Changes after delivery

How long does it take to recover from childbirth?

The long awaited delivery has come and gone and you are now responsible for you and a new life! Try to slow down and take the time to get to know your baby and enjoy this time together. If friends or family offer to help, let them. Try to arrange for some help before the baby is born. You could use help with household chores, cooking, grocery/errand running and baby care. This type of help will make your first couple of weeks much easier. The birth process does alter many of your body functions. With proper care and attention, your body will return back to its pre-pregnant state within a few weeks.

Mental Changes

Depression after pregnancy is called postpartum depression or peripartum depression. After pregnancy, hormonal changes in a woman's body may trigger symptoms of depression. During pregnancy, the amount of two female hormones, estrogen and progesterone, in a woman's body increases greatly. In the first 24 hours after childbirth, the amount of these hormones rapidly drops back down to their normal non-pregnant levels. Researchers think the fast change in hormone levels may lead to depression, just as smaller changes in hormones can affect a woman's moods before she gets her menstrual period.

Occasionally, levels of thyroid hormones may also drop after giving birth. The thyroid is a small gland in the neck that helps to regulate your metabolism (how your body uses and stores energy from food). Low thyroid levels can cause symptoms of depression including depressed mood, decreased interest in things, irritability, fatigue, difficulty concentrating, sleep problems, and weight gain. A simple blood test can tell if this condition is causing a woman's depression. If so, thyroid medicine can be prescribed by a doctor.

Body changes

Breasts
Whether you choose to breastfeed or not, your breast will begin making and secreting milk. At first, they make colostrum and then the milk will come in a few days later. Sometimes when the milk comes in, it can make your breasts engorged (full to the point of discomfort). If you are breastfeeding, the best way to relieve engorgement is to allow your baby to nurse frequently. If the baby is a sleepy or lazy nurser, you may need to express the milk on your own with a pump or by hand. If you have decided not to breastfeed, efforts need to be made to prevent milk production. Cold packs, a well-fitting bra, or medication (if available) can be used.

Bowel movements
When the perineum is sore, it may be painful to have a bowel movement. By the third day after delivery, mothers usually have a bowel movement. The bowel may become relaxed and lazy due to pressure and inactivity during pregnancy and labor.

Some helpful hints to make bowel elimination less difficult:

• Include course fibrous foods (whole grains, bran, dried fruits, fresh fruits and veggies) in your diet
• Drink plenty of fluids
• Do moderate exercise
• Take the needed time to go!!

Hemorrhoids
Hemorrhoids are swollen, painful blood vessels at the anus and may be a problem for you after pregnancy or delivery. Hemorrhoids do tend to heal with time.

Lochia (Flow)
Lochia is the bloody vaginal discharge that occurs for several weeks after childbirth. It is similar to a menstrual period. This happens as the uterus sheds and renews its lining.

• For the first two to three days this flow is dark red with small clots and has a non-offensive odor.
  
• Gradually the flow lessens and becomes brownish to pinkish in color.
  
• By the tenth to the fourteenth day the flow becomes yellowish - white.
  
• Your flow may increase in amount or change due to any emotional upset, cold, lack of sleep or drastic increase in exercise.
• You should take it easy during these first few weeks, as overexertion can cause a heavier, bright red flow.

Cesarean incision
Once the anesthesia wears off, your incision wound is going to hurt. You will probably be given pain relief medicine to relieve most of the pain. Try to limit coughing, laughing or sneezing. Keep the area clean so that infection does not set in.

Menstruation

• If you do not breastfeed your baby, menstruation should return within eight weeks after birth.
  
• Menstruation may not occur as long as your baby's sole source of nourishment is breastfeeding.
  
• In both cases, pregnancy can occur before menstruation recurs.
  
• Birth control: It is necessary to use some form of contraception to avoid pregnancy even before menstruation returns.
  

