Uterus wound healing during postpartum recovery - Ruth Health

Uterus wound healing during postpartum recovery

Fast facts:

  • After childbirth, the placenta leaves behind a wound the size of a dinner plate inside your uterus.
  • Throughout pregnancy, your uterus becomes up to 500 times larger than it was before. Once the placenta is gone, it shrinks back to its pre-pregnancy size in a process called uterine involution.
  • As the uterus shrinks, you will experience postpartum bleeding and may have cramps (aka afterpains).
  • Prioritize your rest and recovery. Taking on more than you can handle may increase postpartum bleeding and slow the healing process.

It’s important to take it slow during postpartum recovery. Healing encompasses many physical changes, including some you can’t see.

After childbirth, the placenta leaves behind a wound the size of a dinner plate inside of your uterus. During the healing process, you will experience postpartum bleeding and contractions as the uterus shrinks back to its pre pregnancy size.

Give yourself time to recover. It typically takes a minimum of about  six weeks for the uterus to contract, though each individual’s recovery is unique.

The timeline of full healing depends on a variety of factors including whether you had a vaginal or c section delivery, the size of the placenta, and complications such as hemorrhaging.

Here’s how the uterus transforms during pregnancy and postpartum, and what you can do to prioritize your rest and physical comfort as it heals.

What happens to the uterus during pregnancy?

During pregnancy, the body transforms into a source of nourishment for your growing baby.

The placenta, a temporary organ that provides oxygen and nutrients to a developing fetus, attaches to the wall of the uterus during pregnancy.

Its growth begins about 7-10 days after conception. It starts as just a few cells and grows until it is about 10 inches long.

As your baby grows in the womb, and as the placenta develops, your uterus expands. By labor and delivery, your uterus will be up to 500 times larger than it was pre pregnancy.

Additionally, the uterine lining thickens and uterine blood vessels widen. All of these changes allow your body to deliver nutrients to your baby.

What is uterine involution?

Once your baby is outside of the womb, the placenta no longer serves a purpose. During a vaginal delivery, you will deliver the placenta during the third and final stage of labor.

If delivering by c section, your healthcare provider will remove the placenta from your uterus.

Uterine involution begins after the placenta’s removal. In this process, the uterus returns to its pre pregnancy size and weight. It will take up less space in your pelvic cavity with each passing day.

Involution affects both your physical comfort and your fertility, as it allows your menstrual cycle to restart.

During this process, you will experience contractions that compress the blood vessels in your uterus. This prevents postpartum hemorrhage, or excessive blood loss, from the placenta’s detachment, in addition to helping the uterus shrink.

Breastfeeding may accelerate the shrinking of the uterus. A newborn’s nursing stimulates production of a hormone called oxytocin, which increases uterine contractions.

Uterine involution involves a type of vaginal bleeding called lochia. This postpartum bleeding typically tapers off over four to six weeks. You may also experience cramping, or afterpains, from the uterine contractions.

There are ways to reduce discomfort and abdominal pain during uterine involution and postpartum bleeding, including:

  • Chilled pads or ice packs
  • Padded pillows
  • Witch hazel sanitary pads
  • Sitz bath herbs
  • Over-the-counter pain relief

What are the signs and symptoms of postpartum uterine infections?

Though it is rare, a postpartum uterine infection — also referred to as puerperal infection — may develop after childbirth if bacteria enter the uterus and surrounding areas.

There are different types of postpartum uterine infections, categorized by where they develop:

  • Endometritis is an infection of the uterine lining.
  • Myometritis is an infection of the uterine muscle.
  • Parametritis is an infection of the area surrounding the uterus.

Seek medical care if you experience any of the below signs of postpartum infection. They may take several days to develop.

  • Blood clots
  • A fever or other flu-like symptoms including chills, nausea, headache, or loss of appetite
  • Intense abdominal pain or pelvic pain
  • Redness, swelling, or discharge near a c section incision or perineal tear
  • Foul-smelling discharge

As a precaution against infection, use pads during postpartum bleeding until a healthcare professional gives you clearance to insert anything intravaginally, and change them frequently.

Many women need to change pads every one to two hours when postpartum bleeding begins. This will gradually decrease in the following days.

What is postpartum hemorrhaging?

Postpartum hemorrhaging is another rare but serious complication to be mindful of. This is excessive blood loss in the days or weeks after giving birth. The bleeding may occur from the placenta’s detachment from the uterus or vaginal or cervical tears.

Seek medical care immediately if you experience any of the below signs of postpartum hemorrhaging.

It can develop up to 12 weeks postpartum or more, so continue to watch for signs and symptoms.

  • Excessive vaginal bleeding (i.e., soaking through a menstrual pad in an hour or less)
  • A drop in blood pressure and related symptoms such as dizziness, faintness, or blurred vision
  • Pale or clammy skin
  • Nausea or vomiting
  • Intense abdominal pain or pelvic pain

What should I prioritize during postpartum recovery?

Rest, rest, rest! The body takes time to recover from childbirth — more so than is often acknowledged in the U.S.

Many cultures recognize the importance of “lying-in” during postpartum, with various practices that support a birthing person’s recovery. However, our own society doesn’t prioritize this phase as it should.

Lying-in isn’t only about your physical healing.

The fourth trimester, as the first 12 weeks after childbirth are classified, is an emotional transition. It includes hormone changes, new responsibilities, and not nearly enough sleep.

Resist the pressure to bounce back quickly. In fact, taking on too much can slow postpartum recovery and increase bleeding.

Prioritize your care and well-being and seek support from friends, family, and trusted birthing professionals.

If you’ve chosen to breastfeed, work with a lactation consultant to ease the transition and address any breastfeeding challenges.

We’re here for you during postpartum

Postpartum isn’t a few months following childbirth — it’s an ongoing health journey. And we’re with you through it all.

Ruth Health provides expert, evidence-based information and support, so that you can make the best decisions for you.

Visit our resource hub for more on pregnancy, postpartum, and everything in between — and be sure to join our community by signing up below!

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