Postpartum care: what to expect after a natural birth
Your newborn may be your top priority, but postpartum care is also important. Here’s what you might find during your recovery from natural childbirth, from pain to vaginal discharge.
Pregnancy changes your body in more ways than you might expect, and it doesn’t stop when the baby is born. Here’s what to expect physically and emotionally after a vaginal delivery.
If you had a vaginal tear during childbirth or your doctor had to make an incision, the wound may take a few weeks to heal. Severe tears may take longer to heal than this. To relieve pain during the recovery phase:
Sit on a soft or cushioned ring pillow.
Cool the wound with cold compresses or place a cooling pad with witch hazel extract between a tampon and the area between the vaginal opening and the anus (called the perineum).
While urinating, use a squeeze bottle to pour warm water into the perineum area.
Sit in a bath of warm water that is deep enough to cover your buttocks and hips for five minutes. Use cold water if you find it works best for relieving the pain.
Take over-the-counter pain relievers. Ask your health care provider about the possibility of using a numbing cream or spray if needed.
Talk to your health care provider about using a stool softener or softener to prevent constipation.
Tell your health care provider if you have severe, persistent or increasing pain, as this may indicate an infection.
After delivery, you will begin to shed the superficial mucous membrane lining the uterus during pregnancy. Vaginal secretions consisting of this membrane and some blood will come out for a period of weeks. These secretions are thick and red in the first few days after birth. After that, it will decrease in density and gradually become more water-like and change in color from reddish-brown to yellowish-white.
Call your health care provider if you have severe vaginal bleeding — one sanitary pad soaking with blood in less than an hour — especially if it’s accompanied by pelvic pain, fever, sensitivity or tenderness.
You may feel occasional cramping, sometimes called postpartum pain, in the first few days after giving birth. These contractions — which often resemble painful menstrual cramps — help prevent excessive bleeding by compressing the blood vessels in the uterus. Postpartum pain is common during breastfeeding, due to the release of oxytocin. Your health care provider may recommend over-the-counter pain relievers.
Pregnancy, labor and vaginal delivery can stretch or injure the pelvic floor muscles, the muscles that support the uterus, bladder and rectum. This can cause drops of urine to leak while sneezing, laughing or coughing. These problems usually improve within weeks, but they can persist in the long term.
Meanwhile, wear sanitary napkins and do pelvic floor muscle (Kegel) exercises to help tighten your pelvic floor muscles and control your bladder. To do Kegel exercises, imagine you are sitting on a marble and tightening your pelvic floor muscles as if you were lifting a marble. Do this for three seconds at a time, then relax for a count of three. Keep doing the exercise 10 to 15 times in a row, at least three times a day.
Hemorrhoids and defecation
If you have pain during defecation and swelling near your anus, you may have swollen veins in your anus or lower rectum (hemorrhoids). To relieve discomfort during recovery from hemorrhoids:
Apply an over-the-counter hemorrhoid cream or suppository (wick) containing hydrocortisone.
Use pads containing hamamelis or a numbing agent.
Sit in warm water without any additives for 10 to 15 minutes two to three times a day.
If you find yourself avoiding bowel movements out of fear of damage to the perineum, worsening hemorrhoid pain, or a cut in the episiotomy, take steps to keep stools soft and regular. Eat foods rich in fiber, including fruits, vegetables and whole grains, and drink plenty of water. Ask your health care provider about a stool softener if needed.
A few days after giving birth, your breasts may feel full, firm and tender (engorgement). Frequent breastfeeding of both breasts is recommended to avoid or reduce engorgement.
If your breasts — including the darker circles of skin around the nipples — are engorged, your baby may have difficulty attaching to the nipple when feeding. To help your baby latch on, you can express a small amount of breast milk by hand or using a breast pump before feeding your baby. To ease the feeling of breast relief, place a warm washcloth on your breasts or take a warm bath before breastfeeding or expressing, as this may make the milk come out easily. It is also recommended to place a cold washcloth on the breasts between feedings. Over-the-counter pain relievers can also help.
If you’re not breastfeeding, wear a supportive bra, such as a sports bra. Don’t use a pump or express milk from your breasts, as this will cause more milk to come out.
Hair loss and skin changes
During pregnancy, elevated hormone levels increase the ratio of ingrown hairs to hair loss. The result is usually a dramatic increase in head hair — but now is the time to pay the price. After giving birth, you will experience hair loss for up to five months.
After giving birth, stretch marks will not go away, but eventually they will change from red to silver. Also, expect any skin that has darkened during pregnancy to slowly disappear — such as dark spots on your face
changes in mood
Childbirth stimulates a mixture of strong emotions. Many new moms experience periods of frustration or anxiety, sometimes called the baby blues. Symptoms include mood changes, crying spells, anxiety, and difficulty sleeping. Baby blues usually go away within two weeks. Meanwhile, take good care of yourself. Share your feelings and ask your partner, loved one or friend for help.
If you experience extreme mood swings, loss of appetite, extreme fatigue, and feeling miserable shortly after giving birth, you may have postpartum depression. Contact your health care provider if you think you might be depressed, especially if symptoms don’t go away on their own, you have trouble caring for your baby or completing daily tasks, or you have thoughts of harming yourself or your baby.
After giving birth, you will likely feel pregnant. that’s normal. Most women lose more than 13 pounds (6 kg) of weight during childbirth, including the weight of the infant, placenta and amniotic fluid. In the days after giving birth, you’ll lose extra weight from the remaining fluid. Then, by eating a healthy diet and exercising regularly, your weight can gradually return to its pre-pregnancy weight.
The American College of Obstetricians and Gynecologists recommends that postpartum care be an ongoing process rather than a one-time visit after delivery. Contact your health care provider during the first three weeks after birth. Within 12 weeks after delivery, be sure to see your health care provider for a comprehensive postpartum evaluation.
During this appointment, your health care provider will check your mood and mental state, discuss contraception and birth separation with you, review information about infant care and feeding, talk about your sleep habits and issues with fatigue, and conduct a physical exam. This exam may include an examination of your abdomen, vagina, uterus and cervix, to make sure you are recovering well. This is the perfect time to talk about any doubts you may have, including resuming sexual activity and how you’re adjusting to life with a new baby.