Post Partum Information

Congratulations! Those months of waiting and preparing for your little one are finally over and now you are faced with the challenging but delightful role of motherhood. The initial days and nights following your baby's birth are exhilarating and exhausting. Relatives and friends will overwhelm you with visits and phone calls, father and siblings will want to get acquainted with the baby, and you will feel the need to recover from childbirth-all while the daily chores mount up. But don't despair! Your strength and organization will soon return as you master the art of fitting the baby into your schedule. In the meantime, we encourage you to rest, relax, and enjoy your baby!

To prepare you for the weeks ahead, we would like to inform you of some of the physical symptoms that are not uncommon in women during the post-partum period.

Post-Partum Blues
You may feel down, depressed, irritable, and even get teary-eyed. It is important to not feel guilty; most women experience some form of mood swings after the delivery. Most of these emotional symptoms can be attributed to the hormonal changes occurring in your body and also to the lack of sleep that you will inevitably endure with a newborn. If these symptoms persist or worsen after the initial postpartum period, notify your doctor.

Lochia
Bleeding caused by the afterbirth pulling away from the uterine wall usually lasts two to six weeks. The blood will be bright red with big clots at first and then will taper off to a light brownish flow. Do not use tampons during this period. Also, your bleeding may increase with exercise or during breast-feeding.

Swelling and Tenderness
Sitz baths, warm cloths, loose clothing, a heating lamp or pad, and Epifoam can all be used to relieve the pain caused by episiotomy and/or hemorrhoids. The episiotomy stitches dissolve in two to four weeks and the hemorrhoids usually reduce in size in a few days.

Afterbirth Contractions
You will experience some small uterine contractions for a few days after delivery, especially if you are nursing your baby. These pains are usually worse after a second baby's birth because your uterus has to work harder to shrink down again. Your uterus will usually be pre-pregnancy size in four to six weeks.

Hair and Skin Changes
Hormonal changes after giving birth can cause your hair and skin to be oilier or drier than usual and some women even lose some of their hair. Nursing can prolong some of these changes, but usually they return to normal in a few weeks.

Weight Loss
Most women lose fifteen pounds during the delivery and five to ten additional pounds in the first few weeks after the delivery. If you gain between twenty-five and thirty pounds during your pregnancy, you will have five to ten pounds to lose after the first post-partum month. If you are nursing, your increased caloric intake and the weight of your breasts could keep you five to ten pounds above your pre-pregnancy weight, but you will lose those pounds when you wean your baby.

Constipation
If you are constipated, eat more fruits and vegetables and more fibrous foods. Avoid harsh laxatives, especially if you are nursing, because they will give your baby diarrhea.

Painful Urination
Try to empty your bladder frequently. Sometimes the bladder is affected by the anesthesia you received during the delivery. The swelling and tenderness around your episiotomy can make urinating painful. Epifoam and sitz baths can reduce the pain.

Menstruation
You may have a menstrual period four to six weeks after the delivery of your baby, or it may take longer. Some women do not menstruate while nursing. Remember that you can still become pregnant, even if your cycle has not returned to normal, so adequate birth control precautions must be taken.

Precautions You Should Take
1. Your good health is as important as your baby's. You need to rest and relax for the first few days after the delivery. Take advantage of help offered by family and friends and avoid physically stressful tasks. Take naps and sitz baths as often as you can. Play with your baby; spend quality time with your husband and other children- indulge yourself! You deserve it.

2. Do not try to diet during your first post-partum month. When your strength has returned, you can start losing any excess weight you gained during the pregnancy. Remember: it took you nine months to gain the weight, so don't expect to lose it too quickly. Eat three nutritious meals each day and you should continue your prenatal vitamins for at least four weeks after the delivery.

3. If you are breast-feeding, you should continue to take your prenatal vitamins during this time. Your daily calcium intake should be about 1500 mg., so you should drink at least one quart of milk per day. If you are unable to tolerate this much milk, you can take calcium supplements.

4. There are exercises you can do right after your first post-partum week that will strengthen your abdominal and pelvic muscles, prevent backache, and improve posture. It is, however, best to wait until the bright lochia has stopped flowing.

A. Lie on your back. Raise your head to touch your chin to your chest several times.
B. Lie on your back. Alternate raising each knee and drawing it down toward your chest several times.
C. Lie on your back. Slide your feet toward your buttocks with your knees bent. Press your knees together, push up with your buttocks, and contract your stomach muscles. Repeat several times.

5. If you are nursing, do not use soap on your breasts. Keep them well supported by wearing a bra, even at night, and use breast creams if they become sore or cracked. It is important that you do not feed your baby with the same breast every time, or that breast will become larger than the other. Some women like to attach a small safety pin to their bra strap to help remind them of which breast they should start with at the next feeding. After each feeding you should air out your nipples for a few minutes. Also, nursing pads can be helpful for leakage problems.

6. If you are bottle-feeding your baby, your breasts may become engorged with milk. To help resolve this discomfort, try using ice packs on your breasts. You can also wear a tight bra, avoid exposing your breasts to the hot shower, and minimize the stimulation they receive. You can pump them to alleviate the pressure, but only when it is absolutely necessary. Medications to dry up the milk are ineffective and have many side effects, so they are not routinely used. It usually takes three to seven days for your breasts to return to normal.

Intercourse
1. It is recommended that you do not resume sexual intercourse for three to six weeks after the delivery. Most women prefer to wait until after their post-partum checkup to make sure they have healed properly and to discuss birth control methods that are available to them.

2. When you call the office to schedule your post-partum visit, please schedule it for four to six weeks after delivery and state which physician you would like to see. This will establish you as his or her gynecologic patient for future yearly examinations.

3. At the time of your post-partum visit, you will have an internal examination and have your blood pressure and weight checked. Birth control methods should be discussed, as well as any problems or concerns you may have.