We’ve teamed up with Emily Oster at ParentData to help you manage all things postpartum. Emily is on a mission to empower parents by providing the data and tools they need to make confident decisions. As an economist and mom of two, Emily uses her expertise to review and analyze data to help other parents navigate everything from pregnancy to postpartum and all that goes into raising young kids. Learn More.
Checking in
"How are you doing?"
When pregnant, most of us spend a lot of time planning for the baby — onesies, diapers, crib, and more. We tend to spend much less time preparing for our own postpartum experience. We’ve got enough baby wipes to last for months, but we forget to consider what we need for our own healing, both physical and mental. Without preparation, we often find ourselves asking, Is this normal? Should this be happening now? Should I be worried? My core belief is that facts and data can help us answer these questions and prepare for our own experience.
Today: The facts and data about what to expect at four weeks postpartum.
Things you're probably already experiencing
"What should you expect and when do they end?"
BLEEDING
Heavier at first, gradually tapering
Everyone, regardless of how you gave birth, will have bleeding after delivery (this bleeding is called lochia). This is very heavy for the first few days post-birth, and then it tapers to more like a heavy menstrual period and then a lighter one. In one large study, the average length of bleeding was 36 days, which means you may be coming toward the end. Learn more.
EXHAUSTION
Sleep deprivation peaks around 3-4 weeks
Babies sleep for many hours a day, but mostly those hours are not continuous. Parents at the three or four-week mark are often hitting a maximum level of exhaustion. You may have less help than you did in the first weeks, and the sleep deprivation has accumulated. Sleep deprivation is a form of torture — literally — so if you’re struggling with it, first give yourself a break. This is the time to call in reinforcements: a friend with an older child to take a night shift or even your mother-in-law. Don't be afraid to ask for help.
PAIN
What's normal and when to get help
Nearly everyone experiences some pain after childbirth. At this stage — about a month out — you may still be having (among other things) breast pain, nipple pain, or pain from a C-section or vaginal birth recovery. Some of this is normal and will ease with time, but pain that gets worse or is agonizing (for example, if you are in intense pain every time your baby latches) should be addressed with your doctor.
MOOD CHANGES
“How can you tell the difference between baby blues & PPD depression?”
Postpartum mood changes are extremely common. Pregnancy, giving birth, breastfeeding — they all cause changes in hormones, which can affect mood. Sleep deprivation can impact mood as well. All postpartum mood changes deserve attention, but it is often helpful to separate what’s sometimes called “baby blues” from “postpartum depression.”
BABY BLUES Heightened Emotions Shortly After Birth.
Nearly everyone will experience heightened emotions in the week or two after birth. When my daughter was a week old, I recall crying for an hour because someone brought me a plate of food. These emotions can be happy, but they can also be sad. Baby blues are relatively mild and, importantly, limited in time. They typically overlap with the initial week or two’s surge of hormones.
vs.
POSTPARTUM DEPRESSION Persistent Depression Post-Delivery
Postpartum depression affects at least 10% to 15% of women post-delivery (and can occur for non-birthing partners also). Unlike the baby blues, this can persist—and may even arise months later. There are some situational factors that increase risk, and some women are at higher risk because of a history of depression. But everyone is at some risk and should be screened. You can find a screening tool for postpartum depression in this ParentData post. This screener may be used at your doctor’s visit at six weeks, but I would urge you to use it before that and after — we know that postpartum depression can be treated, and getting the right care is so important. Learn more.
3 other important notes for this period
Body Shape: Whatever self-care looks like for you, give yourself a bit of it. A walk, a coffee alone, a manicure — do something for you.
Hair Loss: Your hair sticks around for longer during pregnancy and then it falls out at a higher rate postpartum. Don’t panic! This can last for up to a year, but things should return to your pre-pregnancy normal.
Self-Care: Your uterus takes six to eight weeks to return to its pre-pregnancy size, which means you likely still look a little pregnant. This is completely normal.
Congratulations on making it through the first month! Four weeks old can be a difficult moment — your baby probably isn't smiling yet, they often cry a lot, and you’re tired. But you’re doing an amazing job, and it gets so much easier (I promise).
If you want more content like this, please check out ParentData.org, where you find all of my writing on pregnancy, parenting, and beyond. My goal is to save you from the panicked late-night googling that we all know parents do ("is this a normal poop color?!") and make sure that you've got the answers you need to get back to sleep (as long as the baby let's you!).
— Emily Oster,
Parenting Author & Economist