Perineum

• The area "between" your legs (perineum) may be sore, bruised or swollen due to the pressure and stretching during a vaginal birth. If you have stitches you may feel more discomfort.
• It can help to put an ice pack on the site for the first 24 hours to reduce swelling and discomfort. Avoid direct contact with the skin by placing a towel between the ice and skin.
• Keep the perineum very clean to prevent infection and odor (sitz baths, tub baths and showering).
• Make sure you clean the area after going to the bathroom.
• Sitting is made easier by tightening buttock muscles, lowering oneself squarely on the chair and then relaxing buttock muscles.
• This area normally heals in about ten days.
• Important to continue to do pelvic floor exercises (Kegels).
• The area is sensitive to the touch, so do not wipe after using the restroom. Instead, squirt the area with some water from a bottle and pat dry with a clean soft tissue.
• Sitz baths also can offer relief. Sit in about 4 inches of either very warm or very cold water several times a day for 20-30 minutes. Keep this water very clean and don't bathe in this water.
• Showers are better than baths in the first few weeks after birth because the soapy dirty water could contaminate the healing of the perineum.

Uterus afterpains

• Your uterus has ungergone a tremendous change on the hours of labor and birth. Your uterus contracts down from being large enough to hold a baby to the size of a fist by 5 - 6 weeks.
  
• Some women feel these contractions as "afterpains" during the first 2 - 3 days after delivery. You may not feel these contractions after the birth of your first baby. They may be painful if you have had previous births (due to the stretching of the uterine muscles which have lost some of their elasticity).
  
• These contractions are often felt more strongly during breastfeeding due to the release of oxytocin. This hormone is produced in response to the baby's suckling.
  
• Walking, breathing and relaxation techniques, and frequently emptying the bladder can lessen these pains.
• You can massage your uterus or breastfeed the newborn to encourage your uterus to contract.
• Your doctor or health care professional may prescribe a mild pain-relieving drug.

Urination

• The nerves to the uterus, bladder and lower intestine are closely linked. They may be affected by the stretching during delivery.
  
• For a short time after birth the mother may lose the sensation that her bladder is full.
  
• It is important to urinate at regular intervals to prevent the bladder from becoming over full
  
• Sensation usually returns in 1 - 2 days.

Post-Partum Check Up

Your doctor will probably schedule for a postpartum check-up four to six weeks after delivery. During that checkup, your doctor will check a variety of things.
* Blood Pressure
* Weight
* Your uterus- to make sure it has returned back to its pre-pregnant shape, size and location
* Your vagina-to make sure it has regained most of its muscle tone
* Your cervix- to make sure it is on the way back to its pre-pregnant state
* Episiotomy site, if you had one
* Cesarean incision, if you had one
* Breasts-for abnormalities
* Hemorrhoids, if you had them
* Varicose veins, if you had them
* Questions/Concerns that you may have
* Birth control options

Comments: Changes after delivery

Comments 1 to 3 of about 3.


mochas4me - 1345 days ago.
i'm looking for encouragement from someone. my poor breasts got huge during pregnancy (I went from a D to F which I didn't know existed). I breastfed my daughter for 11 months and now she is 16 months old. they are totally deflated, saggy, loose etc. I am probably a C cup now. the D bras are big. eventually we will have another baby and I was hoping someone could tell me that they experienced the same thing with the first one but after the second their breasts filled out a little more (after all the nursing was over of course). anyone? or do they really just get worse with every child?

Lou-Li-Ro - 1472 days ago.
'With proper care and attention, your body will return back to its pre-pregnant state within a few weeks.' - I WISH!!!! What about stretchmarks, hips and ribs pushed out of place, caesarean scar, saggy boobs, slack belly, etc etc etc !!!! ?!?!

Jas192 - 1620 days ago.
Just wondering if anyone experiences pain in the area around the urethra after giving birth? It hurt so bad to pee for 2 weeks afterward and every now and then, usually when I'm letting urine out on the toilet (sorry TMI) I'll get this pain. I think it's from the stretching of everything, but even 12 months on I still get this pain from time to time..

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