Postpartum
Congratulations! on your recent delivery.
You made it.
The postpartum period is referred to as the six-week period post-delivery.
After 9 months of waiting, you are probably excited to finally be home with your new baby.
During this time pay attention to your body.
This is very important as you heal.
Slowly adjust to the fact that you are a mother. There is a certain rhythm that needs to fall into place. Discover it. Firm it up. Adjust it in such a way that it works for you and your baby.
As you begin to feel better, resist the temptation to do more. Overdoing things at this point can set you back in your recovery.
The New Mother: Taking Care of Yourself After Birth
REST
Every new parent soon learns that babies have different time clocks than adults. A typical newborn wakes up about every 3 hours and needs to be fed, changed, and comforted. Especially if this is your first baby, you and your partner can become overwhelmed by exhaustion.
You may not get a solid 8 hours of sleep for several months.
Here are ideas to help you get more rest:
- In the first few weeks, you need to let someone else take care of all responsibilities other than feeding your baby and taking care of yourself.
- Sleep when the baby sleeps. This may be only a few minutes of rest several times a day, but these minutes can add up.
- Save steps and time. Have your baby’s bed or basinet near yours for feedings at night. Do NOT sleep with the baby in your bed.
- It’s nice to have visits from friends and family, but don’t feel that you need to entertain guests. Feel free to excuse yourself for a nap or to feed your baby.
- Get outside for a few minutes each day. You can start walking and doing postpartum exercises, as advised by your healthcare provider.
- Avoid strenuous activities, heavy lifting
- Avoid excessive social activities
- You may drive a car but not when taking pain medication
- No driving a car for 2 weeks following a Cesarean section
NUTRITION
The weight gained in pregnancy helps build stores for your recovery and for breastfeeding. After delivery, you need to eat a healthy and balanced diet so you can be active and able to care for your baby.
Maintain a healthy diet consisting of proteins and carbs, as well as fiber-rich foods (whole grains, vegetables, and fruits).
Most mothers want to lose their pregnancy weight, but extreme dieting and rapid weight loss can harm you and your baby if you are breastfeeding. It can take several months for you to lose the weight you gained during pregnancy. You can reach this goal by cutting out high-fat snacks.
Along with balanced meals, you should drink more fluids if you are breastfeeding. You may find that you become very thirsty while the baby is nursing. Water and milk are good choices.
PERINEAL CARE
The perineum is the area between your vagina and anus.
During childbirth you may have had a repair of a tear or episiotomy with stitches (which are absorbable and do not need to be removed) which may cause your perineum will be sore and possibly swollen postpartum. It will take 7-10 days to heal. The stitches will absorb over time.
It is important that you keep the stitches from getting infected by gently cleaning them with warm water after each time you use the toilet. Do this by using a squirt bottle to rinse the area and pat it dry.
Sitz baths is a shallow tub of water (enough to cover your bottom) that should be done 5 times a day for the first week following a vaginal delivery if you had stiches. This will help with swelling and bruising, will keep the site clean as well as provide some anesthetic relief.
- Sitz baths regularly for the first week.
- 5-10 minutes at a time
- You do not need to add anything to the water but you can bathe if desired.
- Do not wipe the area with toilet paper or you could irritate the stitched area
- Use a clean sanitary pad each time you go to the bathroom
- If the area begins to hurt worse or the stitches seem weepy, contact your doctor. It could be a sign of infection.
You may shower at any time you desire.
HEMORRHOIDS
You may have developed hemorrhoids (painful swelling of a vein in the rectum) during your pregnancy. If not, you may have gotten them from the strain and pushing during delivery. A hemorrhoid is a blodd clot within the hemorrhoidal vein.
They can bleed and cause pain after a bowel movement and they can cause some itching as you heal. Hemorrhoids usually resolve by your six week appointment
- Can be treated with sitz baths and stool softner
- Sitz baths with warm water will help to reabsorb the clot
- You can get some relief from the pain and itching by applying witch hazel to your hemorrhoids. This is especially effective if you keep the witch hazel in the refrigerator.
- Local medications like Anusol or preparation-H
VAGINAL BLEEDING
After giving birth it is common that you will have vaginal bleeding and discharge (this is called lochia), even if you had a C-section. Expect this to be heavier at first (up to 10 days), but then taper off.
Light bleeding and spotting is normal up to 8 weeks postpartum although most bleeding resolves by 2-4 weeks. Also expect to pass some clots.
Bleeding may increase when you go home and your activity level increases.
You may see an increase in blood flow while breast feeding.
- While you are breast feeding your body is releasing oxytocin which causes the uterus to contract helping the uterus to involute or shrink to prepregnant size. This contraction may squeeze out any blood that has accumulated inside the uterus.
