seem as if you should be done after pushing out that baby, you still have one important step of birth left. Your body will usually give a good rest as you meet and hold your baby for the first time, and then it will begin to contract again, this time a bit less intense than it was as the baby was coming out. The placenta after birth begins to close off the blood vessels that were securing it to the uterine wall and prepares to release. Once it is completely detached, it will slide to the uterine opening. You will be exhausted, but you will need to push a bit more to get the placenta out. This is not nearly as much work as the baby, thankfully, and the placenta usually comes out in one or two pushes once you feel the contractions again. It is important to wait until the placenta has completely detached from the wall of the uterus. Unless there is a serious concern, no one should be rushing the placenta along, but it is also important to make sure it comes out soon after birth and is intact. Many women want to see the placenta, and it truly is an amazing thing, this organ that has been the constant supply of oxygen and food and blood to your baby!
After the Birth
After birth, your body will immediately begin the process of recovering and healing. The uterus will continue to contract so that it can return to its pre-pregnancy size. These postpartum contractions are important for stopping the blood flow from the site where the placenta was attached. If the placenta is pulled out before the blood vessels have time to begin to close off, or if your uterus is not sufficiently contracting, it can cause a loss of blood that may be dangerous.
This is where that oxytocin knowledge helps again. Oxytocin is what causes the uterus to contract again. Remember the third time that oxytocin is released in huge amounts? When a baby is nursing! When the baby begins to suck at the breast, the released oxytocin not only helps stimulate your body to produce colostrum and then milk from your breasts, but it stimulates the uterus to keep contracting. This is one of many reasons why it’s important to keep you with your baby and help the baby to nurse right away. If your baby cannot nurse (or if a doctor is concerned about blood loss), you may be given Pitocin, the synthetic form of oxytocin, via an IV in order to mimic that natural response.
Your body will still bleed heavily for the next few days, gradually lightening over the course of a few weeks. Thinking of it as the menstrual periods that were missed over the last nine or ten months is a helpful way to understand it. The lining of the uterus is still shedding as it used to, but this time it has had nine months to build up. Small clots are normal, and the overall flow should resemble that of a period — heavy red the first few days and getting lighter and browner as the days and weeks pass. If you begin to go back to bleeding more heavily, it is usually because you are not getting the rest you need and are being too active. One doctor explained it like this: the site where the placenta was attached needs to close up and heal. It’s like a scab, and if you are doing too much before it is completely healed, you risk opening that scab back up and bleeding again, which means you need to heal again.
Immediately after birth, you will still look about five to seven months pregnant. The after cramping that comes with the uterus getting back down to size intensifies with each baby, since the uterus has more work to do to get back to that size. In the day or two following a birth, your provider or nurse will be checking your uterus to make sure it is firm and contracting well. The checking can be very uncomfortable! However, it is important to make sure that your uterus is contracting. Within a few weeks your uterus should be back to pre-pregnancy size. A good provider will make sure that this is happening well, that bleeding is controlled, and that your body is healing properly. You will be checked a day or two after birth, possibly a week later, and then there is usually a six-week checkup to ensure that your body has done the major recovering and there are no serious issues. Within two to four days your breasts switch from producing the extremely important thick yellow colostrum for baby to filling up with normal breast milk.
By natural design, baby will usually want to nurse frequently during these first few weeks. You often can’t do much else but lie or sit and nurse the baby. The frequent nursing helps to heal your uterus and forces you to lie down and rest so your body can recover. This is the time when mothers need a good support system in place to take care of the home and other children, provide meals, and offer emotional support. This help is vital to a mother’s physical, mental, and emotional well-being. The task of growing and birthing a baby is monumental, and it would be wise for us to recognize that a mere few weeks is not enough to heal and feel back to normal. This time is a tremendous opportunity for family, friends, the Church, and neighbors to pay their respects and play a part in building a culture that honors motherhood and birth.
The Fertility Cycle Design
Another interesting part of the design of the woman’s body is that typically there is a period of natural infertility after birth (called amenorrhea). Each woman is different in how long it will last, but breastfeeding releases hormones that tell your body to suppress ovulation. It is nature’s way of spacing births so that mom and each baby get the time they need before another pregnancy. The more often you nurse and the more that baby relies on your breast, the more often those hormones are released that potentially delay the return of fertility. For some women, the return of regular cycles can take eighteen months; for some it is only a few weeks. Factors that may increase the length of this time include nursing exclusively and not supplementing with formula or food, sleeping near the baby, nursing the baby during the night, not timing feedings but feeding on the baby’s cues, and soothing the baby with the breast rather than with pacifiers or distraction. The more often your breasts are releasing milk (and prolactin and oxytocin), the more your body will know that it’s not yet time to return to normal fertility. However, each woman is different, and God’s timing may be different, too. It is definitely possible to get pregnant before the period returns if ovulation occurs before that first cycle. So, a woman who is hoping to avoid pregnancy should be observing her body and noting any signs of fertility, even if her period hasn’t returned.
Familiarity with some form of natural family planning (NFP), or at least an awareness of your body’s personal fertility cues, can be helpful to know what is going on and if fertility is returning soon. An NFP instructor, through an official method such as Billings, Creighton, Sympto-Thermal, or Marquette, can be invaluable to a woman who is experiencing confusing signs (which is normal postpartum), especially if there is a need to delay another pregnancy.
That, in a nutshell, is how the female body and birth are designed to work. It is absolutely amazing to realize that we are still learning the many interconnected ways that the systems of our body and our baby’s body interact for the great act of birth.
The design is remarkably complex and intricate, and unless there is reason to intervene, mothers and babies have the best outcomes when the natural design is respected. We know that we have an all-knowing God who has planned us from all eternity, and that he is a God who desires only our good. His design for our bodies is not haphazard. We can honor and respect that design, which functions very well, while still acknowledging that sometimes we must intervene for good reason. We can thank God and praise him for the amazing design of our bodies, and we can use our bodies to give glory back to him. Our bodies are a gift to us, beautifully and intricately designed at the service of life. We truly are wonderfully made.
It’s so strange to me now that the only thing we learned in school about our fertility was how NOT to get pregnant. I don’t necessarily think it’s the school’s job to teach that stuff, but the irony is not lost on me that we didn’t learn how the female body actually works, just how to keep it from working. It wasn’t until I was an adult that I even fully understood my cycle. Learning NFP was really empowering for me. It taught me that my body made sense! I think that helped as I prepared for birth. I still had a lot to learn, but underneath [there] was a new confidence that my body worked, and when it was time, it would know how to birth.
— Teresa A., mom to five on Earth and one in eternity
The Birth of a Father