Post partum care & issues

It is most common for new mums to self-neglect once they reach home with their little bundle of joy. In most cases, its not intentional but due to the overwhelming amount of things they need to see to, most new mothers tend to put their own needs last compared to that of her new baby and the rest of her family. If you are a new mum, it is crucial to be reminded that post birth care, for you, mama, is just as important as pre-natal care and the event of the birth itself. You need this reminder because it is very easy to forget about yourself with all the excitement around you.

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After the labor is over

After delivery you will be transferred to your room or to the maternity ward so that you can rest. You will be in a very tired state, both physically and mentally, more so if you had a difficult labor and had little rest before the birth. In cases of normal delivery, you will be prompted to pass urine, where else if you had a C-sec delivery, catherization, a procedure whereby a tube is passed into the bladder to help you urinate, will be administered. Unless you have requested otherwise, pain relievers will be given to you to help you deal with the pain from the stitches.

Initial episiotomy care will be given if you had one. Episiotomy is a cut made by the doctor in the perineum to aid delivery. If you have hemorrhoids, care will be given. In most medical centers, you will be advised on how to manage your sanitary pads and how to clean up after your visit to the washroom.

Learning the proper ways to care for your wounds will help prevent infection. It is normal to feel dizzy and light-headed when you get off the bed – sometimes this is due to the after effects of an epidural if you had one. With proper care and ample rest, you should be in good condition to be discharged from the hospital within a day or two. Before leaving the hospital, be sure to address any issues if in doubt with your doctor or midwife.

 

Home sweet home with baby

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While nothing can beat the relief and happiness of going back home with your new bundle of joy, among the first thing you will have to contend with is the unpredictability of your newborn. Sleep will be quite a luxury, no matter how much help there is around the house. The lack of sleep and rest may be a tad overwhelming to some new mums. The main thing here is to keep calm and don’t lose sight of the big picture, which is to do the best you possibly can to care and nurture for your baby and to gradually get back on your feet. Sooner or later, you will adjust to the unpredictable schedule of your baby as well – it is just a matter of time.

The early postpartum period is the time where your body undergoes major changes. Post partum hormones go into a frenzy, sending some new mommies to certain depths of baby blues while body shapes and sizes naturally attempt to shrink back to their pre-pregnancy state. Some of these changes, particularly where your hormones are going amok, will not be pleasant; where else other changes such as pounds rolling off the bathroom scales, you will gladly welcome!

For relief from the discomforts of uterine contractions, try sleeping or lying on your stomach with a pillow tucked under your abdomen. Make sure your bladder is kept empty. If pain is unbearable, consult your doctor for medications to help manage it.

As the days go by, you should be gradually regaining your strength and stamina. Loss of blood during delivery may slow down your recovery, so it may take more than a few days to regain your strength. If you find yourself still overly tired even after a month, be sure to mention this to your doctor during your first postpartum visit.

For most new mums, muscle tone in the abdomen returns very slowly. This again differs from one woman to another and is dependant on the amount of stretching the abdomen underwent and the new mother’s original muscle constitution. Many confinement practices in Asia concentrate strongly on the recovery of the uterus and regaining muscle tone around the abdomen. The main thing to remember here is to listen to your body. No two pregnancies are alike and the same applies to the recovery period. While for some, the ideal postpartum recovery timetable may fall through perfectly, while for others it may not go according to plan. These are all part and parcel of welcoming your bundle of joy into this world!

 

Breast Engorgement

Within the first few days your body will be busy producing milk in abundance; simultaneously blood vessels fill up causing breast tissues to swell. This is termed as breast engorgement and can be a source of pain and discomfort in the breast and also around the armpits. Your breasts may feel tender and lumpy when touched – a condition which can be remedied by expressing your milk regularly.

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Feeding your baby is by far the best way to beat breast engorgement. The use of a well-fitting nursing bra will help immensely by supplying ample support to tender breasts. A nursing sleep bra worn at night may also offer some light support and much comfort during sleep and night-time feeds.

 

Episiotomy

Episiotomy can take a while, up to six weeks or more to heal. The V zone having been stretched or torn during delivery may cause your perineum area to feel sore. Continue with the ice packs or try a sitz bath (sitting in warm water for a while) after going home. Be particular in how you clean yourself to avoid infection; a spray bottle will come handy while toilet paper should be avoided for the time being.

 

Lochia

Lochia is a bloody vaginal discharge experienced after birth – yet another ‘discomfort’ to deal with. It is actually the uterus shedding the lining that was formed during pregnancy. After the initial heavy bleeding which lasts for about a week, light bleeding resembling normal period blood will follow. Period-like flow continues for a few weeks, usually to be replaced by white, creamy discharge with a not-so-pleasant odor at the tail end. Lochia usually stops 3-6 weeks after delivery. Your next menstruation will depend on whether you are nursing. However, some nursing mothers will have their periods even before they stop breastfeeding.

