Post Partum Care

The post partum period begins after delivery and extends to six weeks. This is the time when your body returns to the prepregnant or nearly prepregnant state. There are many changes that occur in your body during this period.

LOCHIA- Lochia is the vaginal discharge you have from your uterus.

Immediately following your delivery you will have bright red heavy bleeding for the first few days. Over the next two to three weeks the flow will decrease and change in color from red to pink, then yellowish white, white, or brown.

CERVIX AND VAGINA- Your cervix will gradually shrink back down to its prepregnant size. The vagina will regain its tone with exercise and time. The labia will remain somewhat more loose, larger, and darker than before pregnancy.

AFTERPAINS: After birth the uterus contracts down to normal size. Some women continue to feel these contractions even after delivery. They are more noticeable during breastfeeding and more common if you have had other pregnancies. They decrease after the first week.

CIRCULATORY CHANGES: During pregnancy your blood system had a larger than normal volume to accommodate your baby’s needs. After delivery this is no longer needed. Some blood volume is lost during delivery. The rest is lost over the next several days. For the first 24 to 72 hours after delivery you will urinate large quantities of fluid and you may perspire more than normal. As a result of this loss of fluid some women experience as much as a five pound weight loss.

ABDOMINAL AND SKIN CHANGES: Your abdominal muscles will feel soft and loose. In about six weeks you will begin to notice the muscle tone returning. Exercise can speed up this process. If you experience stretch marks they will begin to fade. If you had an increase in skin pigmentation it will fade also. There will be a gradual reversal of any increase in hair growth.

Your body will go through a recovery period during the next few weeks. Here are some tips to help you during this time:

  • Rest: Rest is essential for a speedy recovery. Let family members help you as much as possible. When the baby sleeps you should try to nap as much as you can.
  • Don’t lift anything heavier than 15 pounds.
  • Driving a car can be resumed as soon as you desire. However, if you had a cesarean section, do not drive until after your two-week post partum check up.

PERINEAL/EPISIOTOMY CARE

  • If you had an episiotomy or perineal tear that was repaired, you will have stitches which will dissolve over a period of time. Usually it takes approximately four weeks to heal. It is essential that you keep this area as clean as possible.
  • After urination you should rinse your perineal area with warm water and pat dry. Always wipe from front to back with a bowel movement.
  • To relieve swelling and soreness take warm soaking baths or use your sitz bath at least twice a day for 20 minutes the first two weeks after delivery.
  • Avoid tampons or douches until after six weeks.
  • KEGEL EXERCISES (periodic tightening of your vagina),will increase tone and decrease swelling.
  • If your episiotomy or laceration involved your rectum (a 3rd or 4th degree repair), you should use stool softeners to avoid constipation.
  • You must do sitz baths or warm tub soaks for 20 minutes 3 to 4 times per day for two weeks. This will decrease your chances for developing an infection in this area.

ELIMINATION

Some women experience difficulty controlling their flow of urine after childbirth. Kegel exercise can help with this problem. You may try to urinate while doing your warm tub baths. Stool softeners help you with constipation.

HEMORRHOIDS

Hemorrhoids are very common after delivery, especially if you had a long pushing stage. To help them return to normal try thefollowing recommendations:

Avoid constipation
Try pelvic floor contraction exercises
Sitz baths or warm tub soaks
Tucks or Anusol HC cream for comfort

BATHING
You can resume regular tub baths. Showers and baths are both acceptable.

BREAST CARE
Breast feeding moms: Wear a nursing bra at all times, even while sleeping. You may apply Vitamin E oil to your nipples but make sure you wash it off before baby nurses.
Bottle feeding moms: Wear a supportive bra and keep your breast bound for the first two weeks. Just remove them to shower only. Avoid nipple stimulation and keep your back to the water flow from the shower.

DIET
A well balanced diet is important during this healing time. Continue to take prenatal vitamins as long as you breastfeed. Drink at least 6 to 8 glasses of fluid per day.

SEXUAL ADJUSTMENT
Resuming sexual intercourse is an individual decision. It is recommended to wait until after your six week check up, especially if you had a cesarean section.

EXERCISE
A gradual increase in exercise is recommended to help your body return to a healthy state. Any basic program is all right to start ten to fourteen days after delivery. If you experience pain or heavy bleeding, notify your doctor at once.

CIRCUMCISION CARE
Your pediatrician will discuss how to care for the circumcision.

CESAREAN SECTION
If you had a cesarean section follow all of the same instructions discussed above. In addition to those there are a few other instructions that are necessary to follow. Because you have had surgery it may take longer to regain your strength. Rest is very important. Climb steps slowly. Do not lift anything heavier than your baby for four weeks. A gradual increase in exercise can be started at 5 to 6 weeks.You will have steri stips placed on your abdominal incision before you leave the hospital. They may fall off on their own or you can remove them after one week. You may shower with them on. You will be given a 2-week post partum appointment before you leave the hospital so your physician can check to make sure your incision is healing well. Any time before your two-week follow up appointment you notice any redness, drainage or swelling from the incision site, please notify the office at once.

NOTIFY THE OFFICE FOR ANY OF THESE SYMPTOMS

Heavy persistent bleeding that is bright red and heavier than a menstrual period
Have a foul odor to your vaginal discharge
Have a fever greater than 100 degrees
Have a persistent increase in pain
If you had a cesarean section and have redness, drainage, or swelling from the site.

POST PARTUM FOLLOW UP VISITS

Vaginal uncomplicated delivery = 6 week visit
Cesarean Section delivery = 2 week & 6 week visits

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