Congratulations on the birth of your new baby. Many women focus on the pregnancy and forget to ask about what will happen following delivery. Recovery from vaginal and cesarean birth takes about six weeks, sometimes it can take longer. During this time, your body will gradually be returning to normal. When you leave the hospital, expect to be wearing maternity clothes (you will still look about 6 months pregnant). Below are a few things to expect when you return home with your newborn.
Your post partum visit is very important and should be scheduled as soon as possible (preferably before you leave the hospital). Please try to make your appointment with the same doctor that delivered your baby. If you had a c-section, see your provider or doctor 1-2 weeks following your surgery and again at 6 weeks postpartum.
You may notice cramping or “afterbirth pains”. This is the uterus contracting to return to its pre-pregnancy size. These pains are usually worse with each pregnancy. They also get stronger while breastfeeding. Therefore, you may want to take a mild pain reliever before each nursing session.
You will have vaginal bleeding for up to 6 weeks following delivery (even after cesarean sections). Flow will gradually decrease in amount and darken in color. Do not be alarmed if bright red bleeding reappears from time to time throughout the first 6 weeks. Increased activity can increase flow and change the color from brown to red. If your bleeding increases to more than a heavy menstrual flow, get off your feet and rest for a few hours. If it continues to be heavy after resting, please call your provider.
To prevent infection and promote healing:
Use pads instead of tampons
Do not insert anything into the vagina
No sexual intercourse for 6 weeks after delivery
It is not unusual for your first period to be heavier or different. You may notice an increased menstrual flow with clotting. Your period may also last longer than normal. If you are saturating a new sanitary pad every hour â€“ get off your feet until the bleeding slows. If it continues, please call your provider.
Don’t be surprised if you are not feeling great on your first day home. You will notice a gradual increase in your stamina over time. It is important to rest when the baby rests, and sleep when the baby sleeps. If family and friends offer to help out, take them up on it. If no one offers, ask. Your energy should be directed toward taking care of yourself and your new baby.
Do not lift anything over 10 lbs (gallon of milk)
No heavy exercising
Light walking is okay
Do not drive while you are on prescription pain medication
It is very common to feel bruised and sore in the vaginal, perineal, and rectal areas after delivery. If you have stitches, these will dissolve gradually over the next six weeks. Keep the area as clean as possible. Pour water over the entire area, and then pat dry (front to back). Change your sanitary pad frequently. You may use a sitz bath for relief from discomfort (sit in a bath with 6-8 inches of warm water for 15-20 minutes, this can be done 3-4 times/day). You may use a topical anesthetic spray such as Dermoplast for additional relief.
Incision Care for Cesarean Section
Your staples may be removed before you leave the hospital or at your 1 week follow-up visit in the office. After the staples are removed, you may have clear plastic strips called steri-strips covering parts of your incision. If these strips have not fallen off on their own in a week, you may remove them. The easiest time to remove the tape is after a shower while the strips are damp. Be sure to keep the incision clean and dry. Leave the incision open to the air to facilitate healing. Call the office it you notice any increased redness, increased pain, pus-like drainage or odor from the incision site.
Breast Care While Bottle Feeding
Wear a well fitting, sturdy bra day and night for the first few weeks following delivery. Keep all stimulation away from your breasts â€“ stand with your back to the water in the shower. Even though you are not breast feeding, your body will begin to make milk. Your breasts may get engorged (hard, lumpy, tender, hot) as the milk is produced and not released. Expressing milk for relief may lead to more milk production. You may apply ice packs or cabbage leaves to your breasts 3 or 4 times/day for up to 20 minutes at a time. You may bind your breasts with an ace bandage for added support. Call the office if you have tenderness, redness, fever of a particular area of the areal.
Breast Care While Breastfeeding
Wear a good supportive bra. When showering, do not use soap on the breasts. Call your lactation consultant if you develop dry, cracked nipples. Lanolin cream may be applied to the nipple area. If you notice a warm, red, tender, lump or induration on the breast, have a fever and flu-like symptoms, please call your provider.
Breastfeeding and Diet
Now that you are no longer pregnant, you can be more liberal with your dietary choices. Continue with a balanced diet. You will need an additional 500 calories per day for breast milk production. Try not to skip meals. Take your prenatal vitamin as long as you continue to breastfeed. You should try to drink at least 8-10 glasses of water/day. It is helpful to have a glass of milk, water, or fruit juice available to drink every time you nurse.
The first bowel movement is usually within 2-3 days. To help alleviate or prevent constipation, you should consume 8-10 glasses of water a day. Eat high fiber foods, such as fresh fruits and vegetables, whole grain bread and crackers, high fiber cereals, raisins, and prunes. If you need a medication for constipation, you may try over the counter fiber supplements, such as Fibercon, Metamucil, or Citrucel, a stool softener such as Colace, or a mild laxative such as Milk of Magnesia. For gas, you may take Gas-X (simethicone 40-80mg) three to four times a day.
Hemorrhoids are varicose veins in the rectum. Pregnancy can cause hemorrhoids to develop when the growing uterus interferes with the blood flow in the region of the rectum. When you are constipated or strain with a bowel movement, these veins become enlarged and painful. You may notice some itching and slight bleeding. They are generally most uncomfortable in the first week following delivery. The hemorrhoids will begin to shrink and many go away. For comfort, you may use a sitz bath 3-4 times a day. You may also apply Tucks pads (witch hazel) to the area as needed. Drink plenty of fluids and eat a diet high in fiber. You may take a stool softener (Colace) as needed. Anusol and Preparation H may be purchased over the counter and used according to directions on the package.
Postpartum Depression and “Baby Blues”
Emotional lability, anxiety, irritability, sadness, anger, and fatigue are common after delivery. The postpartum period may be a time of anxiety and uncertainty for new parents, and when combined with hormonal changes and lack of sleep, a transient depression known as “baby blues”, is not unusual. While 70-80% of all women experience “baby blues”, only about 10% will have postpartum depression. With postpartum depression, the feelings of sadness, anxiety, or despair are more severe and interfere with the ability to function. Postpartum depression can develop many days later. If you feel you may be suffering from postpartum depression, if you are unable to care for yourself or your child, or if you feel you may harm yourself or your child, please call your provider.