Heal Your Body: Physical Postpartum Care
Having a baby is a life-changing event, both emotionally and physically, and proper postpartum care is crucial to your recuperation after giving birth and to your adjustment to life as a new parent. For the first two weeks after giving birth, allow yourself to focus on caring for yourself and your child.
Your body needs to recover after the physical stress of pregnancy, labor, and delivery. For the first few weeks after you give birth, give yourself time to rest and take special care of your body as it heals from nine months of pregnancy and delivery.
Bathing and Sitz Baths
To prevent infections after delivery, it is preferable to take showers rather than a tub baths for two weeks. If showers are not possible, fill the tub with three to four inches of water, and leave the drain open and the water running. This is called a sitz bath and may be continued as long as needed for comfort.
Normal bleeding after delivery is similar to a heavy menstrual period and it should decrease by the third or fourth day after birth, but can last for up to four to six weeks. You may notice an increase in bleeding or blood clots on your first or second day at home because your activity has increased. If you experience a heavy bleeding (soaking a pad every hour for two to three hours) or begin cramping, it is a sign of over-activity and you must rest. If the bleeding or cramping continue, please call our office.
Menstrual periods often resume between 5 and 12 weeks after giving birth unless you are breastfeeding. Nursing may suppress periods for some women, but breastfeeding is not a form of birth control since it is still possible to become pregnant while nursing.
Constipation and Hemorrhoids
After giving birth, it is essential to maintain normal bowel habits and avoid constipation. Consume extra fluids and a healthy, high-fiber diet. If necessary, your physician may also recommend a stool softener such as Colace® or Surfak®. If a laxative is needed, Colace and Milk of Magnesia® are safe to take while nursing. If hemorrhoids are a problem, use medicated cream or suppositories. To relieve additional discomfort from hemorrhoids try lying on your side with your upper leg slightly bent, and take therapeutic Sitz baths.
To sooth an episiotomy incision, take Sitz baths while you heal. Stitches should dissolve within four to six weeks and do not have to be removed. Over-the-counter or prescription pain medications can also provide relief, but discomfort should decrease daily. However, if any unusual pain develops, call your physician at Kansas City ObGyn.
A Cesarean birth is a major surgery and the recovery period is longer than it is after a vaginal birth. Special care and attention is needed during recuperation after a C-section and it is especially important to keep an eye on the incision as it heals. If any of the following symptoms should occur, call our office:
- Red, hard, tender or hot area around your incision
- Separation and/or bleeding of incision
- Moderate or large amount of oozing or drainage
- Fever higher than 100º F
However, if there are no concerns with healing after a Cesarean section, a heating pad can help with localized pain. You should wait two weeks to drive after a cesarean section and lifting should be limited to 15 to 20 pounds for the first six weeks.
Nursing and Breast Care
Initial attempts at nursing can be painful, but tenderness and discomfort should decrease once let-down (a tingling sensation that occurs in the breast right before and when milk comes into the milk ducts, a sign you need to feed your baby) has occurred and should cease altogether within a few days. However, if you have sore, cracked, or bleeding nipples, express a few drops of breast milk on the nipples after nursing and allow to air dry. To prevent future irritation, always keep your nipples clean, change the nursing pads when they become moist and avoid wearing pads with plastic liners.
For a more comfortable breastfeeding experience, experiment with different nursing positions to see what works best for you and your baby. For example, try holding your baby so that he is lying on his side with his head resting in the bend of your arm and make sure that his mouth covers one inch or more of your nipple and areola when sucking. For additional comfort, use pillows to help support your arm and baby.
If you are not nursing, wear a good support bra at all times while your breasts are engorged. You may use ice packs under the armpits and to the side of each breast during the first couple of days of engorgement and take Tylenol® or ibuprofen for discomfort. Do not be surprised if you have a slight elevation in temperature for a day or two while your breasts are engorged, and you should expect milk to lbe eaking from the breasts during this period. Read our article about breastfeeding for more information.
You may start mild exercise after two weeks rest and recovery after giving birth, but more strenuous exercise should be delayed for four to six weeks. Begin with easier exercises and increase them gradually if you are comfortable and it does not cause pain. If you had a Cesarean, do not begin an exercise program for at least six weeks after delivery and with your physician’s permission.
It is important to maintain a healthy and balanced diet while pregnant and you should continue prioritizing your personal nutrition after your baby is born. Eat a wide variety of foods, emphasizing fruits, vegetables, lean meat, and healthy proteins. Limit processed foods and empty calories from high starch and sugary foods as much as possible.
Do not rush into dieting in an effort to lose your pregnancy weight, but if you are concerned about reducing, cut down on high fat and high sugar foods and alcohol, but do not over-restrict breads and cereals or fruits and vegetables. If you are nursing, you will need to consume a few hundred additional healthy calories a day, and you should continue taking prenatal vitamins.
Sexual Intercourse and Contraception
Sexual intercourse is appropriate when it is comfortable for you, usually six weeks after giving birth, but is preferable to wait until your vaginal discharge is clear. Vaginal tenderness may be eased by using a water soluble cream (K-Y Jelly®), or a contraceptive foam or cream to lubricate the area, but do not use VASELINE®.
Before intercourse is resumed, you and your partner should consider your contraceptive options. Condoms, foam or vaginal suppositories may be used without a prescription and are compatible with breastfeeding. Be sure to discuss other forms of birth control with your doctor at your postpartum checkup.
Causes for Concern
After leaving the hospital, call our office if you have any of the following:
- Heavy vaginal bleeding, soaking a pad every hour for three hours
- Severe chills or fever over 100.4º F
- Frequency or burning with urination (emptying your bladder)
- A red, hard, tender area on the breast
- A red, hard, tender or hot area along the leg veins
- Shortness of breath and/or chest pain
- Any other unexplained signs or symptoms
Postpartum Medical Checkups
Your healthcare provider at Kansas City ObGyn will need to see you for your postpartum checkup, usually five to six weeks after you give birth. This appointment provides an opportunity to discuss any questions or concerns you have, including contraception, physical recovery, and your emotional well-being. Call our office to schedule a doctor’s visit before leaving the hospital or soon after going home.
Postpartum Emotional Care
Having a baby is a special time in your life, full of anticipation and joy, but it can also be a time of great stress and anxiety as you adjust to life with a child. In the weeks and months after giving birth, try to be especially attentive to your own emotional feelings and those of your partner. It is perfectly normal to experience complicated and even difficult emotions after you have a child, but be mindful if those feelings become extreme.
After having a baby, some women may experience overwhelming feelings of frustration, inadequacy, fatigue, and worry. These are normal emotions related to becoming a new parent and these feelings may also be further compounded by ordinary life stresses, such as finances, feelings of isolation, and being overwhelmed by other work or home responsibilities. If you are experiencing difficult emotions try to be patient with yourself – take time to adjust to your new life.
If depression persists or increases and you are experiencing thoughts and feelings that go beyond the normal anxieties of being a new parent, or if you think your feelings are impairing your ability to care for yourself and your family, call us immediately and we will refer you to Kansas City area support groups or counselors that specialize in postpartum depression.
Postpartum Care for Partners
Parenthood is just as life-changing for new fathers as it is new mothers and men can experience conflicting feelings of elation, overwhelming responsibility, depression, pride, and even jealousy in response to becoming a dad. Allow yourself to process the complex experience of parenthood and support your partner through her adjustment, too. Learn along with your partner how to care for your newborn by helping with feeding, dressing, bathing, and diaper duties, and take the time to get used to your new baby. Enjoy the new addition to your family and try not to let the new responsibilities get in your way of sharing this special time with your family.