- This is usually shorter if you breast feed.
It is important that you use only sanitary pads during this time. Using tampons can introduce bacteria and lead to infection.
WATER RETENTION
You may notice an increase in swelling especially in your legs and hands after delivering. This is normal and will worsen over the next 7-10 days following delivery at which point your body will reabsorb and release the extra fluid.
WEIGHT
If you were hoping for immediate weight loss after your baby was born, you were probably very disappointed.
You can expect to lose about 6-12 pounds (depending on the size of your baby) during the birth. After that, your weight loss will slow considerably. Depending on how much weight you gained during pregnancy (the average is 25-35 pounds), it may take several months to lose the baby weight.
For many women, breastfeeding seems to help promote weight loss. Other moms don’t see weight loss associated with breastfeeding.
Try to keep your nutrition consistent while you are breastfeeding and do not get frustrated if it takes longer than you’d hoped to lose the weight.
HORMONAL CHANGES
BABY BLUES
You are so excited and happy to bring baby home. The next minute, though, you are sad. It can be confusing, especially to new moms.
Know that many women (70-80%) struggle with feeling sad the first few weeks after having a baby. It is commonly called the “baby blues” and is caused by hormone changes.
The exact cause of the “baby blues” is unknown at this time. It is thought to be related to the hormone changes that occur during pregnancy and again after a baby is born. These hormonal changes may produce chemical changes in the brain that result in depression.
Also, the amount of adjustment that comes after the birth of a baby, along with sleep disturbance, disruption of “routine”, and emotions from the childbirth experience itself can all contribute to how a new mom feels.
Often the symptoms of “baby blues” will hit forcefully within four to five days after the birth of the baby, although depending on how the birth of the baby went, they may be noticeable earlier.
Symptoms of “baby blues” include:
- Weepiness or crying for no apparent reason
- Impatience
- Irritability
- Restlessness
- Anxiety
- Fatigue
- Insomnia (even when the baby is sleeping)
- Sadness
- Mood changes
- Poor concentration
If these feelings last more than a few weeks or you are not able to function because of them, you could have postpartum depression.
POSTPARTUM DEPRESSION
Postpartum depression may be mistaken for baby blues at first — but the symptoms are more intense and last longer.
Symptoms usually develop within the first few weeks after giving birth. But they may begin earlier — during pregnancy — or later — up to a year after birth.
These symptoms may eventually interfere with your ability to care for your baby and handle other daily tasks.
It’s important to call your provider as soon as possible if the symptoms of depression have any of these features:
- Don’t fade after two weeks.
- Are getting worse.
- Make it hard for you to care for your baby.
- Make it hard to complete everyday tasks.
- Include thoughts of harming yourself or your baby
Postpartum depression symptoms may include:
- Depressed mood or severe mood swings
- Crying too much
- Difficulty bonding with your baby
- Intense irritability and anger
- Withdrawing from family and friends
- Loss of appetite or eating much more than usual
- Inability to sleep, called insomnia, or sleeping too much
- Overwhelming tiredness or loss of energy
- Less interest and pleasure in activities you used to enjoy
- Reduced ability to think clearly, concentrate or make decisions
- Hopelessness
- Fear that you’re not a good mother
- Feelings of worthlessness, shame, guilt or inadequacy
- Restlessness
- Severe anxiety and panic attacks
- Thoughts of harming yourself or your baby
- Recurring thoughts of death or suicide
Also consider these options if you’re having suicidal thoughts:
- Call a mental health provider.
- Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential. The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader or someone else in your faith community.
Hormones are also responsible for other postpartum symptoms.
NIGHT SWEATS
You may be sweating more, especially at night when you sleep. Just make sure that your sweating is not accompanied by a fever. That could be a sign of infection. clot within the hemorrhoidal vein.
HAIR LOSS
Hormonal changes also cause hair loss for many new moms. This is only temporary. When your estrogen levels increase, your hair will return to its normal thickness.
appointment
If you have any questions regarding your postpartum, do not hesitate to call the office.
You should call if you are experiencing:
- Heavy vaginal bleeding that soaks more than one pad per hour or vaginal bleeding that increases each day instead of decreasing.
- Passing large clots (bigger than a quarter)
- Chills and/or a fever of more than 100.4°F
- Fainting or dizziness
- Changes to your vision or a severe headache (persistent)
- Painful urination or difficulty urinating
- Vaginal discharge with a strong odor
- Heart palpitations, chest pain or difficulty breathing
- Vomiting
- Incision from C-section or episiotomy is red, weepy (with pus), or swollen
- Abdominal (lower belly) pain that is getting worse or new abdominal pain
- Sore breasts that are red or feel hot to the touch
- Pain in your legs with redness or swelling
- Increase in swelling
- Headaches