After childbirth: caring for yourself and your baby in the first 6 weeks

The first 6 weeks after birth are a healing time for you and a growing time for your baby. Most problems are small and fix themselves. But some signs need care today, not next week. This page teaches you what is normal, what is not, and when to go to a health facility.

On this page

• The 4 postnatal check-ups
• Danger signs for the mother
• Danger signs for the newborn
• Bleeding and healing
• Breastfeeding
• Caring for the umbilical cord
• Your feelings — baby blues and postnatal depression
• Family planning after birth

The 4 postnatal check-ups

Ethiopian Ministry of Health follows the WHO postnatal care schedule of at least 4 contacts in the first 6 weeks:

• First 24 hours (before you leave the health facility, or at home if you delivered there)
• Day 3 (48-72 hours after birth)
• Between day 7 and 14
• 6 weeks

At each visit, a health worker will check you (bleeding, blood pressure, healing, mood) and your baby (weight, feeding, cord, vaccines). Bring your antenatal card — it becomes your postnatal card too.

If you gave birth at home, go to your nearest health post as soon as possible. Home birth without complications is not an emergency, but the first check-up should still happen within 24 hours.

Danger signs for the mother

::: urgentAdvice severity=“urgent”

Urgent advice: go to a health facility today if:

• You have heavy bleeding (soaking a cloth in less than an hour)
• Your bleeding smells bad
• You have severe pain in your lower belly
• You have a fever above 38°C
• Your breasts are red, hot, and painful (breast infection)
• Painful, burning urination
• Swelling and pain in one leg (blood clot risk)
• You feel very sad, hopeless, or have thoughts of harming yourself or the baby :::

::: urgentAdvice severity=“emergency”

Emergency: go straight to a hospital if:

• You have very heavy bleeding (soaking a cloth every 15 minutes)
• You feel dizzy, faint, or lose consciousness
• You have a seizure
• You have severe headache with blurred vision (could be late pre-eclampsia — can happen up to 6 weeks after birth)
• You have difficulty breathing
• Your stitches (if you had a caesarean or tear) open up :::

Danger signs for the newborn

::: urgentAdvice severity=“urgent”

Urgent advice: take your baby to a health facility today if:

• Your baby is not feeding or feeds very weakly
• Your baby is very sleepy and hard to wake
• Your baby’s temperature is below 35.5°C or above 37.5°C
• Your baby’s breathing is very fast (more than 60 breaths a minute) or very slow
• Your baby’s skin, tongue, or lips look yellow (jaundice worsening after day 3)
• Your baby has a rash, boils, or the skin around the umbilical cord is red or oozing
• Your baby vomits everything and passes no urine for 6 hours
• Your baby’s soft spot on the top of the head is sunken or bulging
• Your baby has not passed meconium (first sticky black stool) within 48 hours of birth :::

Babies get sick fast. Do not wait until morning if any of these signs appear at night.

Bleeding and healing

Vaginal bleeding after birth is called lochia. It is normal.

• Days 1-3: heavy, bright red — like a heavy period
• Days 4-10: lighter, pinkish-brown
• Days 10-42: yellow-white, small amounts

If bleeding gets heavier again after it has slowed, or turns bright red again after week 2, go to the health post.

If you had a caesarean birth, your wound needs 6 weeks to heal. Keep it clean and dry. Do not lift anything heavier than the baby. Return the same day if the wound gets red, hot, painful, or leaks fluid.

If you had a tear or episiotomy, wash gently with clean water after every visit to the toilet. Pain that gets worse instead of better needs to be checked.

Breastfeeding

Breastfeed within the first hour of birth if you can — the first thick yellow milk (colostrum) protects your baby against infection.

Exclusive breastfeeding for 6 months — no water, no other food, not even a sip. Breast milk has everything your baby needs.

Common problems and what to do:

• Sore or cracked nipples: usually caused by the baby not latching well. Ask a health worker or trained counsellor to help you position the baby.
• Not enough milk: the more your baby feeds, the more milk you make. Feed on demand, day and night. Formula only if a health worker recommends it.
• Engorged breasts: feed more often. Express a little milk by hand before feeding. Warm cloths help before feeding, cool cloths help after.
• Red, hot, painful breast + fever: possible mastitis — go to the health post today. Keep feeding on that breast (it does not harm the baby).

