 Postpartum Physiology in Maternity & Women's Health Care 10th Ed. by Lowdermilk et al.

Callai Nagle
Certified Doula and Childbirth Educator
Callai is a certified Childbirth Educator and Doula, and a mom of two school-aged kids living in Vancouver, WA. She has a BA in Art History from UC Berkeley, but becoming a mother radically realigned every aspect of her life, including her career goals. After experiencing two empowering births firsthand, she found a new passion in life and has dedicated herself to supporting families during their transition to parenthood through personalized emotional support and evidenced based education.

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