Postpartum Care

What does postpartum mean?

Postpartum is the period of time after the birth of your baby when your body is changing back to normal. It lasts about 6 weeks or until your uterus returns to its normal size.

What special care will I need after delivery?

• Rest: You will need extra rest. However, with caring for and feeding a new baby, there is not much time to rest. Get help from friends and family with household chores so you will have extra time to care for the baby and yourself. Because you must feed the baby day and night, you may need to change your sleeping schedule to get enough rest. Try to sleep while the baby sleeps. Morning and afternoon naps can be very helpful.
• Pain relief: If you delivered the baby vaginally through the birth canal, pain in the area between your rectum and vagina is common. To relieve the pain and prevent infection, you can sit in a warm bath, put cold packs on the area, or put warm water on the area with a squirt bottle or sponge. It is also important to wipe yourself from the front to back after a bowel movement to prevent infection. If sitting is uncomfortable, you may want to buy a doughnut-shaped pillow at your local drugstore to help ease the pressure when sitting. An over-the-counter pain reliever may also help. If you are breast-feeding, make sure you take a pain reliever that does not have aspirin in it.
• Bleeding and discharge: You may have a vaginal discharge for 2 to 6 weeks after delivery. Sometimes it may last longer. It may come out in gushes or more evenly like a menstrual period. The discharge may start out red and slowly change to pink and finally a yellow-white color. Do not use tampons for the first 6 weeks after delivery. You will need to use pads because tampons may bring bacteria into your body while it is still healing and cause infection.
• Constipation and hemorrhoids: It is common to be constipated or have discomfort from hemorrhoids after delivery. You can use hemorrhoid ointments and sprays to help reduce swelling in the area of your rectum. For constipation try eating foods rich in fiber and drinking lots of liquids. Do not use any medicines to loosen your bowel movements without first asking your healthcare provider.
• Urination: In the first days after delivery you may notice a change in your usual pattern of urination. During the first 72 hours your kidneys work harder than usual in order to get rid of any extra fluid that has built up in the body during pregnancy. In addition, your bladder may be swollen and bruised which may lead to temporary problems with sensing bladder fullness and complete bladder emptying. To help prevent bladder infections, practice good hygiene and wipe from front to back after urination and bowel movements. Try to drink plenty of fluids, especially water or cranberry juice. Make regular urination a habit and avoid long waits between the times you empty your bladder. If you are having difficulty controlling your bladder, or if urination is accompanied by burning, lower abdominal pain, back pain, or fever, consult with your healthcare provider.
• Breast soreness: Your milk will come in about 2 to 4 days after your child is born. This may make your breasts very large, hard, and sore. If you are breastfeeding, this will get better once you start a breast-feeding routine. If you are not breast-feeding, your breasts may become large or painful while you are waiting for your milk to dry up. To help with pain and discomfort, wear a well-fitting support bra, put ice packs on your breasts, and do not stimulate your nipples.
• Headaches: Many women develop headaches in the first few weeks after delivering their baby. Most of the time, these are tension headaches. Try to get plenty of rest while you can, even if you have to nap while the baby is sleeping. Be sure to eat meals on a regular basis. Try to avoid drinks that contain a large amount of caffeine. You may get some relief from lying down with a cool damp cloth on your forehead, using relaxation techniques such as meditation, or taking nonprescription pain medicines such as acetaminophen. If you are breastfeeding, check with your healthcare provider before taking any medicines. If your headache is severe, or if you have changes in your eyesight such as difficulty focusing or blurred vision, nausea, vomiting, or weakness in any part of your body, notify your healthcare provider immediately.

When can I start doing normal activities?

If you had a normal delivery without any problems, you can get back to doing most of your normal activities right away. You should still take it easy and avoid heavy lifting, vacuuming, and a lot of stair climbing for the first couple of weeks. If you have had a Cesarean section (C-section), you will need to avoid heavy lifting for 6 weeks.

Exercise is one of the best ways to lose weight, get more energy, relieve stress, and build your strength. Unless you had a C-section, difficult birth, or other pregnancy problem, you can usually start exercising as soon as you feel up to it. If you have had a C-section, you can usually start exercising in 6 weeks.

When will my period start again?

If you are not breast-feeding your baby, you may start having menstrual periods 3 to 10 weeks after delivery. If you are breast-feeding, there is no specific time when your periods will start again. It may not happen until after the first 6 months of breast-feeding, but it could happen earlier. Some women do not get their period again until they stop breast-feeding.

When will I return to my normal weight?

During birth, you lose about 12 to 14 pounds. However, this may still leave some weight to lose, depending on how much weight you gained during pregnancy. Losing this weight takes time. It takes most moms 8 to 12 months to return to their normal weight. Losing the weight slowly is healthy and natural. The key is to eat healthy and exercise. After the first few months of eating right and exercising, you can begin a healthy weight-loss program if necessary. If you are breast-feeding, you should make sure you are still eating at least 1800 calories a day. Because breast-feeding uses a lot of calories, it usually helps women lose their pregnancy weight.

When can I have sex again?

The number of weeks you should wait before having sex depends on your specific situation. If you had an episiotomy, you should wait at least 3 to 4 weeks for it to heal. If you had a C-section you should wait at least 4 weeks so your cuts can heal. Because it takes approximately 6 weeks for your uterus to return to normal size, many providers recommend that all moms wait a full 6 weeks. It is normal to feel uncomfortable at first when you start having sex again after childbirth, especially if you are breastfeeding.

Talk to your provider about methods of birth control you can use after the birth of your baby. The method that may be best for you depends on the type of delivery you had, how you are recovering, and if you are breast-feeding.

What are the postpartum blues?

Many physical and emotional changes happen when you are pregnant and after you give birth. These changes can leave you feeling sad, anxious, afraid, or confused. These feelings are called the baby blues and usually start right after the baby is born and go away within a week. However, for some women, these feelings do not go away and they may get worse. When this happens it is called postpartum depression. Postpartum depression can start right after the baby is born or begin weeks later. It can be a serious problem and needs treatment. If you feel depressed, talk to your healthcare provider.

When do I need to see my healthcare provider for a checkup?

Your provider will tell you when you need to return for a checkup. For a normal delivery, it is usually 4 to 6 weeks. If you had a C-section, your provider will want to see you 1 to 2 weeks after the birth of your baby and again at 6 weeks after the birth. A follow-up appointment may be scheduled sooner if there were any problems during your pregnancy, such as high blood pressure or diabetes.

When should I call my healthcare provider?

Call your provider if:

• You have a fever over 100.4°F (38°C).
• You have unusual abdominal or genital pain.
• You have increased pain, swelling, redness, or discharge from an episiotomy or C-section cuts.
• You are bleeding through more than 1 pad per hour.
• The discharge from your vagina smells bad or itching.
• You pass blood clots the size of a plum or larger.
• Your breasts are red or warm, or there is an unusual discharge from the nipples.
• You are unable to empty your bladder, or you feel a burning pain when you urinate.
• Your legs are tender or red.
• You have felt depressed or blue for more than 2 to 3 days.

You should get more detailed information and instructions about these possible problems when you leave the hospital.