Louise Kolin of New York City remembers clearly how she felt the first six weeks after delivering Charles, now three months old. "I was very sore in my back and vaginal area. I felt like I had been beaten up." Although Louise's extreme physical condition was a result of a complicated delivery, all new mothers are met with varying degrees of physical challenges following childbirth and the weeks beyond.

Your body has performed a physical feat that far surpasses the demands expected of million-dollar athletes. In less than a year, you conceived, developed and delivered a beautiful, living creature - a performance that used every ounce of your body's resources and then some.

Now your body must take on the rigorous new role of readjusting to its prepregnant state. "This is a time of incredible transition," says Gail Heathcote, CNM, MSN, CNS and Ob Outreach Coordinator at Spectrum Health-Downtown, in Grand Rapids, Michigan. Hormones continue to play a big role in directing your body through the necessary changes after childbirth. Progesterone and estrogen levels drop by 90 percent within the first few days after birth. This rapid plunge, plus the physical discomfort and fatigue, can wreak havoc on a new mother's emotional state - fluctuating from bouts of irritability to sustained periods of crying.

"The postpartum time is not exactly a time of bliss for most women. It's a time of incredible exhaustion," explains Heathcote. "A new mother needs to be treated like a princess for at least the first two weeks to make sure the family bonds. She also needs this time to get her energy back."

Fighting fatigue when your newborn doesn't sleep for more than two hours at a time may be impossible if mothers don't get help. "By day five or six, we see a crash where some new mothers get completely exhausted from lack of sleep," says Ruth Hope, CNM, MSN, of BirthPartners in Portland, Maine. "We've found that if mothers can get a good, solid four-hour pocket of sleep, they feel much better. That also combats depression and sleep deprivation."

This certainly held true for Debbie Gray from Louisville, who recalls an easy adjustment to new motherhood. "I stayed with my mother for three months after Shelby was born while our house was being remodeled," she says. "I'd take care of Shelby during the night and at 7 am my mother would take over. I'd get an extra hour-and-a-half of sleep. It was wonderful."

Within six weeks of delivery, your body is well on its way to recovery and your midwife or doctor will want to check your progress. Although you may be anxious to return to your prepregnant shape, being informed of the process will help you to appreciate the phenomenal changes your body is undergoing and will help you to be more patient.

Abdomen. You may be surprised that your tummy still looks pregnant for a few weeks after delivery. Your uterus is still enlarged and the muscles supporting it need time to become taut again. Within six weeks, in a process called involution, your uterus will contract back to its normal state - about the size of a small pear.

During involution, you'll experience mild cramping, or after pains, that are instrumental in clamping off blood vessels and reducing postpartum bleeding. If you are breastfeeding, you may feel these after pains as your baby nurses since this activity stimulates oxytocin, the same hormone that causes the uterus to contract.

C-Section. If you delivered your baby via c-section, your recovery process will take longer and you will need more help. You'll need plenty of rest to recoup and will probably take pain pills that will make you groggy. As converse as it may sound, you'll also need to keep moving to promote circulation and speed up the overall healing process.

Your incision should heal on the outside in two to three weeks, but may remain sore and sensitive for up to two months. Some new moms contend with itching around the incision site for several months more.

Vagina. Your body's blood volume doubled during pregnancy. Now that it's no longer needed, the excess blood will be released through vaginal discharge, called lochia. For the first four or five days, the flow will be bright red and heavy, and may contain clots of blood. The color will gradually lighten, and may change to yellowish-pink, then creamy white. The flow should taper off within two weeks. Occasionally, it may return to a reddish color, especially when breastfeeding. If the discharge becomes heavy, remains red in color, or has an unpleasant odor, contact your midwife or physician.

Other stored fluids are eliminated through your urine which explains your seemingly endless trips to the bathroom. Some new mothers experience heavy perspiration - another way that your body chooses to eliminate excess fluids.

Perineum. The area between your vagina and rectum, the perineum, also takes time to heal, whether you receive stitches or not. The discomfort shouldn't last more than four or five days. To provide relief and reduce the risk of infection, spray the area often using a peri-bottle filled with warm water. A warm bath or an ice pack will also relieve some of the discomfort.

Constipation. One of the more undesirable side effects of childbirth is constipation which, if not prevented, can affect new mothers for at least a few days, maybe even weeks. A number of factors are responsible for this sluggish intestinal behavior beginning with out-of-shape abdominal muscles, swollen tissue following delivery, use of anesthesia, epidurals and some pain relievers. New mothers are also leery of putting pressure on the stitched perineal area and may inadvertently create a logjam.

There are several things you can do to lessen these problems: keep moving; don't sit for long periods of time; drink plenty of water; eat high-fiber foods, such as raw fruits and vegetables; and choose whole grains products.

