11.1 Normal postpartum events

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    The postpartum period extends from delivery to six weeks after delivery. This is the time it takes for the uterus to return to its initial size and for pregnancy-related biological and hormonal changes to disappear.

    11.1.1 Uterine involution

    • After the delivery of placenta, the uterus contracts and becomes hard. It is palpable below the umbilicus.
    • Around the fifth or sixth day, it is halfway between the navel and the symphysis pubis.
    • Around the tenth day, it is at the symphysis pubis.
    • After 6 weeks, it returns to its normal size.
    • The internal os closes between the eighth and twelfth day.

    11.1.2 Lochia

    Vaginal discharge, which is bloody during the first 3 days and then blood-tinged. It is usually odourless and stops after 15 to 21 days.

    11.1.3 Lactation

    • The first two days: secretion of yellowish colostrum.
    • Around the third day, breast tenderness, sometimes accompanied by a short-lived fever of 38-38.5 °C. The composition of the milk changes: mature milk, which is whiter and more abundant.

    11.1.4 Return of menstrual periods

    The first menstrual period usually occurs between the sixth and eighth week in women who are not breastfeeding.