I just had my baby…Now what?

October 17, 2012

It’s natural to give labor and delivery a lot of thought and attention, but what happens to your body once the delivery is over?  Unfortunately, your pre-pregnancy body does not return overnight.  Women’s bodies continue to undergo changes once the baby has arrived, and questions about that transitional phase come up often.

How long will I bleed?

The bleeding (called lochia) is your body’s way of cleaning out the uterus and it occurs in three stages.  The first stage consists of heavy, red bleeding and lasts for a few days.  The second stage is a watery, pinkish discharge and lasts from 1-3 weeks.  The third stage is a yellowish-white discharge and its length varies.  You may also pass clots.  If the clots are very large (size of an orange), be sure to call your doctor.  Lochia should end around 4-6 weeks postpartum.  

Why am I cramping?

These cramps or afterbirth pains are due to the uterus contracting as it returns to normal size and usually only last a few days.  They may be increased by breastfeeding, and they can also get worse with subsequent pregnancies.  To alleviate discomfort, try changing your position often, emptying your bladder often, using a heating pad, or taking ibuprofen.  

What can I do for my swollen breasts if I’m not breastfeeding?

To reduce swelling, try ice packs, wear a tight-fitting bra 24 hours a day, and avoid stimulation (touch, shower water hitting them directly).

When will the rest of my body stop swelling?

Postpartum swelling in the hands, feet, and ankles usually goes away within 1-2 weeks as your body gets rid of excess fluid.  You may be urinating and sweating more than usual during this time period.  This swelling is rarely serious, but call your doctor if it lasts longer than a week or if you have bad headaches or pain or swelling in your legs.

How should I care for my episiotomy?

It’s normal to feel the stitches pull and itch after a couple of days, and they will ultimately be absorbed by your body.  For discomfort, try cold packs, dry heat, or sitz baths (baths of clear, comfortably hot water).  Sitz baths can be taken 2-3 times a day for 15-20 minutes at a time.  You may also want to sit on a cushion or a rubber ring to increase comfort.

Why am I so emotional?

It is normal to feel overwhelmed, exhausted, and sleep deprived!  The abrupt lifestyle change and fluctuating hormones might cause anxiety and feelings of helplessness.  Try to communicate effectively and ask for help when you need it.  Please call your doctor if you are feeling something more than “the blues” that last for more than two weeks or are worsening, are unable to function, have no interest in your baby, or have significant changes to your normal sleep or eating patterns. 

When will my body be ready for sex?

You can attempt sex 4-6 weeks after a vaginal delivery without an episiotomy.  If you had a vaginal delivery with an episiotomy or a C-Section, wait 6 weeks. You may need to use lubrication (Astroglide or KY Jelly), especially if you are breastfeeding.

When should I start using birth control?

Most non-lactating women will resume menses within 4-6 weeks of delivery, and most women will have ovulated by 45 days after delivery.  Contraception should be initiated by your six-week postpartum doctor visit whether or not you are breastfeeding.

Can I take the pill while I’m breastfeeding?

Yes, you can take the progestin-only pill, known as the mini pill.  This pill does not contain estrogen, which suppresses milk production.  It contains less progestin than the combination (progestin and estrogen) pills, and it’s important to take the mini pill at the same time every day for maximum effectiveness.  There is no placebo week with this pill—each pill must be taken.   

What can I do for hemorrhoids and constipation?

For hemorrhoids, try Preparation H, Anusol creams, Tucks pads, dry heat, or a spray bottle with warm water to clean and sooth the area.  You can usually expect to have a bowel movement by the second or third day after delivery.  For constipation (which is often worse if you have hemorrhoids or had an episiotomy), try increasing the fiber in your diet, drinking more water, or using stool softeners. 

Why can’t I control my bladder?

Loss of bladder function or leakage of urine is often caused by decreased perineal muscle tone.  Try doing Kegel exercises and be sure to urinate whenever you feel the urge—don’t hold it!  You should regain control of your bladder within a few weeks as your body heals, but if it persists, contact your doctor. 

Why is my hair falling out?

People lose around 100 hairs each day, but pregnancy hormones cause your hair to stay put.  After delivery, your body simply resumes shedding hair normally.  The most noticeable thinning takes place around 5-6 months after delivery.

What medications are safe to use if I’m breastfeeding? 

Many medications are safe to use, although most will get into your milk supply to some extent.  It’s a good idea to ask your baby’s pediatrician about both prescribed and over-the-counter drugs before you take them. 

When can I begin exercising?

After a vaginal delivery, exercise may be resumed when you are feeling back to normal (usually around 3-4 weeks).  If you had a C-Section, wait 4-6 weeks before starting to exercise and at least 6 weeks before any abdominal exercise like sit-ups.

Many additional questions may come up, and be sure to call your doctor’s office for any medical concerns.  In addition, be sure to schedule a two-week postoperative visit after a C-Section or a six-week postpartum visit after a vaginal delivery.  Your doctor will answer your questions and concerns and make sure that you are healing properly at that time.  The bottom line is that these symptoms and changes are completely normal, so try to rest assured that the recovery process is occurring as it should.