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Guide for a Healthy Pregnancy

POSTPARTUM CARE

Our bodies go through many changes during pregnancy, vaginal or cesarean delivery, and during the postpartum period. Some discomforts are common after the birth of your baby. Caring for your newborn can be overwhelming and it can be difficult to find time to take care of yourself. Remember to make time for yourself. Try to nap when the baby naps, snack frequently, and keep up with your fluids. Take people up on their offers to help – even if it’s a casserole, load of laundry, or watching older siblings. This can give you more time for yourself and the baby, and people love to feel they’re helping.

Fatigue: This is caused by physical exertion in labor, nighttime sleep disruption, and hormonal and emotional changes. The following will help:

• Rest when possible, nap when the baby sleeps.
• Eat well, avoid high sugar foods.
• Limit phone calls and visitors if you feel tired.
• Allow/encourage family and friends to help.
• Continue your vitamins.

Afterbirth pains/cramps: This process, which is the uterus shrinking down to its nonpregnant size, occurs over the first few weeks after delivery. The cramps tend to lessen over the first few days after birth. The following will help:

• Take medications such as Motrin, Advil or Tylenol.
• Take frequent warm showers.
• Lie on your stomach with a pillow under your stomach to put pressure on the lower abdomen.
• Empty your bladder frequently.

Breastfeeding mothers may note cramps when nursing. Pain medication should be taken one hour before nursing.

Perineal pain: Some discomfort is normal after 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 or tear. The stitches may pull, sting or hurt. The following will help:

• Take pain medication as prescribed.
• Put an ice pack on the area. Ice helps reduce discomfort and swelling. This is most important in the first days after delivery.
• Use medicated sprays, creams and Tuck’s pads.
• Use the sitz bath 2 to 3 times a day. Ask the nurses to give you a portable sitz bath when you are discharged. You will fill the bath with warm water only, set it into the raised toilet seat and put the seat down and sit.

Abdominal pain: If you have a cesarean birth, abdominal pain is normal. The pain is usually from your incision. Your incision may pull, sting or hurt. It is usually most tender the first few days after giving birth. Another source of abdominal discomfort after cesarean birth is gas pain. Usually this discomfort happens 1 to 2 days after giving birth. The following will help:

• Take pain medication as prescribed.
• Move around in bed and change positions frequently.
• Take frequent walks of 5-10 minutes.
• Avoid carbonated drinks and foods that cause gas for you.

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. The following will help:

• Eat a diet high in fiber – whole grains, fruits and vegetables
• Drink eight to ten glasses of fluids daily
• Try over-the-counter mediations such as Colace (two times daily) or Metamucil (must be taken with plenty of fluids,) or Dulcolax suppositories if still having difficulty.

Sore breasts: In 3 to 5 days after giving birth, your breasts will swell and fill with milk. This is called engorgement and may be uncomfortable. Your breasts may also leak at times. The following will help:

If you are breastfeeding:

• Nurse 8-12 times per day to prevent overfilling of the breasts.
• Warm soaks.
• Feel free to call the office and ask for lactation advice.

If you are bottle feeding:

• Wear a well-fitted support bra.
• Place an ice pack under each armpit to decrease swelling and pain.
• Try Advil or Motrin.
• Avoid breast stimulation or running hot water over the breasts.

Hemorrhoids: Hemorrhoids are dilated veins in the rectum. They are caused from the extra weight of the pregnancy and the birth process. They usually shrink 6 weeks after delivery. The following may help:

• Use an ice pack to decrease swelling.
• Use Tuck’s pads, and medicated creams such as Anusol.
• Do a sitz bath 2 or 3 times daily.
• Do not sit for long periods of time.
• Follow the suggestions for constipation to keep your BMs soft.
• Do not use heated seats in your car.
  

Baby blues/depression:Postpartum blues is a frequent occurrence. Women can feel sad, weepy, or overwhelmed. These feelings tend to resolve fairly quickly and on their own. Feel free to call the office and talk to one of the staff. More severe symptoms such as trouble eating or sleeping or difficulty with caring for you or the baby need to be addressed immediately – please call the office or emergency room immediately.

Bathing: You may take showers or tub baths as desired.

Intercourse: It is good practice to wait to have intercourse until after your 6-week checkup.
It is possible to become pregnant during the 4-6 week period after delivery. Be aware that breastfeeding will not prevent pregnancy.

Menstruation: If you are breastfeeding, you may not menstruate until after your baby weans from the breast. If you are bottle feeding, you will usually menstruate 4 to 5 weeks after delivery.