Breasts. Your breasts have just spent nine months preparing themselves for nourishing your newborn. As they prepare for breastfeeding, they may feel achy, full and tender to the touch. Your nipples may be sore. Wearing a supportive bra after childbirth, morning and night, will help protect the tender breast tissue and ease the achy feeling.

Eager for the job ahead, your breasts may fill themselves to overcapacity. Once engorged, they'll feel rock hard, and possibly hot to the touch. If your breasts are too full, your baby may have trouble latching on. Express a little milk manually or with a pump to soften the areola. Engorgement will occur less often once a feeding routine is established.

Skin. If your skin took on the proverbial glow of pregnancy, don't be alarmed when all of that changes after childbirth. Coupled with fatigue and a host of other physical changes, your skin may feel drier and less radiant. Rest assured, your skin will regain its normal tone once your menstrual cycle begins again.

Any skin discoloration that occurred during pregnancy, such as pregnancy mask or linea nigra, should disappear about three months after delivery. Eliminating sun exposure to these areas will keep the color from darkening. Stretch marks will also begin to fade.

Hair. If your hair is falling out at such a rate that baldness suddenly seems feasible, don't panic, the condition is only temporary. Prior to pregnancy, you probably lost an average of 100 hairs per day. Pregnancy hormones essentially put a hold on this hair loss rate, causing your locks to feel thicker and healthier. Now that hormone levels have drastically dropped, your hair must make up for lost time. All should be back to normal by the end of baby's first year.

Exercise. You probably haven't yet been given the green light to enter into a full-fledged exercise program (and mustering the energy to even think about it is unlikely right now), but starting with simple movements soon after childbirth will boost your energy and speed your recovery.

Begin with Kegel exercises as you did during pregnancy. These will help strengthen the pelvic floor, increase blood flow to the perineum, and promote healing. They will also help prevent incontinence and help your body to regain vaginal tone.

Walking is a perfect warm-up to more aerobic exercise later on. "Walk gently, 15 to 20 minutes per day, and get out into the fresh air," suggests Hope. "By eight weeks you should be ready to resume your regular exercise routine."

Nutrition. Watching what you eat for nine months may be a long enough sentence for some, but good nutrition is especially important now that your body is on the rebound. Careful food selection will help speed your physical recovery, keep your energy level up, and help with milk production. Unfortunately, with your new and demanding responsibilities, grabbing a quick bite may encourage unhealthy food choices. Eliminate this temptation by keeping cut-up fruit and veggies in the refrigerator for between meal munchies. Stock up on yogurt, low-fat cheese, and other quick fixes that offer essential body-healing nutrients.

Dieting to lose extra weight before your baby is weaned from breastfeeding could affect your milk supply. If you aren't breastfeeding, your midwife may give you the thumbs up after your six-week visit. Remember: losing weight too quickly can slow the recovery process and lead to postpartum depression.

Sex. If you're like most new mothers, it may take a while for your desire for sex to return. There's good reason: your hormones are still at work; you may be experiencing perineal tenderness, vaginal dryness and fatigue; and your thoughts are preoccupied with caring for your baby. "Most women say they're never having intercourse again, and certainly not by six weeks," declares Heathcote. However, she finds that the majority have resumed sex by their six-week checkup.

Waiting six weeks after delivery to resume intercourse will allow your uterus to heal and reduce the risk of infection. However, depending on the type of labor you had, this time frame may be altered.

Contraception. Since ovulation occurs about two weeks before your period returns, it's especially important to use birth control each time you and your partner have sex. The most commonly recommended form of contraception during this six-week time frame is the condom used in conjunction with spermicidal jelly, but consult with your midwife for alternate suggestions.

Six-week check up. Your midwife or doctor will typically schedule you for a six-week checkup after delivery. By this time, your body is on the mend, and you've had time to adjust, though not fully, to your new lifestyle. Any concerns, both physical and emotional, should be discussed now, if not sooner.

The physical examination will include checks of the following:

• Shape, size, and location of uterus to insure that it has returned to its prepregnant state
• Episiotomy or c-section stitches have healed
• Vaginal discharge is clear
• Blood pressure
• Weight - down by about 20 pounds since before delivery
• Cervix, vagina, ovaries, fallopian tubes and perineum
• Abdominal wall if you had a c-section
• Breasts
• Hemorrhoids
• Birth control
• Urine sample
• Legs for swelling or varicose veins
• Pap test

You'll be encouraged to discuss parenting issues, social support, sex, birth control, exercise, diet, breastfeeding and emotional concerns. Prior to your visit, write down questions of concern so that you won't forget them.