Four weeks postpartum

No one’s recovery journey is the same, but at four weeks postpartum, there has likely been significant physical healing. You may still have light bleeding or spotting, and muscle strength — such as back, abdominal and pelvic floor strength — can take months if not a full year to recover. 

It can take time to refamiliarize yourself with your post-baby body, and you may not feel like your old self quite yet. Plus, your reality is quite different now that you’re a parent, and caring for a newborn presents its own set of challenges.

Here’s what to expect in terms of physical changes, mental health, energy levels, self-care needs, and intimacy this week.


Postpartum by week

Your body

Any postpartum bleeding will likely be minimal at this point, or you might still notice mild spotting. If you experience heavy bleeding this week, contact your healthcare provider right away. Those who had C-sections may still have slight tenderness at the incision site or potentially numbness as the nerves around the scar continue to heal.

At the four-week mark, it’s common to still appear pregnant. This is because the uterus is still shrinking and your abdominal muscles are stretched. Some people also experience hot flashes and night sweats around this time. Postpartum hormonal fluctuations are normal, but it never hurts to ask your healthcare provider if they’re frequent.

Breastfeeding exclusively takes a lot of energy, so make sure to eat well-rounded meals and drink plenty of water. The uncomfortable symptoms of breastfeeding may have subsided at this point. If you’re still experiencing pain or if baby is having trouble latching, try talking to a lactation consultant. 

Your six-week postpartum appointment is coming up, but don’t hesitate to reach out to your provider if you have questions or concerns now.

A note about formula 

For some people the decision to switch to formula, or to supplement breast milk with formula, is an emotional one. We’re here to remind you that it’s ok for your breastfeeding goals and plan to change. You know what’s best for your body and your family. 

Mental health

About 11% of new parents experience postpartum depression the first month after childbirth. You might feel sad, hopeless, anxious, disconnected from your baby, or cry over seemingly small things.

With the major lifestyle adjustment of becoming a parent, lack of sleep, hormonal shifts, and body changes, it’s normal to feel emotional. However, if you feel depressed or anxious for more than two weeks, check in with your healthcare provider or call the Postpartum Support International hotline.

Your energy levels

From waking up throughout the night for feedings to shifting hormones and a roller coaster of emotions, it might feel almost impossible to get enough sleep this week. But as you’re probably aware, a lack of sleep can directly affect your physical and mental health, and finding the time is definitely easier said than done. Still, getting plenty of rest can help prevent postpartum depression⁶ while ensuring you have enough energy to care for your baby.

Self-care

Laundry, cleaning, and cooking can feel like insurmountable tasks right now, and any self-care might seem completely out of the question. However, tending to your own needs is vital, even if it’s just taking a daily shower, going outside, getting back into a regular skincare routine, or accepting help from family and friends when you need to tackle a few things on your to-do list.

Sex and intimacy

It depends on your recovery and whether you had any complications, but healthcare providers recommend waiting until at least six weeks postpartum before having intercourse. Even if you’re feeling up for it, this will ensure plenty of time for healing.

It can take time to refamiliarize yourself with your body, and it may be tough to get into an intimate mindset so soon after having a baby. If you have a partner, finding some alone time to connect is important, but remember there’s no rush to have sex. Another important note: if you could become pregnant from sex, remember that it’s possible to ovulate within a month after having a baby, so it’s a good idea to figure out a birth control plan.

Returning to work

You might be returning to work as soon as this week or in the near future. Balancing a job and caring for a newborn is no easy feat, even if you’re able to work from home. Some new parents might feel relieved to get back to normal and have a “break” from childcare during the day, but the pressure to keep up with professional and family obligations can be overwhelming. 

Try to give yourself some grace during this time, and communicate with your healthcare provider about any severe or unusual mental or physical symptoms.

Reviewed by the Ovia Health Clinical Team

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