What to Expect Postpartum

It took nine months for your body to go through a lot of hormonal and structural changes, and then give birth. Now, your body’s going to react. Be patient. To help you, here are some things you may experience postpartum.

Immediately Following Delivery

Your body needs to deliver the placenta and you may still feel contractions. If you are watching, you may see the placenta. It’s a large organ. It was the sack that held your baby.

Don't Be Alarmed

After your baby is born, a nurse will use a bulb syringe to clear mucus and amniotic fluid from your baby’s mouth and nose. The umbilical cord will be clamped and cut. A nurse will record your baby’s Apgar score. This simple test measures your baby’s condition at one minute, five minutes and 10 minutes of life to monitor your baby’s breathing, reflexes, skin color, temperature and heart rate. Using a zero to 10 scoring system, one is critical and 10 is very healthy. Nurses may also apply an antibiotic ointment to your baby’s eyes to protect them from germs that can cause infection and vision problems.

During your recovery, your nurse will continue to check on you regularly for the next two to three hours. You can expect to have heavy discharge and continued mild contractions. Your baby can room with you, unless he or she needs to be cared for in the transition or critical care nursery.

You and Your Baby

Bonding

The first interaction between parents and their baby is a wonderful event. A strong emotional bond is formed as your newborn begins to recognize the voices and faces of its mother and father. Studies have shown that babies arrive with the ability to express a full-range of emotions – they can smile and grimace and yawn or stare intently. Here are some bonding ideas you may want to use.

  • Hold your baby, especially skin-to-skin. This will warm and comfort him/her.
  • Interact closely and keep your faces close to your baby’s. Newborns can see a distance of eight to 10 inches.
  • Sing a lullaby. If you sang to your baby while in the womb, he/she will recognize your voice and be comforted. He/she may even turn his/her head toward the familiar sound.
  • Stay together as a family in your room. Phone calls can be made from here and family and friends can be welcomed.
  • When playing with your baby, make sure you are touching him/her. Touch, closeness and warmth are essential to a newborn’s sense of security. Newborns use touch to explore and understand their new world.

Breastfeeding

If you’ve decided to breastfeed your baby, he or she will need to eat fairly soon after being born. It may take a few tries because it can take a few days for your milk to build. In the beginning, your body will produce colostrum – an antibody-rich liquid. Breastfeeding can also cause uterine contractions. During the first days of feeding, consult with your nurses and a lactation consultant. Ask questions.

You and Your Body

Adrenaline

You probably rushed to the hospital. And although you had your birth partner with you, labor and delivery are hard work. There are doctors, nurses, technicians … then your baby! Now come the phone calls. Family. Friends. And throughout all this excitement, your body is still going through changes. Take the advice of your doctors and nurses. Take a deep breath now and then. And nap whenever you can.

Perineal Tears and Episiotomies

Even though your cervix dilates for birthing, there may be stress on the muscles between your vagina and anus. Stitches may have been necessary. You will be swollen and sore later.

Vaginal Bleeding, Swelling and Pain

It may not be until the first time you need to urinate, but you will pass a lot of blood. You’ll be given a perineum (peri) bottle and sanitary napkins (self-cooling or another specially constructed product). Fill the peri bottle with warm water, then you spray a stream of water onto your perineum while on the toilet. The water helps wash away lochia—blood and tissue left over from pregnancy. The warm water also helps keep this area of your body (and, possibly, stitches) clean. Use the peri bottle every time you use the bathroom and follow the instructions of your healthcare team for specific use and duration. You’ll need to continue this regimen when you go home. As vaginal bleeding can be heavy, your clothes may get soiled from time to time, so ask about special undergarments and be prepared to wear clothing you don’t value too highly. If you’re soaking more than one sani-pad an hour or passing clots that are as big as a lemon, you may need medical attention. Call your doctor. DO NOT use tampons. Self-cooling sanitary pads help. So can a bag of frozen peas. Sitz baths. Inflatable donuts … keep yourself, your clothing, everything clean. And use your cooling device of choice several times a day.

C-Section Scar Itching

The good news is that you won’t have some of the unpleasant after-effects of a vaginal delivery. But a Cesarean section is surgery, even if you had a minimally invasive C-section. For approximately four to six weeks, you can expect to feel a little numbness or tingling and itching at the site of your incision. However, if you develop a fever, redness or oozing from your scar, call your doctor to test for infection.

Night Sweats

For the first few days after giving birth, you body has to expel a lot of liquid. It will make you feel better to have your mattress covered with a crib pad or two.

Constipation

Sometimes women become anxious over episiotomy stitches. Or your body is reorganizing. If you’re not eliminating easily, ask your doctor about stool softeners, fiber-rich foods, drinking extra water, easily walking around your home.

Breasts

If you’re nursing, your breasts can increase by one cup size. Be prepared with a larger-than-normal bra, preferably a feeding-friendly construction. And no underwires for a while. Underwire bras can constrict milk ducts causing infection. Be sure to report any breast pain to your doctor.

Your Hair

Approximately ten percent of new mothers experience hair loss after pregnancy due to a drop in hormone levels. However, sometimes it’s a false perception because your hair grew thicker than normal while you were pregnant. If shedding persists, consult your doctor.

Aches and Pains

This is important. Your body expanded during pregnancy. Muscles and ligaments have stretched. Your organs regrouped to make room for an ever-growing baby. And skeletal changes happened. Think of your rib cage and your back. Now that your baby is born, your body needs time and loving care to realign. You can help by eating well and gradually increasing exercise.

You Gained Weight. Now What?

Be patient. And develop a realistic set of plans and goals to lose the pounds you no longer need.

Pelvic Organ or Bladder Prolapse

The weight of your baby during pregnancy and/or strenuous pushing during labor and delivery can weaken pelvic-floor muscles. Sometimes the bladder, uterus, or bowel can shift from their normal positions. The most common symptom of this is urinary incontinence or fecal bowel leakage. Another sign is vaginal heaviness or bulging. Talk with and visit your OB/GYN. He or she may recommend Kegel exercises. Most women with mild prolapse who do Kegel exercises heal in approximately six months.

Hemorrhoids

Hemorrhoids are enlarged veins of the anus and rectum usually caused by pressure from constipation or from pushing during labor. Occasionally, the hemorrhoid is visible or uncomfortable. Many doctors prescribe stool softeners and topical medications to alleviate swelling. Keep this area of your body as clean and dry as possible. And call your physician if pain or itching becomes intense.

Balance

It’s going to take a while before your body settles down. Don’t be too quick to put your high heels back on.

Indulge Yourself

Schedule a salon visit. Fix yourself a special lunch, or order in something you’ve been craving. Play your favorite music. Sit quietly with your newborn. In other words, take care of your postpartum body.