Activity and Exercise

Care for yourself and your baby. Others can help with housework and your other children. Rest when your baby rests. Limit your visitors; they can tire you. Be sure those who do visit are healthy. Remind everyone that hand washing when around the baby is very important. Don't be in a hurry to get back to your everyday activities.

Your good health is important for you and your entire family. You are probably anxious to lose the weight you gained during pregnancy. Do not do any heavy exercise until after seeing your doctor. Slow walking is usually a safe exercise for the early time after the birth of your baby.

Nutrition

Eating well is just as important now as it was before your baby was born. Your body has just gone through the most physically exhausting job of your life. Eat several servings from each of the four food groups every day. Avoid "junk food" by keeping only healthy snacks like fresh fruits and vegetables in the house. Drink at least eight glasses of fluid daily including water, juices and milk. Take your prenatal vitamins until they run out. If you are breast feeding, keep taking them until you stop breast feeding.

Most new mothers are disappointed when they weigh after delivery, and they have only lost 5-10 pounds. This is normal. By the end of the first week, most mothers lose 12-15 pounds. The rest of the weight will come off gradually.

Vaginal Discharge

The vaginal discharge that you have after childbirth is called lochia. This is usually present for approximately 4-6 weeks. The color of the lochia shows how well the area of the uterus where the placenta was attached is healing. The color should turn from bright red to dark red to pink to brownish and get less and less as time goes on. Excess activity may lead to an increase in bleeding. If you soak more than one pad per hour or if you notice a bad odor to your discharge, call your doctor. If your flow suddenly increases, lie down for an hour. Call your physician if it continues. Use sanitary pads, not tampons. Do not douche.

Swelling and bruising around the vaginal opening sometimes occurs. Keep the area clean and dry and always wash from front to back. If you have stitches, they should heal and disappear within 2-3 weeks and completely in 4-6 weeks. The pain in this area should become less and less as time goes by. If you used a sitz bath in the hospital, you may continue to use this as needed at home. If you have a sudden increase of pain in the vaginal opening, call your doctor.

Uterus

Your uterus enlarged during your pregnancy, and even though the baby is out, it will take 4-6 weeks for your uterus to return to its normal size. Cramping (after pains) is occurring as the uterus contracts and becomes smaller every day. The cramping should decrease over the few days following delivery. Ibuprofen or a non-aspirin pain reliever (which is safe for breast feeding mothers) can help reduce the cramping pain.

Legs

You should not have red, warm or tender spots in the calves of your legs. If you do, call your doctor.

Temperature

If you feel feverish, take your temperature. If you have an oral temperature of 100.4 degrees or above, call your doctor.

Bowel Movements

Constipation is somewhat common after delivery. It will improve as you become more active and are drinking plenty of fluids. Drinking warmed prune juice with apple juice, as well as eating lots of fruits and vegetables, is sometimes helpful to improve constipation. You may take two tablespoons of Milk of Magnesia every evening until you have had your first bowel movement. Avoid straining to have a bowel movement.

If these measures are not effective, call your doctor. Do not give yourself an enema.

Urination

It is normal to experience some difficulty emptying your bladder after childbirth. You should try to urinate every 4-6 hours. If after urinating you continue to have feelings of fullness, you may not be completely emptying your bladder. This problem, as well as pain or burning with urination, should be reported to your doctor.

Hemorrhoids

Hemorrhoids are a common problem after childbirth. The first few days after delivery they are the most painful. Creams or ointments may be prescribed by your doctor. Use them as indicated. Avoiding constipation is helpful in managing their ongoing tenderness.

Hygiene

No special soap is needed to wash yourself. A bath or shower should be taken daily, and you can wash your hair as often as you want. Many women have hair loss after having their baby. This is normal.

Breasts

Wear a clean nursing bra if breast feeding. Please refer to your Breast Feeding Booklet for further information. If you are not breast feeding, wear a clean supportive bra, even at night, for the first two weeks, until your breast milk has dried up.

Some women who bottle feed experience engorged breasts. Engorgement can be painful. Fortunately, this condition is temporary, lasting only 1-2 weeks. Wearing a supportive bra, avoiding breast stimulation, and ice packs to breasts are the best remedies. Do not attempt to express or pump the milk out. This will only increase milk production.

Follow-up Appointment

Your doctor will want to see you in four weeks. Call the office and make your appointment soon after you leave the hospital.

Sexual Relations/Birth Control

Wait until the healing process is complete before you have sexual intercourse. Your doctor will advise you when it is safe to resume sexual activity, which is usually after four weeks. Remember, without birth control you can become pregnant, even if you are breast feeding. Decide what form of birth control is right for you and discuss it with your doctor before you begin having sex again.

Cesarean Care

A cesarean section may be pre-planned or may become necessary during labor if there are problems with you or the baby. The average hospital stay after a cesarean section is 2-3 days. Incision pain is expected and may be helped by taking pain medication. Caring for your abdominal incision will begin during your hospital stay. If you have staples, they may be removed before you go home or your doctor may ask you to return to his or her office for removal. Strips of tape will then be placed over your incision. It is alright to get your incision wet, but you should always shower with your back to the water spray. If you prefer to take a bath, make sure the water line does not reach your incision line. Always dry the incision first with a clean towel, then dry the rest of your body. Look at your incision daily and call your doctor if it becomes red, separates, or if you notice drainage, bleeding or a foul smelling odor. The tape should be removed after a week. Even though you had a cesarean section, you will still have vaginal flow, called lochia, for several weeks. (See Vaginal Discharge earlier in this section.) Your recovery may be a little slower than if you had a vaginal delivery, but with a little tender loving care you will soon be back to normal.

Baby Blues

Baby blues occur in 50 to 80 percent of new mothers. They usually start on the second or third day after the birth and last no more than 10 days. Symptoms include crying spells, mood swings, anxiety, loneliness, decreased sex drive, worry about the baby, and lack of confidence in mothering ability.

While waiting for the blues to pass, you'll feel better if you take the following steps:

• Rest- Get help with the chores or let them go. Rest or sleep when the baby sleeps.
• Play- Plan frequent outings with the baby or ask someone to baby-sit while you go shopping, take a walk, attend exercise classes or dine out with your husband.
• Eat well- Include plenty of whole grains, milk products, fresh fruits and vegetables and protein-rich foods such as fish, chicken, beef, cheese and beans.
• Seek support- Tell your partner how you feel and ask for his help and support. Join a new mothers' group or get to know other new mothers at your church or workplace.
• Trust yourself- Remember, even without experience, most parents do what is right for their baby.

Postpartum depression (PPD) occurs in about 10 percent of new mothers. It may start as early as the second or third day or take several weeks to develop. Many of the symptoms of baby blues are present, but they are more intense. Other symptoms include loss of appetite, feelings of helplessness or loss of control, over-concern or no concern at all about the baby, dislike or fear of touching the baby, frightening thoughts about the baby, little or no concern about one's own appearance, and inability to sleep.

Tell your doctor how you feel. When caught early, PPD can be cured with medication and counseling. If the depression is severe or if treatment is delayed, a temporary hospitalization may also be necessary.

Taken from CBE/Fall 1989.