These are the topics we'll cover in this section:
Afterbirth Pains
Perineal Discomfort
Abdominal Pain
Constipation
Difficulty Passing Urine
Sore Breasts
Hemorrhoids
Fatigue (Tiredness)
Night Sweats
Hair Loss
When to Call Your Doctor
Afterbirth Pains
After the placenta is delivered, the uterus (womb) tightens firmly to the size of a grapefruit. Over the next 4 to 6 weeks, the uterus will continue to shrink to its nonpregnant size. This is called involution. As the uterus tightens, you may feel cramping in your lower abdomen or back. This discomfort is known as afterbirth pain and may last for several days after delivery.
How to help yourself:
Take your pain medicine as prescribed.
Take frequent warm showers.
Lie on your stomach, tucking a pillow under your stomach. This puts pressure on your lower stomach. Cesarean-birth mothers can also lie on their stomach. You will not harm your incision.
Put a warm pack on your lower stomach or lower back.
Empty your bladder. A full bladder puts pressure on the uterus and can cause cramping.
Breastfeeding mothers may have increased afterbirth pain while nursing.
Try taking your pain medicine 1 hour before nursing.
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Perineal Discomfort
Some discomfort is normal after a vaginal delivery. The perineum is the area around the birth canal or vagina. This discomfort is from stretching, bruising and swelling of the muscles during birth. You may have stitches from the repair of an episiotomy (incision to ease delivery) or tear. The stitches may pull, sting or hurt. Pain medicine may ease the discomfort.
How to help yourself:
Take your pain medicine as prescribed.
Put an ice pack on the area. Ice helps reduce discomfort and swelling.
Use your medicated sprays, creams and Tuck's® pads.
Take a sitz bath 2 to 3 times a day.
Use a doughnut ring or soft cushion for sitting.
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Abdominal Pain
If you have a cesarean birth, abdominal pain is normal. The pain is usually from your incision, which may pull, sting and hurt. It is usually the most tender the first few days after giving birth. It is also normal to have a small amount of pink watery drainage from the incision. If the drainage does not stop, call your health care provider. Another source of abdominal discomfort after a cesarean birth is gas pain. Usually this discomfort happens 1 to 2 days after giving birth.
How to help yourself:
Take your pain medicine as prescribed.
Move around. Change positions frequently.
Take frequent walks of 5 to 10 minutes.
Avoid carbonated drinks, very cold drinks or eating foods that cause gas for you. Do not drink through a straw.
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Constipation
The loss of abdominal muscle tone, hemorrhoids, surgery and stitches may cause constipation. It is normal not to have a bowel movement (BM) the first 2 to 3 days after giving birth.
How to help yourself:
Eat a diet high in fiber—whole grains, fruits and vegetables.
Drink 8 to 10 glasses of fluids daily.
Take a stool softener if instructed by your doctor.
If you do not have a BM within 7 days of delivery, let your health care provider know.
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Difficulty Passing Urine
You may have difficulty passing urine immediately after giving birth. Some vaginal-birth mothers may have swelling around the birth canal and opening of the bladder. This can make passing urine difficult at first. Some cesarean-birth mothers may have difficulty urinating after the catheter (plastic tube in the bladder to drain the urine) is removed. You may have cramps if your bladder gets too full. A few days after delivery, you may notice that you are passing urine in large amounts. Your kidneys are helping rid your body of the extra fluid retained during pregnancy.
How to help yourself:
Drink 8 to 10 glasses of water daily.
Try these suggestions to help relax the opening of the bladder while you are urinating:
Breathe deeply and slowly.
Run tap water. The sound of running water may help relax the opening of the bladder.
Pour warm water over your perineum.
Place your hands in warm water.
Be alert to the signs of infection and call your doctor or nurse right away if you have any of these symptoms:
Pain and burning while urinating
Passing urine in small amounts
Chills
Fever
Pain in the lower abdomen or back
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Sore Breasts
Three to five days after giving birth, your breasts may swell as milk production increases. This swelling is called engorgement and may be uncomfortable. Your breasts also may leak at times.