 

Hemorrhoids

Hemorrhoids are most annoying and can add to the discomfort of an already uncomfortable new mum. They can become swollen and even protrude during pregnancy, labor and delivery. The pain can be quite discomforting. There are specially made products for Hemorrhoid treatment available in the market in the form of sprays, ointments or creams. Cold compresses are also very soothing. Hemorrhoids will eventually shrink in size and may even disappear altogether.

Uterine care

After-birth pain, also known as uterine contractions, is a common discomfort new mums will have to go through. It is caused by your oversized uterus shrinking back to its pre-pregnancy size. Take heart though that this won’t last and there are ways to counter the pain. With the birth of a first-born, the pain is usually mild and easily managed. The contractions get stronger with subsequent babies but in both scenarios they rarely last for more than a couple of weeks. In most cases, new mums will continue to feel some bloating and discomfort and the abdomen might still appear large.

Constipation

Difficulty in passing stools after delivery is caused by lax abdominal muscles and reduced movement through the intestines. Pain from the incision or haemorrhoids are also capable of causing a mental block, which in turn might aggravate the problem further. At all cost, avoid straining on the toilet. Instead , do the smart thing and consume plenty of fluids. Enjoy your favorite juices and tuck into some dried fruit. A diet rich in fibre will also do the trick. If all natural methods to get things moving fail, consult with your doctor for a mild laxative.

Frequent urination

Pressure on your bladder creates the urge to pee frequently. Some new mums might also find it difficult to hold in their urine. This condition is temporary and it goes away in time. In the meantime it would be a good idea to try some kegel exercises which can help strengthen your V zone.

 

When postpartum symptoms become your doctor’s concern

In the exception of a caesarean section and episiotomy pains which will take more time to heal, most post-natal aches and pains should disappear after a few days post delivery. However, if you find that these pains are intense and unbearable and they are taking much too long to subside, consult your doctor.

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Call your doctor if you notice any of the following:

• Fever over 38 degrees Celsius (after the first 24 hours)

• Nausea and vomiting

• Pain in the lower back or abdomen

• Chills

• Loss of appetite

• Painful urination, burning and urgency to pee frequently

• Pain, swelling and tenderness in the legs

• Severe constipation

• Chest pain and cough

• Hot, painful, swollen or tender breasts

• Persistent pain in the V zone with increasing tenderness

• Bleeding heavier than your normal period

• Overwhelming fatigue

• Vaginal discharge with foul smell

 

Pelvic Floor Exercise

Many women don’t think much of this but pelvic floor exercises are important for your pelvic muscles to restore its tone soon after your delivery. It might be the last thing on your mind but do try to set time aside for this after checking with your doctor. Pelvic floor exercises are essential to avoid possible repercussions in the form of inability to retain water and prolapsed womb in later life. It’s actually very easy to do and can even be done several times anytime of the day while you are sitting, standing or lying down!

Stitches are no excuse here for this exercise will actually promote healing by increasing blood flow to the affected area. Just squeeze and lift the muscles around the front passage as if you are trying to interrupt the urine flow. Hold to the count of three and then relax. Repeat a number of times.

 

Your first post natal check up

You will need to see your doctor or midwife four to six weeks after you give birth to check on your physical and emotional recovery from pregnancy and delivery. If you had a C-section, you may need to see your practitioner before this visit as well for your incision needs to be checked on a week or two after delivery to make sure it’s healing properly.

You may still be dealing with some pregnancy or childbirth-related aches and pains. If have questions about your labor and delivery, and about postpartum issues like breastfeeding, birth control, exercise, sex and work, it would help if you jotted down all your concerns beforehand so you will be less likely to leave out any important questions you may have. Don’t feel constrained by the appointment date, though. Sometimes physical or emotional issues come up that need immediate attention and should prompt a call to your doctor even before your scheduled visit.

 

What to expect during a typical post natal check up

• Body weight check

• Blood pressure check.

• Pelvic exam to assess if your uterus is getting back to its pre-pregnancy size, if your cervix is closed properly and the episiotomy stitches have healed well

• A check on your emotional and overall well being

• Advice will be given on problems such as constipation and birth control

 

Go easy on yourself!

Resist declining offers of help. This is the time you need it the most, in the initial phase with the basics around the house i.e. cooking, cleaning up, shopping etc. If possible, hire some temporary help – it is easily available these days.

Visitors will come pouring in to visit you and your baby. Since this is especially customary in any culture, it becomes all the more necessary to make it clear to them that there will not be much entertaining from you.

There is absolutely no need to get back to normalcy just after coming home from the hospital. If you feel most comfortable in your night clothes, there’s nothing wrong in wearing them all day! You should take all the time you need to get back to looking and feeling like your old self without pressure. The key issue is to get as much rest as possible and avoid any form of tension. The more you rest and take care of yourself in the first few weeks, the quicker you will be able to recover and return to your normal self.

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