Your recovery at home: What to expect physically after birth

After Birth Pains

You may be able to feel your uterus contract off and on for several days after giving birth. To help ease discomfort:

Gently massage your lower abdomen or uterus.
Lie face down with a pillow under your stomach.
Use a heating pad on your abdomen.
Relax and take deep breaths, or use one of your labor breathing techniques.
Take acetaminophen (Tylenol�) or ibuprofen (Motrin� or Advil�).

If the cramping is worse when you breastfeed, take pain medicine 30 to 40 minutes before breastfeeding.

Normal Vaginal Bleeding

Whether your baby was born vaginally or by Cesarean, you will bleed from your vagina. This is part of the healing process for your uterus.

In addition to blood, the flow contains cells your uterus sheds as it gets smaller. This flow lasts for several weeks. In the beginning it is like a heavy menstrual period. It will be red and may contain small clots. As the site of the placenta heals, the flow will lessen, turning pink, then brown, and eventually white or clear.

Six weeks after giving birth, your uterus will be back to its nonpregnant size.

If you are breastfeeding, your uterus will heal faster. The contractions that let down your milk also make your uterus contract.

If your flow has been pink or brown and then turns bright red again, you have become too active too soon. Your body is telling you to slow down. You need to lie down and rest. If you push yourself too hard in these early weeks, your physical healing will take longer. This can mean feeling tired for weeks longer.

Use sanitary pads and change them often. Do not use tampons until after your post-birth checkup.

Constipation

You will probably have your first bowel movement two to three days after giving birth. If you have stitches in your perineum (area around your vagina), supporting these stitches with a wad of toilet paper may make that first bowel movement more comfortable.

It is common to get constipated after giving birth. This can be the result of being less active and not eating enough fruits and vegetables. Pain medicine can also make you constipated. To help avoid constipation:

Drink six to eight glasses of water a day.
Eat whole grains, fruits and vegetables.
Increase your activity as you feel more comfortable.

Talk with your health care provider if you think you need a laxative or stool softener. Your health care provider may recommend that you take milk of magnesia at bedtime or prescribe a stool softener.

Hemorrhoids

If you have hemorrhoids, it may take two to four weeks for them to shrink. If they are still painful at your postpartum checkup, talk with your health care provider about treatment options. To help hemorrhoids heal:

Reduce the swelling.

—Sit with your feet up or lie down whenever you can.

—Sit in a shallow bath of cold water.

—Apply an ice pack or cold gel pack wrapped in a clean towel for 20 minutes.

—Apply a Tucks� pad that has been chilled in the freezer for 10 to 15 minutes.

—Talk with your health care provider about using an over-the-counter anesthetic cream.

Speed healing.

—Sit in a shallow bath of warm water.

—Apply a warm pack, such as a rice-filled sock warmed in the microwave, wrapped in a clean towel for 20 minutes.

Do Kegel exercises .

Avoid constipation.

Avoid straining when you have a bowel movement.

Engorgement

Even if you are formula feeding, your breasts may become engorged. Your breasts will still get ready to produce milk and become full. Here are some things to help make you more comfortable:

Wear a supportive, tight-fitting bra 24 hours a day. Be sure that the bra does not pinch your breasts.

Avoid nipple stimulation, warm packs, or expressing milk. These signal your body to make more milk, which can make you feel more uncomfortable.

If your breasts become full and tender two to four days after giving birth:

— Apply ice packs to the sides of your breasts under your arms. You can keep the packs in place by winding an elastic bandage around your chest several times. Be sure to protect your skin with a light towel between your skin and the ice pack.

— Drink only when you are thirsty.

— Take acetaminophen (Tylenol�) or ibuprofen (Motrin� or Advil�) as needed.

It will take several days for the fullness to go away.

Episiotomy and Perineal Care

If you had an episiotomy or a tear, the stitches will dissolve. They do not need to be taken out. At first the site of the stitches may feel sore and bruised. Healing usually takes three to four weeks.

To help healing and relieve tenderness, sit in a bath of warm water several times a day.

To help prevent your stitches from pulling, sit squarely on your bottom and do Kegel exercises .

To cleanse the area, use the “squirt” water bottle you got in the hospital. After you go to the bathroom, rinse from front to back with warm water. Continue these rinses for as long as you have vaginal bleeding.

Pat (don’t wipe) from front to back to dry.

To help relieve soreness and swelling, consider using a medicated pad, such as Tucks.

Exhaustion

Caring for your baby around the clock is demanding. Because your baby does not sleep more than a couple of hours at a time, you can become exhausted. To help you get the rest you need for your own healing and to be able to care for your baby:

Plan rest periods for whenever your baby sleeps.

Stay in your pajamas until you have gotten a total of six to eight hours of sleep for that day.

Ask someone else to take care of your baby so that you can nap.

If you can’t sleep when your baby is sleeping, focus on relaxing your body:

— Do a relaxation routine.

— Concentrate on breathing slowly and deeply or use your relaxation breathing .

— Soak in a warm bath.

Perspiration

Heavy perspiring or sweating, especially at night, is common during the first week after birth. This is due to changes in your hormones and your body getting rid of extra fluid. Wear lightweight nightclothes and drink plenty of fluids. Using a fan to circulate the air can also help.

After a Cesarean Birth

Because of the surgery, anesthesia, and blood loss during a Cesarean, your recovery will take longer than if you had a vaginal birth. You will feel more tired and will need more rest and time to heal.

If you had several hours of labor and then had a Cesarean birth, you are recovering from the physical exertion of labor as well as major surgery.

It’s normal for your incision to itch, feel numb, or feel prickly when you touch it. This can last for many months.
Use pillows to get comfortable when you sleep and when you feed your baby.
If you get constipated:

— drink six to eight glasses of water a day

— eat whole grains, fruits and vegetables

— increase your activity as you feel more comfortable.

Limit stair climbing and other activities until you feel ready.
Ask your health care provider when you can start driving a car.
Don’t exercise vigorously for at least six weeks.
Wait to resume sexual activity for six weeks or until after your postpartum checkup.

Follow-up Care

Your health care provider will tell you when to schedule your postpartum checkup. If you have any questions or concerns before that visit, call your health care provider.

Getting Your Period

There is no way to predict when your period will resume. If you are not breastfeeding, your period will probably return in four to six weeks.

If you are breastfeeding, your period may not return for three months or longer. Some women don’t menstruate until after they have weaned their baby from nursing.

You can get pregnant while breastfeeding, so it is important to use a reliable form of birth control every time you have sex.

When your period does begin, it may be heavier than normal for a while.