If you are breastfeeding:
Nurse at least eight times daily.
Wear a well-fitted support bra.
Seek the help of your doctor or lactation specialist if engorgement continues to be a problem.
If you are bottle-feeding:
Wear a well-fitted support bra.
Place an ice pack under each armpit to help decrease swelling and pain.
Take your pain medicine as prescribed.
Avoid running hot water over your breasts.
Avoid frequent touching or handling of your breasts.
The engorgement usually goes away in a few days. There are no safe medicines to "dry up" the milk.
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Hemorrhoids
Hemorrhoids are enlarged veins in the rectum. They are caused from the extra weight of the pregnancy and birth process. You may have
tenderness around the rectum from hemorrhoids, which may cause problems sitting. Hemorrhoids usually shrink 6 weeks after giving birth.
How to help yourself:
Use an ice pack to help decrease swelling.
Use your medicated spray, ointments or Tuck's® pads.
Take warm or hot sitz baths 2 to 3 times a day.
Sit on a soft cushion or rubber ring.
Follow the suggestions under "Constipation" to keep your BMs soft. This will help decrease discomfort when moving your bowels.
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Fatigue (Tiredness)
A period of high energy and excitement usually follows the baby's delivery. This may last 1 to 2 days after delivery. However, you are bound to feel some physical and mental fatigue from both labor and caring for a newborn. Other causes of fatigue are physical changes, hormonal changes, emotional adjustments to motherhood and lack of sleep.
How to help yourself:
* Limit unnecessary activity like frequent stair climbing.
* Do not lift items heavier than your baby.
* Whenever possible, sit down to do work. If you are too active, you may notice an increase in the amount of vaginal discharge.
* Get plenty of rest. Nap when the baby sleeps.
* Accept offers of help.
* Eat a well-balanced diet. Avoid foods high in sugar.
* Limit telephone calls and visitors if you need more rest.
* Treat yourself to something special, like going out to eat, getting a new hairstyle, or getting your nails done.
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Night Sweats
Once you are beyond the first few postpartum weeks, the rapid and radical changes that your body has undergone since delivery will slow down. You may still have puffy hands, legs or feet for a few months. Some women experience "night sweats" for a few weeks. When these occur, you may wake up during the night to find yourself drenched with perspiration and needing a complete change of clothes. These sweats are not related to breastfeeding, but to hormonal "ups and downs."
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Hair Loss
Another postpartum event that is often unexpected and may occur 6 to 12 weeks after giving birth is a certain amount of hair loss. Although seldom severe, it can continue for several months. Both breastfeeding and bottle-feeding mothers experience it. It, too, is caused by the influence of hormones, which takes hair follicles from a growing phase (present all during pregnancy) to a resting phase.
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When to Call Your Doctor
While some discomfort is common after your pregnancy, there are other problems that require the advice of a doctor. If you have any of the problems listed below, take your temperature, then call your health care provider immediately:
* Heavy bleeding. Passing blood clots or heavy bleeding is not normal. Vaginal bleeding will decrease every day. Bleeding will change from a red color to pink to dark brown and then to clear. This
discharge will continue for 2 to 4 weeks. Bleeding that begins one month or more after the birth of your baby is probably your period. If you are passing bright-red blood clots or need to change your pad more often than every 2 hours, your bleeding is considered heavy.
* Chills with fever of 101°F or more
* Frequent and painful urination
* Blood in your urine
* Swelling and/or pain in your legs or feet
* Dizziness, headaches and/or blurred vision
* Soreness, pain, red spots or red streaks on the breasts
* Severe and persistent pain in the abdomen, vagina or in the area of stitches
* Vomiting
* Foul-smelling vaginal discharge
* Drainage from an incision or sudden opening of an incision
* Feeling like you cannot cope with caring for yourself and the baby (excessive crying, anger, or feeling overwhelmed are all signs of difficulty adjusting to this new lifestyle)
If you have any questions or concerns, call your doctor or nurse. He/She will be happy to help you.
