Recovery After Birth
Giving birth is a strenuous activity that depletes your body's resources, so you need time and rest to restore yourself. Let rest be your first priority whenever the baby sleeps. With your night sleep interrupted by the baby, you will need to plan carefully to ensure you get enough rest. Both you and your family will benefit greatly from your being well rested.
After the birth of your baby, your uterus (womb) undergoes several changes to return to its non-pregnant state. During this process of change, called involution, the uterus sheds its inner lining, shrinks in size and returns to its usual space in the pelvis. As these changes occur, secretions and tissue from the inner lining of the uterus will drain from the vagina. Your vaginal flow (lochia) will be bright red following the birth of your baby. Slowly it will fade from brown to pink, finally becoming clear about four to six weeks after delivery.
If the bright red color returns or the quantity of flow increases, you are doing too much and need to slow down. If the bright red color or increased flow continues despite rest, if you pass blood clots the size of a golf ball or if the flow has a foul smell, call your doctor.
An episiotomy is an incision from the vaginal opening toward the rectum made by the doctor to prevent tearing or speed the birth process. If you have had an episiotomy, examine the stitches using a mirror. They will be smaller than you imagined. The stitches may feel uncomfortable for a week to ten days, but will eventually dissolve by themselves. Healing and discomfort are highly variable. Within three to four weeks, healing should be complete and you should no longer have any discomfort.
Ice packs will help relieve the initial swelling. After 24 hours, try taking a sitz bath-a few inches of warm water in a clean tub-several times a day to help speed the healing process. Sitting with your legs crossed under you helps to minimize the pressure on your stitches or hemorrhoids. Remember to shift your position every 20 minutes or so.
During the postpartum period, it is important to urinate at least every six hours. When your bladder is empty, your uterus can resume its position in the body. It is also necessary to void frequently to prevent urinary tract and bladder infections.
Women are more prone to urinary tract infections after the birth of a baby because the birth has caused trauma such as stretching, tearing or swelling to the pelvic area. The signs and symptoms of urinary tract infections include itching, burning or painful urination; difficulty starting to urinate; a feeling of having to urinate "right away" (urgency); and cloudy or foul-smelling urine. If you have any of these symptoms while you are in the hospital or at home, you should notify your doctor.
Hemorrhoids are varicose veins (swollen blood vessels) in the rectum. You will be able to feel the hemorrhoids and may notice itching, bleeding or pain while having a bowel movement. Hemorrhoids are common during pregnancy because increasing pressure of the uterus on the pelvic vessels causes the vessels to swell. The strain of pushing during your baby's birth may cause more swelling.
Hemorrhoids are usually most painful during the first few days following the birth of your baby. During this time, there are several ways you can make yourself more comfortable. These include using a donut-shaped pillow to sit on, taking sitz baths, using Tucks® or suppositories and modifying your diet. Try to avoid constipating foods such as sweets and cheese. Eat more whole grain products, raw fruits and vegetables.
The suggested waiting period before resuming sexual intercourse varies from two to six weeks for most postpartum mothers. You will be physically ready for intercourse when your flow is no longer bright red and when you can insert a finger or tampon into your vagina without pain. (Tampons should not otherwise be used during this time.) The time required before you are mentally and emotionally ready is highly individual and far more variable. Remember, intercourse is not the only way to express physical affection.
You may find it helpful to use a water-soluble lubricant, like K-Y Jelly®. Have some on hand before you attempt lovemaking in case you need it. You might begin by using the position with the woman on top. That way there is less pressure on an episiotomy or cesarean incision and the woman can control the speed and depth of penetration.
It is possible to become pregnant again soon after giving birth. Breast-feeding does not provide adequate birth control. The diaphragm you used before your pregnancy may no longer be a reliable fit. A special birth control pill may be used for breast-feeding women. But, foam and a condom used together is the preferred form of contraception in the period immediately after birth. Learn about contraception options
Most women experience fluctuating moods to some degree during the postpartum period. They feel happy one moment and weepy the next. No one is sure of the cause. It may be your body's reaction to the end of the pregnancy, the result of sudden hormone changes, or fatigue from childbirth and interrupted sleep at night.
The sudden intensity of emotions can be frightening if you are not aware that these responses are normal. Rest is one of the most effective remedies. Treat yourself to half an hour with a cup of warm milk and a good book in a comfortable chair. Call another new mother from your childbirth class to talk and compare notes. If these moods begin to keep you from caring for yourself or your baby, call your doctor.
Call Your Doctor If
- You have a temperature over 100.4°F even after drinking plenty of fluids
- You have increased or bright red bleeding that soaks a large pad in less than two hours
- Your breasts are red, hot to the touch or have painful lumps-especially if you feel like you have the "flu"
- You experience severe stomach or leg pains; burning with urination (after the first 2 to 3 days); inability to urinate or notice a foul odor to the vaginal discharge
- Your cesarean incision opens or drains increasing amounts