Obstetrics & Gynecology
Wright State Physicians Health Center
725 University Blvd.
Fairborn, OH 45324
After the Baby Arrives
Congratulations on the birth of your baby! Finally, you’ve achieved the culmination of all your hopes and dreams. Now the real work begins, and we hope to answer a few questions and allay any fears you may have as you move forward in the postpartum period.
In the beginning, it’s often hit or miss. Did you meet the baby’s need or is he still crying? If he did stop, WHAT did you do and can you do it again? Within six weeks, you will have this communication dance down like a fine ballet. So pamper yourself. Get good friends or family to help support you while you get to know your baby.
We are sure you have heard how important it is to get rest at this time. Here are some practical suggestions. Have family or friends bring dinner in for the first couple of weeks. This is especially nice if you have other children. Try not to live on pizza if you can! Forget the housework for a while, or let a friend or family member help. We know that may really be difficult for you, but your body, mind, and spirit will be in better shape if you can get rest. Pamper yourself. Take charge and ask for help!
Here Are a Few Tips:
- Ask for help with groceries, laundry, and meals
- Sleep when your baby sleeps. Resist the urge to clean house!
- Suggest quiet play for older siblings
- Do only what needs to be done. Realize some things will have to wait
- Limit visitors
- Eat healthful foods, high in iron and protein
- If comfortable, lie down to nurse your baby
- Continue prenatal vitamins while nursing or until six weeks postpartum
- Maternal Changes
- Non-lactating (Bottle Feeding)
- Bladder and Bowel Function
- Emotional Adjustments
- Other Physical Adjustments
- Return of Menstrual Periods
- Family Planning
- When to Call the Physician
Uterus and Lochia (Bleeding)
Immediately after birth your uterus begins to contract. These contractions are commonly called “after birth pains.” If you place your hands on your lower abdomen, you can feel your uterus as a hard swelling that will gradually disappear as it becomes smaller.
Breastfeeding mothers may notice an increase in contractions during breastfeeding. Keeping your bladder empty helps your uterus to contract effectively and prevents too much bleeding. Lying face down with a pillow under your lower abdomen can be effective in easing after birth pains. When you first lie on your stomach you might have fairly severe cramps for about five minutes, but then you experience complete and total relief. Ibuprofen or similar anti-inflammatories work especially well for this type of pain.
Lochia is the vaginal discharge that occurs while you are healing after you have a baby. The flow may last four to six weeks. The amount of bleeding varies with individual mothers. As a rule of thumb, you will bleed like a normal heavy period for the first week or so. It is common for a mother to have a small amount of bleeding while lying down and to flood when she gets out of bed. After being up for a moment or two the bleeding should return to a normal amount. This is more common during the first one or two days after birth. The bleeding will at first be bright red. It will change over several days to dark red, to brown, to brownish yellow, and then to white. It should not have a bad or foul odor. Let your bleeding be your guide. If you are doing too much at home, your bleeding will increase and become bright red again. This will be your sign to take it easy. Breastfeeding mothers often have no periods while breastfeeding full time. Bottle feeding mothers can expect to have their first period around six to eight weeks postpartum.
Perineum and Vagina
If you have a tear or required an episiotomy, stitches that were placed will dissolve on their own. The stretching of your vagina and any non-stitched tears will take about two to four weeks to heal. At the hospital you will receive a small squeeze bottle. Fill this with warm water and spray on your perineum to dilute your urine as you empty your bladder. This will ease any stinging you may have. Ice packs may be applied in the hospital. At home, sitting in a tub full of warm water three to four times a day for 30 minutes can ease discomfort.
Basically, you should feel better every day. Remember to listen to your body. If you do too much, you will have more discomfort. Call the office if the pain in your perineum or vaginal area increases after you are home.
The most important thing to remember is that breastfeeding is a learning process for both you and the baby. Babies are born knowing how to suck, but not necessarily how to breast feed. Even if you have breastfed a baby before, remember that each baby is different and has his or her own characteristics and personality.
The first few days your breasts will produce colostrum. This is a thick, yellowish, sticky fluid. Colostrum is produced before milk to provide your baby with important nourishment and infection fighting antibodies. After three to four days your breasts will feel full, hard and uncomfortable. To relieve this discomfort, put your baby to your breast frequently.
You may experience a little nipple discomfort for a few days until you become adjusted to the new experience of nursing a baby. Correct latch on is very important to prevent or minimize sore nipples.
Helpful treatments include:
- Breasts open to air frequently
- Cool cloths to nipples
- Warm water compresses or regular (not herbal) tea bags, just wet and apply 15-20 minutes three or four times a day
- After each feeding, rub colostrum into nipple area. Remember to bring baby to breast, not breast to baby
- Gel packs or wet green cabbage leaves on breast 15 minutes two to three times a day for severe engorgement
- No underwire bras. If you are comfortable without a bra, don’t wear one
- Lactation Clinic at Miami Valley Hospital located on the W level of the Berry Women’s Center (937) 208-6160. Lactation Support meetings are held every Thursday at the clinic from 2-3:30 pm.