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A portion of the information contained within this page has been taken from patient education material from www.medicalcenter.osu.edu. © the Ohio State University Medical Center, Columbus, Ohio. All rights reserved.
The information contained in the www.medicalcenter.osu.edu website is provided as a public service by The Ohio State University Medical Center. It is posted for informational and educational purposes only. This information should not be construed as personal medical advice. Because each person’s health needs are different, a physician should be consulted before acting on any information provided in these materials. Although every effort is made to ensure that this material is accurate and up-to-date, it is provided for the convenience of the user and should not be considered definitive
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Postpartum Checkup
You will need a checkup 4 to 6 weeks after delivery to make sure your body is healing without problems. If you had a cesarean birth, you may need to have your checkup sooner.
The postpartum checkup has three parts:
General Physical Examination
Pelvic Examination
Questions and Answers
General Physical Examination
This part of the checkup includes:
Measuring your weight. A woman usually returns to her prepregnancy weight about 6 months after delivery. The postpartum period is not a good time to diet. Eat a healthy, well-balanced diet low in fat. For more information on weight loss after having a baby, talk to your health care professional, who can advise you on the best way to lose weight.
Taking your blood pressure. During pregnancy, your blood pressure may increase. By the end of the sixth week after delivery, your blood pressure usually returns to its prepregnancy level.
Examining your breasts. It is important to have your breasts checked for lumps and nipple problems. Your health care professional can show you how to check your breasts. Breast self-examination is important to do every month. If you are bottle-feeding, your breasts will usually return to their normal shape and size in 4 to 6 weeks. You still need to check your breasts regularly for any changes. If you are breastfeeding, your breasts still may be full and feel firm by the sixth week. Checking your breasts daily for lumps or plugged ducts can help prevent problems with discomfort or infection.
Examining your abdominal incision.If you had a cesarean birth or your tubes were cut or tied, you have an incision. Your health care professional will check your incision to make sure healing is complete.
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Pelvic Examination
This part of the checkup is an internal examination to check the health of your ovaries, uterus (womb), cervix (opening into the womb) and vagina (birth canal). Your health care professional also will check your perineum (area around the birth canal) for healing. The first part is checking your perineum. Your health care professional will examine the areas around the vagina, urethra (opening of the bladder) and rectum for healing. The second part of the internal examination is checking your vagina and cervix. Your health care professional will use a speculum to allow a visual inspection of the vagina and cervix. A few cells will be taken from your cervix and tested for cancer. This is known as a Pap smear and is routinely done at the postpartum checkup. The last part of the examination is checking your uterus and ovaries. Your health care professional will feel the shape and size of both. Vaginal bleeding, or lochia, usually stops in the first 4 to 6 weeks postpartum. Bleeding that begins one month after delivery is usually your period.
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Questions and Answers
After the examinations, your health care professional will tell you if your body is healing properly after childbirth. This is a good time to ask questions. You may be wondering about returning to work, exercising, birth-control methods or general health concerns. Write your questions on paper and take them with you to your appointment. Review them with your health care professional.
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Adjusting to a New Baby
Giving birth takes a lot of energy. And when baby arrives at home, your usual routine disappears. This section gives you some advice on how to cope with the demands and emotions centered around your new baby.
These are the topics we'll cover in this section:
The Demands of Daily Activities
Mixed Emotions
Postpartum Depression
Abuse Concerns
The Demands of Daily Activities
To get needed rest, you must realize that your baby does not need your attention every minute—for instance, when he is safely in the crib or playpen. By sharing child care and necessary household tasks with your partner—and with other family members or outside help—you will be able to regain your energy in due time. This sharing helps you feel good about both your baby and yourself.
Women rearing babies alone should try to establish contact with others for psychological support and for help in emergencies. Sharing your experiences with a single parents' support group, child care provider, neighbors, family, and friends can be reassuring. Interacting with other adults can also enlarge your baby's sense of belonging.
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Mixed Emotions
Both mother and father may have mixed emotions about being parents in general. Parents may find themselves resenting their loss of independence—and may feel guilty as a result. Or they may be
disappointed in themselves as parents. These feelings are common. The reassuring truth is that there's no such thing as a perfect parent or a perfect child.
