What is the puerperium and how long does it last? Complete Postpartum Guide
The puerperium, also known as quarantine or postpartum stage, is a physiologically, emotionally and socially intense period that begins after the birth of the baby and extends until the mother's body recovers, to a large extent, the conditions prior to pregnancy. It encompasses much more than a physical recovery: it involves hormonal readjustment, the establishment of breastfeeding, the bond with the newborn and a process of psychological adaptation to motherhood.
How long does the puerperium last?
Although popularly referred to as "the 40 days", the actual duration of the postpartum period is not exact or the same for all women. Traditionally, it has been divided into three phases:
- Immediate puerperium: covers the first 24 hours after childbirth. It is a critical stage where vital signs, uterine contraction, blood loss and the baby's first feeding are monitored if breastfeeding is chosen.
- Clinical or mediate puerperium: it goes from the second day to the tenth day approximately. Here there is an intense uterine regression, hormonal decrease, appearance of lochia (vaginal discharge) and initial adaptation to breastfeeding.
- Late puerperium: extends from day 10 to 6-8 weeks after delivery, although some hormonal, emotional, and sexual functions can take up to 6 months or more to stabilize, especially if there is exclusive breastfeeding.
According to the American College of Obstetricians and Gynecologists (ACOG), postpartum follow-up should not be limited to a single visit at 6 weeks, as the postpartum period can last up to a year in some physical and mental aspects.
The puerperium is a stage of integral recovery: body, mind and bond.
Physical changes during the postpartum period
During the postpartum period, the body begins a progressive recovery. Some common changes include:
- Uterine involution: The uterus returns to its pregestational size. This process can generate discomfort similar to contractions, called wrongs, especially in breastfeeding.
- Lochia: these are vaginal secretions that evolve from red to brown and then to whitish. Its normal duration is 4 to 6 weeks.
- Weakened pelvic floor: it is common to notice urine leakage, a feeling of weight or difficulty retaining gas.
- Breast changes: Bulking, milk let-up, and sometimes congestion or cracking.
- Constipation and hemorrhoids: common after vaginal delivery.
Emotional and psychological changes
Emotional balance in the postpartum period can be very vulnerable. Approximately 80% of mothers experience what is known as baby blues: a state of mild sadness, easy crying, irritability, or anxiety, which appears between the second and fifth day and disappears without medical intervention.
However, 10-15% may develop postpartum depression, a more serious condition that requires professional follow-up. In less frequent cases, postpartum psychosis may occur.
According to the World Health Organization, it is essential that health systems include maternal mental well-being as part of comprehensive postpartum care.
"Postpartum is not the end of labor, but the beginning of a new life for mother and baby."
When to have sex or exercise?
In the absence of complications, it is recommended to wait at least 6 weeks to resume penetrative sex, although the most important thing is that the woman feels comfortable, pain-free and emotionally ready.
Regarding exercise, you can start with gentle movements such as walking from the first days if the body allows it, but it is ideal to start specific exercises for the pelvic floor and abdomen (such as hypopressives or Kegels) after a professional evaluation.
Postpartum check-up: a key appointment
The postpartum check-up visit, usually between 6 and 8 weeks, is critical for:
- Check for uterine involution
- Evaluate the pelvic floor and scarring (episiotomy, cesarean section, tears)
- Talking about contraception and sexuality
- Assess the emotional state and establishment of breastfeeding
The Spanish Society of Gynecology and Obstetrics (SEGO) stresses that this visit should be adapted to each case and even brought forward if there are warning signs.
It is important to seek medical attention if you develop:
- Fever greater than 38 °C
- Heavy bleeding (more than one compress per hour)
- Severe and persistent abdominal pain
- Bad smell in lochia
- Painful urination or severe incontinence
- Deep sadness, severe insomnia, or negative thoughts
Never hesitate to consult a midwife or health professional if you have any worrying symptoms.
This article is not a substitute for medical care