- Lactation consultants who will see patients in their homes: Donna Walls, IBCLC, (937) 434-4650, www.Herbalharmoniesonline.com, and Geneva Carnahan, (937) 256-8367
- Any of the books by William and Martha Sears
- Breastfeeding: Getting it Right for You, Mary Renfrew
- The Nursing Mother’s Companion, K. Huggins
- The Nursing Mother’s Guide to Weaning, K. Huggins
- Your Baby and Child, Penelope Leach
- Touchpoints, T. Berry Brazelton, M.D.
- The Self Calmed Baby, Willam A. H. Sammons and Brazelton
Immediately postpartum, avoid any stimulation of the breast (e.g. running water, hand expressing). Wear a good supportive (not underwire) bra. If your breasts become uncomfortably engorged, place wet green cabbage leaves around your breasts, replacing them frequently over a period of six to 22 hours.
You should be able to urinate soon after giving birth. The urinary outlet may be swollen due to birth, so urination may be difficult. Try running water in the sink, using the peri bottle filled with warm water, or sitting in a tub of warm water. Some mothers experience excessive sweating and increased urination as blood volume decreases and retained body fluid is lost. If you experience difficulty urinating after you are home, call the office.
By the second or third postpartum day, you should have a bowel movement. Constipation can be a real problem for a new mother. Careful dietary choices like high fiber cereals, high water intake and stool softeners or laxatives will aid the return of normal bowel function.
Hemorrhoids are swollen veins that may occur during pregnancy and delivery. They can be painful and may even bleed. Relief can be obtained with ice packs or hemorrhoid creams.
Postpartum is a highly emotional time. Often feelings don’t match expectations. New mothers wonder, “What have I got to be depressed about?” Many women have weepy spells for no apparent reason. These emotions are normal. The baby blues tend to last from a few hours to a few weeks or so. Try to keep the lines of communication open with your partner. Talking helps to lessen fears and brings you closer together. Eat well-balanced meals, get plenty of rest, and get out of the house at least once a day.
Postpartum depression is marked by feelings of despair, severe anxiety, or hopelessness. It is often difficult to perform activities of daily living Women are more likely to have postpartum depression if they:
- Suffered from mood disorders before pregnancy
- Have a family member with a mood disorder
- Have a lot of stress in their lives
Warning Signs of Postpartum Depression:
- Baby blues that last for more than two weeks
- Deep depression or anger that appears one to six months after birth
- Feelings of sadness, doubt, guilt, or hopelessness that get worse with each passing week and get in the way of day-to-day life
- Not being able to sleep, even when you are tired
- Sleeping most of the time, even when your baby’s awake
If you think you might be suffering from a postpartum depression, call the office. Don’t suffer.
Many women experience hair loss in the postpartum period. This is a normal process. Your hair should return to its normal cycle within a few months of birth.
It is not uncommon to find yourself drenched with sweat. This often happens at night. This is also a normal process that will resolve over the first postpartum weeks.
Fatigue goes hand in hand with parenting. Your baby is just breaking you in for the times when you wait up to hear him walk through the front door at 2 or 3 a.m.! Seriously, fatigue for new parents can be a big adjustment.
You can start working out as soon as you feel up to it. If you had a Cesarean birth it may take a little longer to feel ready for exercise. Walking is an excellent way to ease back into fitness. Take a brisk walk a few times a week. Swimming is another great postpartum exercise. No matter what sort of exercise you do, design a program that meets your needs. Also try to choose a program that you’ll keep doing. Staying fit over the long haul is more important than getting into shape right after birth.
If you are not breastfeeding, your period may return about 6 to 8 weeks after giving birth. It could start even sooner. If you are nursing your baby, your periods may not start again for months. Some nursing mothers don’t have periods until their baby is fully weaned.
Once menstruation returns, it may be different from what you experienced before pregnancy. Periods may be shorter or longer, heavier or lighter. Usually, they will slowly return to normal.
If you and your partner are ready to start having intercourse again (and you have stopped bleeding), don’t forget one key thing: birth control. Even if you want your children to be close in age, it’s best to wait 18 to 23 months before getting pregnant again.
If you are not breastfeeding, you can be fertile within weeks of giving birth. If you are breastfeeding it can be hard to tell when fertility returns. To be on the safe side, choose a form of birth control before you have sex for the first time. There are many options for birth control If you think you might be interested in an IUD, tell the office when scheduling your six-week postpartum checkup.
- Fever more than 100.4 (38° C)
- Nausea and vomiting
- Pain or burning during urination after birth
- Bleeding that’s heavier than a normal menstrual period (saturates more than 1 pad an hour)
- Severe pain in your lower abdomen or tender or painful uterus
- Pain, swelling, and tenderness in your legs
- Chest pain and cough
- Red streaks or painful new lumps on your breasts
- Pain from an episiotomy, perineal tear, or abdominal incision that doesn’t go away or that gets worse
- Redness or discharge from an episiotomy, tear, or incision
- Vaginal discharge with a foul or bad odor
- Severe depression