Mom and Dad can develop their own parenting styles by listening, learning, and being honest with themselves and each other. They can benefit by building on their strengths and learning from their limitations.
If you feel distressed about your child or yourself, one of the best remedies is to talk to a friend who is going through the same experiences. You will find that you are not alone, that all parents have trying times, and that discussion brings relief. If there is a chapter of Parents Anonymous in your area, a crisis hotline or a mental health center (look under "Mental Health" in the Yellow Pages), you can get understanding and help immediately by calling and asking for it.
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Postpartum Depression
Most new mothers experience a range of strong emotions after childbirth, largely as a result of changing hormone levels and physical exhaustion. Sometimes these feelings are of sadness, fear, anger or anxiety. About two thirds of all new mothers have the "blues," usually starting about 3 days after the birth of their baby. They may become moody, sad, or quick to cry. They may feel overwhelmed by the responsibility of caring for a new baby. These feelings, sometimes called "baby blues," usually last from a few hours to a week or so and go away without treatment.
However, a few women develop intense feelings of hopelessness, sadness and anxiety that disrupt their ability to function normally. When these feelings become extreme and last longer than a few days, they may signal a more serious condition called postpartum depression, which may require counseling and treatment. If you feel overwhelmed with these feelings, or if they last more than a week, make sure to check with your health care professional.
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Abuse Concerns
It's not unusual for a parent to have a wide range of feelings at this time. The parent may even feel like striking out at a child. But the parent must recognize and control the actions that could result in emotional or physical abuse of a child.
A person who was neglected or mistreated in childhood is more likely to abuse his or her own child. A parent who abuses a child may not understand what a child is capable of doing or not doing at different ages. Parents may expect too much from a child too soon in the child's life.
If you were abused either psychologically or physically as a child, or if you had an unhappy childhood, you may want to ask for help. Health care professionals can help adults who were abused as children better understand their own backgrounds and the normal developmental needs of children. A wide variety of professionals can help people change attitudes and actions to prevent child abuse.
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Sexuality After Childbirth
Caring for your newborn baby is demanding, and you may not feel like having sex. Talk to your partner about these feelings. Getting enough rest and emotional support and eating a well-balanced diet can help boost your energy level.
Here are the topics we'll discuss in this section:
Resuming Sexual Activity
Vaginal Dryness
Breast Tenderness
Birth Control
Resuming Sexual Activity
You may have concerns about resuming sexual activity after the birth of your baby. Becoming a parent does not prevent you from being a loving partner. However, your body goes through many changes during the postpartum period, and sex with your partner may be uncomfortable at first.
Your body needs time to heal. Discuss with your doctor when it is safe to have sex again. This is usually after your vaginal bleeding or lochia stops and your stitches have healed. Healing of the uterus, cervix and vagina takes place during the first 4 to 6 weeks after delivery.
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Vaginal Dryness
The hormone estrogen is necessary for your body to lubricate the vagina for sex. After you give birth, your level of estrogen is low and having sex may be uncomfortable. It is good practice to wait to have intercourse until after your 4- to 6-week checkup. Estrogen levels remain low while you are breastfeeding.
Encourage your partner to go slowly. The use of a water-based lubricant like K-Y® Jelly will help ease discomfort during intercourse. You can purchase K-Y Jelly from your local drugstore. If you are breastfeeding, Astroglide® Jelly may provide more comfort. This jelly is thicker than K-Y Jelly and can be purchased from your local drugstore.
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Breast Tenderness
Let your partner know if your breasts are tender. Discourage your partner from touching your breasts during the postpartum period if you are bottle-feeding. Touching helps stimulate milk production. If you are nursing, breastfeed your baby an hour before having sex.
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Birth Control
When you decide to have sex, choose a good birth-control method. Discussing birth-control choices with your partner before your baby is born is important. You can become pregnant in the first month after delivery. Breastfeeding does not prevent pregnancy. Ask your health care provider for more information about birth-control methods for the postpartum period.
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