The Significance Attached to "6weeks postnatal"

The Significance Attached to "6weeks postnatal"

Why 6 weeks?

The magic number of 6 weeks has long been used and thrown about, but do we truly know what we are referring to or why we have such significance attached to this number?
There is a perception that once you get to 6 weeks, you’re “cleared” – but what are you “cleared” for? And what are you “cleared” from?? Are you magically your pre-pregnancy self at this point?

Simply… no
More complicated… still no.

Health professionals have attached clinical importance to this point due to significant anatomical, physiological changes that occur in the body from birth to 6-weeks, known as “Puerperium” (1).
Puerperium = Anatomical & Physiological Changes occurring as a ‘result of withdrawal of pregnancy hormones’ (1).

This is just a complicated way of saying that there are genuine body hormonal changes that need 6 weeks to occur, only then can you start to utilise your body (on a hormonal level!) similar to that of your pre-pregnancy body. What is very important to take from this, is that you are NOT expected to immediately operate as you did pre-pregnancy, but your body is ready to start taking steps to get there. At what speed? Well, that’s completely up to you (… and your baby, let’s be honest!)

Why do we see such a change in hormones over the 6 weeks?
Because the Placenta is no longer around to act as your hormonal super machine!
In an instant, your body recognises that they’re no longer growing a human, but they’re now feeding & caring for one! Totally different hormones are required for these activities, so in comes your body’s physiology.
After your placenta’s birth, by 7-10 days, your hCG (the hormone that gives you a positive pregnancy test) levels are NO longer detected and your body’s oestrogen & progesterone levels reach basal levels (i.e low).
Little side note… a reason why oestrogen remains so low during breastfeeding is to prevent the menstrual cycle from returning, because without your cycle you can’t have another baby. A very simple way of your body telling you it’s not ready to go again… You can thank your body later 😉
So what else happens in the magical 6 week period??
  1. Your uterus is slowly making its way back to its normal size, along with the subsequent bleeding that occurs from the placenta peeling away from the inside lining of the uterus.
“Involution”: the term used to describe the gradual return and reduction of size of the uterus.
This involves the uterus contracting & reducing to pre-pregnancy size by 6 weeks, shedding of the lining (lochia) for 3-5 weeks and finally there is also the closure of the cervix that occurs after 2 weeks.
  1. Cardiovascular Changes: heart rate and body temperature changes that occur in the first 24 hours can last up to 6 weeks post birth. These include heart rates dropping and core temperatures elevating.
What does this mean for you? Swelling that may have occurred in the later stages of your pregnancy resolves, but this fluid must go somewhere… it goes back into the circulatory system which causes an increase in your urine output in the first day or two. So yes, you can attribute your pelvic floor stretch to your increase frequency to the toilet, but also know there is circulatory changes that are contributing to the frequency!
  1. Tissue Healing Timeframes: tissues need time to heal and recover. Just like a broken ankle, you might be in a boot for 6-8 weeks to allow for bone healing but doesn’t mean when the boot is off you go back to your pre-injury running levels! So why do we think it would be any different to postnatal recovery. 
Our bodies, no matter what the cause, have important tissue healing phases which they undergo to heal and recover. How long each of these phases ultimately is also very individual, depending on the circumstances, age and overall health status of the person.


If you had any degree of perineal tear or a caesarean birth, then your body will be hard at work to rebuild and strengthen. Tissue healing timeframes are as follows, but ultimately depend on the individual, their ages, overall health status and severity of injury:

  1. The Inflammatory Phase: Up to the first week  the goal is to stop the bleeding & initial reaction to injury.
  2. The Proliferative Phase: Up to the first 6 weeks  bulk of the scar tissue is formed by laying down collagen.
  3. The Remodelling Phase: 2-3weeks or up to months or years!  development of more organised and quality tissue, focused on building strength and function.
So what am I trying to say?

That 6 weeks isn’t a magic number that instantly means you should be feeling the way you felt pre-pregnancy. The pressure and stigma that women and society have attached to this has only resulted in women feeling even more isolated in their postnatal journey. Expectations should always remain personal and individual, never made for comparison. Even one mother can’t compare one pregnancy to another.

Finding yourself a trusted health professional (or 10 if you want!?) and a support network that has your best interest at heart will give you the best chance at achieving your postnatal goals… whatever they may be!
Important take away: 6 weeks is a physiological number. It’s not a checkbox that once achieved, all else is forgotten… because I can guarantee your new bub won’t let you forget 😉

Women’s health physios are there at any point. Don’t feel like you must wait until 6 weeks, especially if you have questions or want to know more about how you can best take advantage of the good work your body is doing.  

11th May 2023
(1) Atchan M and Cuss A. Routine care of postpartum women. In: Abbott J, Bowyer L, Finn M, ed. Obstetrics & Gynaecology: an evidenced based guide 2nd edition. Chatswood, NSW: Elselvier Churchill Livingstone; 2014. Ch 17

Back to blog