Private postnatal recovery clinic in London, same-day women's health.

Bleeding and the first weeks

• Lochia — bleeding for two to six weeks, gradually changing from red to pink to brown to yellowish-white. Doing too much often makes it redden again, which is a useful signal to rest.
• Afterpains — cramping during feeds, worse with each subsequent baby. Painkillers before a feed help.
• Perineal soreness — ice packs in the first 48 hours, then warm baths, regular pain relief, and a peri bottle of warm water while passing urine.
• The first bowel movement is dreaded by everyone. Use a laxative, support the perineum with a clean pad while going, and drink plenty.
• Caesarean scar — numbness around it is normal and can persist for a year. Once healed, massaging the scar daily reduces tethering and sensitivity.

Pelvic floor

• Start gentle pelvic floor exercises as soon as you feel able, usually within a day or two, even with stitches.
• Squeeze as though stopping wind and urine, lift inwards, without clenching the buttocks, thighs or holding your breath.
• Long holds and short squeezes, three sets a day, for at least three months.
• Squeeze before you cough, sneeze or lift — this alone reduces leaking substantially.
• If leaking persists at three months, ask for referral to a women's health physiotherapist rather than waiting it out.

Abdominal separation

Some separation of the abdominal muscles occurs in every pregnancy and most closes over the first few months. What matters is how well you can generate tension across the gap rather than the width itself. Avoid sit-ups, crunches and planks early on; start with breathing, deep abdominal activation and gradual loading. A physiotherapist assessment is worthwhile if there is still a visible dome or bulge at three months.

Returning to exercise

Returning to running before around twelve weeks is associated with more pelvic floor problems. The test is not the calendar but symptoms: any leaking, heaviness or pain means going back a stage. This applies equally after a caesarean, where the abdominal wall needs time regardless of the perineum being intact.