Postpartum Recovery and Postpartum Depression

🩹Physical recovery: the first 6 weeks

It usually takes around six weeks for the uterus to return to its normal size and for postpartum bleeding (lochia) to taper off. Lochia is typically red at first, then gradually lighter in color and amount. After a vaginal birth, perineal pain may linger for a while; after a cesarean, wound pain may.

A postpartum checkup around 4 to 6 weeks after birth is a good time to check uterine recovery, wounds, blood pressure, and mood. If you had gestational diabetes or high blood pressure in pregnancy, discuss follow-up tests then too.

• Get sleep, even in pieces. When the baby sleeps, put rest ahead of housework.
• Do not skip water or meals, especially if you are breastfeeding.
• Start heavy lifting or vigorous exercise only after discussing it with your doctor at the postpartum checkup.
• If you leak urine or feel heaviness in the pelvis, pelvic floor exercises may help; ask at your checkup.
• Discuss contraception and the timing of your next pregnancy at the checkup. You can get pregnant while breastfeeding.

🌧️Baby blues vs postpartum depression

Tearfulness, irritability, and mood swings in the first few days after birth are called the baby blues. Many mothers experience them, and they usually go away on their own within two weeks of birth. Rest and support from those around you typically help.

Postpartum depression is when low mood lasts longer than two weeks, or is severe enough to make daily life and caring for the baby hard. It often starts within a few weeks of birth but can appear any time in the first year. It is not a matter of personality or willpower; it is a treatable condition.

• Feeling down or empty nearly every day, losing interest in things you used to enjoy
• Being unable to sleep even when the baby sleeps, or sleeping far too much
• A big drop or rise in appetite
• Feeling no bond with the baby, or guilt that you are not a good enough mother
• Intense anxiety, panic, or thoughts that something bad will happen to the baby that you cannot shake
• Thoughts of harming yourself or the baby

📝Screening

Postpartum depression is screened with a short questionnaire. A well-known one is the Edinburgh Postnatal Depression Scale (EPDS), a brief set of questions about your mood over the past week. In Korea, you can take it at obstetric or pediatric clinics, public health centers, and community mental health welfare centers; a high score leads to a specialist consultation.

Screening is not a diagnosis. It is a tool that shows whether a closer look is needed. Rather than scoring yourself online and feeling reassured or worried, it matters more to bring the result to a clinician and talk it through. You may be asked about your mood at your baby's checkups, too; please answer honestly.

🤝When and where to get help

If depression or anxiety lasts more than two weeks, or sleep, eating, or caring for the baby become hard, see an obstetrician or a psychiatrist. Both counseling and medication work, and some medications can be used while breastfeeding, so tell your doctor whether you are breastfeeding and they will take it into account.

In Korea, local public health centers and community mental health welfare centers also offer counseling and referrals. Many areas have mental health programs for pregnant women and new mothers, so ask your local public health center.

• Mental health crisis line 1577-0199 (Korea): mental health crisis counseling
• Suicide prevention line 109 (Korea): unified into a single number in 2024, 24 hours
• Life-threatening emergency: 119
• Local public health center or community mental health welfare center: counseling and referral to care

🏠How family can help

• Take at least one night feed so the mother can sleep 4 to 5 hours in a row (using formula or pumped milk).
• Handle housework and visitors, and keep visits short.
• Instead of "Are you okay?", ask something specific like "What was hardest today?"
• Listen before advising, and help book and attend appointments.
• Partners can become depressed too. Check in on each other.

💬FAQ