Postpartum care after a vaginal delivery

It is very normal that after child birth your newborn becomes top priority, but you must understand that postpartum or after child birth care and hygiene is very important, too. Pregnancy changes your body in more ways than you could think of, and it doesn’t stop when the baby is born. There are lots of things to be taken care of; from vaginal soreness to urinary problems, here is what to expect as you recover from a vaginal delivery and tips that can help you.

Vaginal soreness

If you had an episiotomy or vaginal tear during delivery, the wound might hurt for a few weeks. Extensive tears might take longer to heal. In the meantime, you can help promote healing, by trying the following tips:

• If sitting is uncomfortable, sit on a pillow or padded ring.
• Use a squeeze bottle to pour warm water over your vulva when you are urinating. Press a clean pad or washcloth firmly against the wound when you bear down for a bowel movement.
• Cool the wound with an ice pack, or place a chilled witch hazel pad between a sanitary napkin and the wound.
• Take pain relievers or stool softeners as recommended by your health care provider.

While you are healing, expect the discomfort to slowly improve. Contact your health care provider if the pain intensifies; the wound becomes hot, swollen and painful; or you notice a pus-like discharge.

Vaginal discharge

You will have a vaginal discharge; lochia for a number of weeks after delivery. Expect a bright red, heavy flow of blood for the first few days. The discharge will gradually stop, becoming watery and changing from pink or brown to yellow or white.

Contact your health care provider if the following occurs:

• Heavy vaginal bleeding
• Your discharge has a foul odour
• You have a fever of 38 C or higher

Contractions

You might feel contractions, sometimes called after-pain, during the first few days after delivery. These contractions, which often resemble menstrual cramps help, prevent excessive bleeding by compressing the blood vessels in the womb. These contractions tend to be stronger with successive deliveries. Your health care provider might recommend an over-the-counter pain reliever.

Contact your health care provider if you have a fever or if your abdomen is tender to the touch. These signs and symptoms could indicate a uterine infection.

Urination problems

Swelling or bruising of the tissues surrounding the bladder and urethra can lead to difficulty urinating. Fearing the sting of urine on the tender perineal area can have the same effect. Difficulty urinating usually resolves on its own. In the meantime, it might help to pour water across your vulva while you’re sitting on the toilet.

Contact your health care provider if you have any signs or symptoms of a urinary tract infection which includes;

• A strong, persistent urge to urinate
• A burning sensation when urinating
• Passing frequent, small amounts of urine

Pregnancy and birth stretch the connective tissue at the base of the bladder and can cause nerve and muscle damage to the bladder or urethra. You might leak urine when you cough, strain or laugh. Fortunately, this problem usually improves with time. In the meantime, wear sanitary pads and do Kegel exercises to help tone your pelvic floor muscles.

To do Kegels, tighten your pelvic muscles as if you are stopping your stream of urine. Try it for five seconds at a time, four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions. Aim for at least three sets of 10 repetitions a day.

Haemorrhoids and bowel movements

If you notice pain during bowel movements and feel swelling near your anus, you might have haemorrhoids; stretched and swollen veins in the anus or lower rectum.

To ease any discomfort while the hemorrhoids heal, soak in a warm tub and apply chilled witch hazel pads to the affected area. Your health care provider might recommend a topical hemorrhoid medication as well.

If you find yourself avoiding bowel movements out of fear of hurting your perineum or aggravating the pain of hemorrhoids or your episiotomy wound, take steps to keep your stools soft and regular. Eat foods high in fiber; including fruits, vegetables and whole grains. Drink plenty of water. Ask your health care provider about a stool softener or an osmotic laxative, if needed.

Another potential problem for new moms after a vaginal delivery is the inability to control bowel movements; fecal incontinence. Frequent Kegel exercises can help with mild fecal leakage. If you have persistent trouble controlling bowel movements, consult your health care provider.

Sore breasts and leaking milk

Several days after delivery, your breasts might become firm, swollen and tender; engorgement. To ease discomfort, nurse your baby, use a breast pump, apply warm washcloths or take a warm shower to express milk. Between feedings, place cold washcloths or ice packs on your breasts. Mild pain relievers might help, too.

If you are not breast-feeding, wear a firm, supportive bra, such as a sports bra, to help stop milk production. Do not pump or rub your breasts, which will cause your breasts to produce more milk. If your breasts leak between feedings, wear nursing pads inside your bra to help keep your shirt dry. Change pads after each feeding and whenever they get wet.

Hair loss and skin changes

During pregnancy, elevated hormone levels put normal hair loss on hold. The result is often an extra-lush head of hair. After delivery, your body sheds the excess hair all at once. Hair loss typically stops within six months.

Stretch marks won’t disappear after delivery, but eventually they will fade. Any skin that darkened during pregnancy, such as the line down your abdomen; linea nigra will slowly fade away as well.

Mood changes

Child birth triggers a lot of powerful emotions such as, mood swings, irritability, sadness and anxiety among others. Many new mothers experience a mild depression, sometimes called the baby blues. The baby blues typically subside within a week or two. In the meantime, take good care of yourself. Share your feelings, and ask your partner, loved ones or friends for help. If your depression deepens or you feel hopeless and sad most of the time, contact your health care provider. Prompt treatment is important.

Weight loss

After you give birth, you will probably feel out of shape. You might even look like you are still pregnant. This is normal. Most women lose more than 10 pounds during birth, including the weight of the baby, placenta and amniotic fluid. In the days after delivery, you will lose additional weight from leftover fluids. After that, a healthy diet and regular exercise can help you gradually return to your pre-pregnancy weight

The postpartum checkup

About six weeks after delivery, your health care provider will check your vagina, cervix and uterus to make sure you are healing well. He or she might do a breast exam and check your weight and blood pressure, too. This is a great time to talk about resuming sexual activity, birth control, breast-feeding and how you are adjusting to life with a new baby. You might also ask about Kegel exercises to help tone your pelvic floor muscles.

Above all, share any concerns you might have about your physical or emotional health. Chances are, what you’re feeling is entirely normal. Look to your health care provider for assurance as you enter this new phase of life.