Discomfort /pain
- Your healthcare provider may prescribe medication or recommend an over-the-counter medication for you.
- Afterbirth pains (cramping or labor-like contractions which occur especially while breastfeeding) are usually mild with the first baby and stronger with subsequent deliveries. To help relieve this pain, try the following:
- Empty your bladder before breastfeeding.
- Lie on your stomach with a pillow under your abdomen.
- Try deep, slow, abdominal breathing for relaxation during feeding.
- Use a heating pad. Take mild pain medication as recommended by your healthcare provider.
Breast Care
- Wear a comfortable, supportive bra.
- Avoid a bra that is too small, has tight areas or under-wires. These might cause blocked milk ducts.
- Breast feeding
- Ensure your baby has a proper latch and positioning during feeding.
- Air-dry nipples after nursing.
- A drop of breast milk left to dry on the nipple area may help ease dryness.
- Avoid soap on nipple area.
- No creams or ointments are needed unless recommended by your healthcare provider.
- Bottle feeding only
- Do not empty, stimulate, apply heat, or pump your breasts, as this will stimulate milk production.
- Discomfort of engorgement (full, swollen breasts) will usually go away in 24-72 hours.
- Use cold compresses or ice packs for up to ten minutes at a time on the breasts.
- Examples of cold compresses include: crushed ice in a sealed plastic bag or a bag of frozen peas covered with a cloth; a disposable diaper, open and partially filled with crushed ice.
- Try a mild anti-inflammatory medication as recommended by your healthcare provider.
- For extreme discomfort or swelling, you may briefly hand express or pump a small amount to ease the pressure.
Perineal/Episiotomy Care
- If you have stitches, they will dissolve within two weeks. You may have some redness, swelling, itching, and bruising. Call your healthcare provider if you have excessive tenderness or any concerns.
- You may use an icepack to relieve swelling and for comfort.
- Change your sanitary pad and use your squirt bottle filled with warm water to rinse the perineal area after each urination or bowel movement. Continue to do this as long as there is bleeding or a discharge.
- Rinse from front to back.
- Pat yourself dry with toilet paper (front to back), rather than wiping until you are comfortable.
- Put nothing in the vagina for four to six weeks after delivery or until you have had your follow-up checkup. This includes:
- Tampons
- Douching
- Intercourse
- Check with your healthcare provider about tub baths and swimming.
- If you have been given a sitz bath, you may use it three to four times a day for two weeks for discomfort until you are healed. Wash the sitz bath after each use and store it off the floor in a clean, dry location.
Incisional care for Cesarean Section
- If you have staples, they may be removed before you go home, and small tape strips will be applied. These will come off in seven to ten days. Allow the strips to wear off. You may remove any remaining tapes after two weeks. If your stitches or staples have not been removed, you will be given instructions.
- Keep your incision dry and clean.
- You may take showers.
- Check your incision daily for new or changes to redness, itching, swelling, or bruising.
- Call your healthcare provider if you have more than a small amount of drainage from the incision.
Bleeding
You will have vaginal bleeding called “lochia” after a vaginal or cesarean delivery.
- Bleeding will change from bright red to dark red to pink. In about 10-14 days the discharge will become white or yellow and gradually stops. This length of time varies from woman to woman.
- You may bleed for approximately two to six weeks, and your menstrual period will return in about seven to nine weeks after delivery if you are not breastfeeding. If you are breastfeeding, your period may not return until you stop (but you can become pregnant).
- Increased bleeding with increased activity or breastfeeding is normal.
- If you saturate a pad in an hour, have bright red bleeding, or pass bright red clots that are egg-sized or larger, this may be a sign that you need to get off your feet. Stop activity, rest, and monitor your bleeding. If the bleeding slows while resting, you were probably doing too much and need to rest. If bleeding does not slow down in the next hour while resting, call your healthcare provider.
Hemorrhoids
Hemorrhoids (swelling at the rectum) can be very painful. They will become smaller and may disappear.
- Avoid constipation (hard stools).
- Use your sitz bath for as long as needed for comfort and to help healing.
- Use witch hazel pads (such as TUCKS®) available without a prescription.
- Talk to your healthcare provider for further concerns.
Elimination
Bowel Movements
- To help prevent constipation and keep your bowel movements soft:
- Eat a high fiber diet (fresh fruits, vegetables, and whole grain breads and cereals).
- Drink water when you are thirsty. You will notice you are especially thirsty when breastfeeding.
- Talk to your healthcare provider about the use of stool softeners, suppositories or enemas.
Urination
If you have difficulty urinating after delivery:
- Squeeze warm water from your squirt bottle while sitting on the toilet.
- Drink water when you are thirsty.
- Call your healthcare provider if your bladder feels full and you are notable to urinate.
Signs of a urinary tract or bladder infection
- Frequent urination.
- Feeling the frequent urge to urinate.
- Painful urination.
Back pain and fever can be signs of a kidney infection, which is far more serious. Consult your healthcare provider if you have these symptoms.
Swelling
You may have an increase in swelling in your feet and ankles the first few days. This is normal and goes away in 10 -14 days.
Activity
Gradually increase your activity. Build up your strength. Do not exhaust yourself.
- Lift nothing heavier than the baby for several weeks.
- No driving for at least two weeks. Do not drive while taking medications
- that make you drowsy.
- Start exercising slowly.
- Talk to your healthcare provider about when to begin more activity.
Your Emotions after Delivery
“Baby Blues”
- After your baby is born, you may feel joyful, excited, nervous, or worried. These are normal feelings, and the feelings of worry and nervousness will usually pass in a week or two after delivery.
- Some women have more upsetting feelings such as extreme fear, worry, sadness, or not feeling well physically or emotionally.
Perinatal Depression and Post Partum Depression
- 10-20% of women experience depression during pregnancy or within the year after delivery. Without treatment, symptoms may last for weeks, months, or years. In rare cases, it can be potentially dangerous to the mother and the baby.
- Symptoms of perinatal or post partum depression might include the following:
- Feelings of anger, instability, or anxiety.
- Lack of interest in the baby.
- Appetite and sleep disturbances.
- Crying and sadness.
- Feelings of guilt, shame, or hopelessness.
- Thoughts of harming the baby or yourself.
- What can you do if you have perinatal depression
- Lean on family and friends.
- Talk to a healthcare provider.
- Find a support group.
- Talk to a mental health care professional.
- Focus on wellness.
- Take medication as recommended by you healthcare provider.
- If you have thoughts of harming yourself or your baby, call your healthcare provider immediately.
Be sure to follow-up with your healthcare provider within four to six weeks after delivery or as directed.
REASONS TO CALL YOUR HEALTHCARE PROVIDER
Watch for any abnormal changes in your health. Call your healthcare provider if you have:
- Fever over 100.4° F (38° C).
- Nausea or vomiting.
- Pain, burning, or urgency with urination.
- Pain or excessive swelling in your legs.
- Chest pain with shortness of breath or difficulty breathing.
- Localized pain or redness in breasts.
- Persistent perineal pain with increasing tenderness or drainage at your episiotomy site.
- Increased pain, redness or drainage from your incision.
- Foul smelling vaginal discharge.
- Bright red bleeding that lasts for more than one hour while you are resting.
- Symptoms of postpartum depression.