If you don’t feel your best after having a baby, it’s no wonder. Your body is recovering from a birth that was, at the very least, physically taxing. It is turning off the pregnancy changes that have held sway for nine months, and turning on your mothering systems—from lactation to that jangly alarm that goes off in your head when your baby cries. Some of these changes are not pretty, but they are pretty impressive. Here's what you need to know about postpartum care for your changing body.
For the first six weeks or so after the birth, your uterus sloughs its lining, causing a vaginal discharge called lochia. At first it is like a heavy period, gradually decreasing to a light discharge.
Plain maxi-pads are best, says midwife Kathi Wilson, of Thames Valley Midwives in London, Ont. She advises against products with deodorant or special outer layers, which can irritate or even impede healing. Tampons are a no-no.
Wilson also tells new moms to play “queen” for the first few days—let others wait on you. “In the first week or so, the bleeding should start to settle down,” she says, but doing too much too soon can delay healing. If your lochia flow suddenly increases, take that as a cue you need to rest a bit more.
If you had a tear or episiotomy during the birth, you will have stitches that can be uncomfortable while they heal. Even without stitches, the area around your vagina (the perineum) may feel bruised and swollen. To speed healing and ease discomfort:
• Keep the area clean with plain soap and water during your regular bath or shower. • In the first few days, an ice pack can help reduce swelling. • Allow air to circulate by going without a pad for an hour or so each day. Use old towels to protect your bedding while you lie down for a rest. • Use a plastic squeeze bottle to gently squirt the perineum with warm water as you urinate. Even a tiny tear may sting when urine touches it. • Do Kegel exercises (tightening and releasing the vaginal muscles) to speed healing by increasing the flow of blood to the perineum.
When your milk “comes in” (usually the second or third day after birth), Mother Nature is often a little overenthusiastic. Many women experience some swelling and tenderness, but the transition will be more comfortable if you feed your baby frequently around the clock, says Gwen Peterek, a nurse and prenatal instructor with Childbirth Educators of London, Ont.
If your breasts become very full, flattening the nipple and making it hard for the baby to latch on, use your fingers to push in the fluid-filled tissue around the nipple, then express some milk before latching the baby on. Thankfully, engorgement doesn’t usually last long.
If your baby has been asleep for a few hours and your breasts feel full, demand feeding works two ways—Mom can demand, too. If baby’s rooting around in his sleep or sucking on a finger or his fist, there’s a good chance you can get him to latch on and nurse to relieve the pressure of overfull breasts.
In the early weeks, your breasts may also leak when your baby cries, or when you snuggle up to your partner at night. However, this will taper off gradually, and is usually much less noticeable than it feels. Wearing nursing pads and light-coloured tops for the first while should disguise most of the evidence.
Don’t be surprised if you sweat profusely for a few days, especially at night. You’ll probably need to urinate frequently during this time, too. Blood volume increases during your pregnancy, so now your body needs to rid itself of excess water to get things back to normal.
Your first bowel movements after giving birth may not come easily. “Your intestines and stomach have been accustomed to the heavy weight of the uterus. Suddenly that’s gone,” Peterek explains. “So things are going to be a little sluggish for a while.”
Adequate fluids plus high-fibre fruit, vegetables and whole grains are preventative prescriptions against constipation. If it persists, try a fibre supplement or prune juice.
These measures are especially important if you have hemorrhoids (rectal varicose veins). Talk to your caregiver about using a stool softener. After a bowel movement, premoistened hemorrhoid pads clean without irritating, and are easily made with witch hazel and cotton cosmetic pads.
Though it took 38 weeks for your pregnant uterus to grow to the size of a watermelon, it will make the return trip to pear size in only six weeks. It may be a slightly uncomfortable journey, though.
“A new mom may have afterpains, especially when breastfeeding,” Peterek explains. Breastfeeding releases the hormone oxytocin, which causes both milk letdown and uterine contractions. These crampy contractions are a sign your body is working properly. A pain reliever like acetaminophen can help if you’re really uncomfortable.
It’s normal to feel a little overwhelmed by the enormity of your new job in the emotional first weeks of parenthood. In fact, all kinds of new feelings are normal now: You may be consumed by walk-through-fire love for your baby one minute, and engulfed in exhausted despair over never having a moment to call your own the next. Plus, there is so much to learn: It’s scary to be in charge of a brand-new human being. (If you’re sad or can’t function, you might be experiencing postpartum depression; consult your doctor.)
Fortunately, babies are resilient and can thrive despite our inexperience. You and your partner can support each other through this transition with open communication about your feelings and needs. Remember, it takes time to learn how to be a family as well as a couple.
“If this is your first baby, that makes you newborn parents,” says Peterek. Your first steps in this role are bound to feel a little wobbly, and you may need someone to hold your hand at first, but you’ll be up and running soon.
Midwife Kathi Wilson suggests an herbal bath to speed healing (plus it’s a great excuse for some alone time). Buy a pre-packaged mix of postpartum bath herbs, or DIY your own in advance. You’ll need equal parts dried calendula flowers, camomile, chickweed and plaintain leaves (check natural food stores or search “herbal products” online). Steep in boiling water for 20 to 30 minutes. Add this “tea” to a warm bath with half a cup of sea salt and a cheesecloth bag containing crushed garlic.
Colostrum, the thin liquid your breasts produce before your milk comes in, is low in volume so as not to stress the baby’s kidneys, yet rich in protein, calories, vitamins and minerals, as well as high doses of protective antibodies. It provides everything your baby needs until Mommy’s milk arrives.
For most women, the process of toning their tummy muscles and paring off pregnancy pounds takes time. In the early postpartum weeks, concentrate on staying healthy rather than losing weight. Eat nutritious food, get enough rest and gradually return to exercise. Walking with the baby in a sling or stroller is a good way to start.
• you experience extreme abdominal tenderness, fever or persistent cramping • you have problems urinating • your stitches become extremely tender • your vaginal discharge suddenly becomes bright red and extremely heavy (soaking one large pad in the course of an hour), develops an unpleasant odour or contains clots larger than a quarter • you develop a fever or flu-like symptoms • you feel dizzy or faint, even after you have rested • you develop a hot, inflamed or red area on your leg that is tender to the touch (sign of a possible blood clot)