If you are HIV positive and on treatment, exclusive breastfeeding is safe and recommended in Ethiopia. If you are HIV positive but not on treatment yet, start ART today and ask your health worker.

Caring for the umbilical cord

The cord stump will fall off on its own between day 5 and day 14.

::: doList

Do

• Keep the stump clean and dry
• Fold the nappy below the stump so it stays exposed to air
• Wipe with clean water only if the stump gets dirty
• Use chlorhexidine 7.1% gel or solution once a day if given by the health post :::

::: dontList

Don’t

• Do not put ash, butter, cow dung, or any traditional preparation on the cord — these cause serious infection
• Do not pull the stump off, even if it seems to be hanging by a thread
• Do not cover the stump tightly with cloth
• Do not use antiseptics other than what the health post gave you :::

Go to the health post today if the skin around the cord is red, hot, oozing, or smells bad — this is a sign of infection (omphalitis), which can be dangerous.

Your feelings — baby blues and postnatal depression

Feeling emotional in the first week after birth is very common. Crying easily, feeling overwhelmed, and mood swings are called the baby blues — they usually pass within 2 weeks without treatment.

Postnatal depression is different. If, after 2 weeks, you feel:

• Sad or empty most of the time
• No interest in the baby or in daily activities
• Extremely tired, even when you sleep
• Worthless or guilty
• Unable to bond with the baby
• Thoughts of harming yourself or the baby

…this needs care. Talk to a health worker. Postnatal depression is common (about 1 in 7 mothers) and treatable. Talking, family support, and sometimes medicine or counselling all help.

::: factBox

You are not alone

Postnatal depression is not weakness. It is not something a good mother would avoid. It happens because of hormone changes, exhaustion, and life pressure. Ask your health worker or health extension worker for support. :::

Family planning after birth

You can get pregnant again as soon as 4 weeks after birth, even if you have not had a period and even if you are breastfeeding.

Talk to the health worker at your 6-week visit about family planning options that are safe with breastfeeding:

• Progestin-only pill
• Injection (Depo-Provera)
• Implant (in the arm — lasts 3-5 years)
• IUD (can be inserted after 6 weeks)
• Male or female condom

Spacing pregnancies at least 2 years apart is safer for you and better for the baby’s health.

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Reviewed by Dr. Hanna Alemayehu, MD, MPH — Family medicine, Addis Ababa Last reviewed: 5 September 2026 · Next review due: 5 September 2028

Sources:

1. World Health Organization. WHO recommendations on postnatal care of the mother and newborn. 2022.
2. Federal Ministry of Health, Ethiopia. National RMNCAH-N Strategy 2020/21-2024/25. 2021.
3. World Health Organization. Guideline for the pharmacological treatment of persistent postpartum haemorrhage. 2020.

Content adapted from WHO 2022 postnatal care recommendations and Ethiopian MoH RMNCAH-N strategy. Reviewed for Ethiopian context by Dr. Hanna Alemayehu.

Draft notes (delete before publish)

• Word count: ~1,150 words (slightly over target — split into two articles if editorial wants shorter)
• Grade 7 reading level
• isTimeCritical: true — postpartum haemorrhage / eclampsia / neonatal sepsis are same-day emergencies
• Uses both urgentAdvice severities (urgent + emergency), doList, dontList, factBox (mental health)
• Ethiopian context: 4-visit WHO/MoH postnatal schedule, chlorhexidine cord care (Ethiopian MoH standard), health extension worker support, ART for breastfeeding mothers
• Addresses the “traditional preparation on cord” issue explicitly — a documented cause of neonatal death in rural Ethiopia
• Includes mental health (postnatal depression) — often missed in postnatal content
• Family planning section acknowledges “you can get pregnant 4 weeks after birth” — under-communicated
• Dr. Hanna Alemayehu is placeholder — B2B-22