11.1 Normal postpartum events


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 six 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 three 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.