By Lovetti Lafua
Nurse • Midwife • Biologist • Maternal Health Advocate • Human Optimization Researcher

The First 24 Hours of Postpartum Recovery

The fourth stage of labour is a time of intense physical adjustment for a woman’s body.

In chapter one we discussed The Body’s Urgent Work After Birth click on the link to read more about it.

After holding a full-term baby for nine months, the uterus begins a process called involution, gradually shrinking back toward its original size.

During this time, many mothers experience strong cramps, especially while breastfeeding. These sensations are commonly known as afterpains, and although they can feel uncomfortable, they are actually a positive sign.

They show that the uterus is contracting effectively and reducing the risk of postpartum bleeding.

Bleeding during this stage is also normal as the body sheds the lining that supported pregnancy. However, skilled midwives closely monitor the amount of blood loss because excessive bleeding can signal complications.

At the same time, the mother’s circulation is rapidly adjusting.

During pregnancy, her body carried a much higher blood volume to support both the baby and placenta. After birth, the cardiovascular system must rebalance itself quickly.

Meanwhile, the newborn is undergoing its own major transition learning to breathe air, regulate body temperature, and begin feeding.

In these first hours, mother and baby are adapting together, and their bodies remain deeply connected.

The Emotional and Physical Reality of the Fourth Stage

For many women, the fourth stage of labour brings a powerful mixture of emotions.

There can be relief, exhaustion, joy, vulnerability, and an overwhelming sense of love all at the same time.

Some mothers describe the hours after birth as peaceful and almost dreamlike. Others feel shaky, weak, or deeply tired after the intense effort of labour.

From a midwifery perspective, all of these responses are completely normal.

Birth is one of the most physically demanding experiences a body can go through. Hormones shift rapidly, energy reserves are depleted, and the process of healing begins immediately.

This is why experienced midwives encourage mothers to:

• rest as much as possible
• stay warm
• remain close to their babies
• allow the body time to recover

Even when it feels quiet on the surface, the body is doing extraordinary work behind the scenes.

Why the Fourth Stage of Labour Matters

Modern maternity care often focuses heavily on labour itself the contractions, the delivery of the baby, and the birth of the placenta.

But what happens after that is just as important.

The fourth stage of labour is when the body protects itself from dangerous bleeding, begins the process of healing, and forms the first deep bond between mother and child.

For midwives, this stage is not simply a period of observation.

It is a time of careful guardianship.

A calm environment, warmth, skin-to-skin contact, and minimal disturbance allow the mother’s body to complete its natural transition from pregnancy to motherhood.

Birth does not truly end when the placenta is delivered.

It continues in the quiet, powerful hours that follow when a woman’s body protects itself, restores balance, and begins the journey of recovery.

And in many ways, these hours deserve just as much attention, respect, and care as the birth itself.

References
• World Health Organization. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience.
• World Health Organization. (2012). Prevention and treatment of postpartum haemorrhage.
• International Confederation of Midwives. (2017). Essential competencies for midwifery practice.
• American College of Obstetricians and Gynecologists. (2017). Practice Bulletin No. 183: Postpartum hemorrhage.
• Myles Textbook for Midwives. Elsevier.
• Varney’s Midwifery. Jones & Bartlett Learning.