Recovery after giving birth
The time after your baby’s birth is a period of physical and emotional readjustment. Your body will gradually return to a semi-normal state. At the same time, you and your family will be taking on new roles to cope with the inclusion and demands of your new baby.The length of time it takes to adjust is different for each family and each family member. Factors such as your baby’s personality, your parenting experience, and the amount of help and support you have will all play a part in your readjustment period. It helps to know what to expect, and plan ahead as much as you can.
After delivery, you may experience mood fluctuations. This is normal, because your body is once again going through hormonal changes. You may also feel unusually tired, which can undermine your ability to cope with the adjustments. To survive this period, try to get plenty of rest, and don’t be afraid to seek help.
Your uterus will return to its pre-pregnant size 5-6 weeks after birth. This is accompanied by postnatal bleeding. This discharge, known as lochia, is the lining of the uterine wall, which is no longer required, and is being discarded, Lochia often has a “fleshy” smell, and looks bloody initially, becoming yellowish-white, white, or brown over the weeks. Lochia tends to be heavy if you change positions, such as when you stand up after lying down.
The duration of postnatal bleeding varies from person to person. Some may experience this discharge for as short as 2-3 weeks, while others may last up to 6 weeks after birth. As your uterus shrinks, the flow of lochia will gradually become less.
Try to avoid using tampons during the postnatal period. Inserting tampons can increase the risk of infection, as well as your discomfort.
If you notice large blood clots, persistent heavy bleeding, or foul-smelling lochia, you should see your healthcare practitioner. These symptoms may indicate infection, or the possibility that part of the placenta is still in your uterus.
Your breast may feel full, hard, and painful for a few days after birth. This is because they are undergoing a process known as engorgement. You can ease this discomfort by frequent nursing (breastfeeding).
If you are not breastfeeding, you may be given medication to suppress lactation. Even so, your breasts may still become engorged and produce milk. You can ease your discomfort using ice packs, which provide temporary pain relief and help to reduce the swelling you experience during engorgement. Avoid milk expression from your breasts as this will stimulate milk production.
Childbirth is always accompanied by some blood loss. If you had an episiotomy (surgical enlargement of your vagina to help with delivery) or large vaginal tear, your blood loss will be greater. After your baby is born, you will continue to lose blood as lochia. There is no need to worry, though, because you will have accumulated extra blood during your pregnancy. However, you should still make sure that your iron intake is sufficient to avoid the risk of anaemia.
Looking after yourself after birth
Rest and exercise
Rest is essential for recovery. Try to sleep when your baby sleeps, and take short naps whenever possible. You should aim to get as much total sleep in a day as you did before you became pregnant, even if it has to be broken up into shorter periods.
If you had an uncomplicated birth, you can begin post-pregnancy exercises to help with recovery. Longer periods of rest is recommended if you had surgical procedures performed on you during or after delivery, including episiotomy and caesarian section. Before attempting any exercises, check with your healthcare practitioner, and do not over exert yourself.
Caring for your perineum
The perineum is the area between your pubic bone and your tail bone (at the bottom of your spine). You should take special care of this area post delivery to prevent infection, relieve pain, and enhance healing, particularly if you have stitches from an episiotomy or tear. Try the following:
- Pelvic floor exercises promotes blood circulation around the perineum, and this will help to strengthen the pelvic floor muscles. This in turn will help your perineum to heal and would reduce any swelling
- Cold and hot packs applied to the perineum can reduce pain. Wrap a towel around the pack to protect your skin from excessive heat or cold.
- Clean your perineum using warm water after you urinate. Remember to pour the water from the front towards your rectum
- Prevent infection by wiping yourself from front to back after going to the toilet
- Avoid using tampons
- Difficulty passing urine and stool
A sore perineum and loss of abdominal muscle tone can make going to the toilet very uncomfortable. If you have trouble passing urine, try to relax, drink lots of fluids and pour warm water over your perineum to promote urine flow. If you are constipated, try to increase your fibre intake by eating fruits, vegetables, wholegrains, and drink plenty of liquids. Gentle exercises, such as walking, can also reduce constipation. Try not to overdo it with iron supplements as they can make your constipation worse.
Getting practical help
One way of ensuring you have time to rest is to accept offers of help from your family and friends. Don’t be afraid to ask them to cook a meal, do the laundry, grocery shopping, or vacuuming. You may also wish to consider hired help at some stage.
It is a good idea to have a check-up with your healthcare practitioner 3-8 weeks after delivery. The purpose of this examination is to see if your recovery is “on track” and identify any problems. However, if you have noticed anything unusual, for instance, abnormal lochia, you should contact your healthcare practitioner immediately, rather than waiting for your check-up.
It is also a good opportunity to discuss any concerns that you may have. For example, if you had a Caesarean section, you may wish to know what it means for any future pregnancy. You may also want to discuss contraception at your postnatal check-up.
Emotional adjustment to parenthood
The early weeks after your delivery are not always easy. You will experience emotional ups and downs caused by hormonal changes, fatigue, inexperience, and maybe a lack of support. At the same time, you are trying to cope with the demands of your new baby. For some, these emotional fluctuations are short-lived. But for others, they can be overwhelming and long-lasting.
If you experience anxiety, depression (“baby blues”), or feeling that you are unable to cope, talk to your partner, family, friends or health provider. Find out if there is a support group for new mothers in your area. Remember to rest whenever you can. You may also benefit from professional help from psychologists and counsellors who have expertise in postnatal emotional issues.
If you are experiencing the following signs, or if your mood remains low, you may be experiencing postnatal depression, and should consult your healthcare practitioner.
Symptoms of postnatal depression
- Insomnia or excessive sleeping
- Extreme changes in appetite
- Crying for no obvious reason, and unable to stop crying
- Feeling of worthlessness
- Loss of interest or enjoyment of things or activities that you normally enjoy
- Feeling irritable with your partner and/or your other children
- Difficulty in concentrating
- Feeling rejected
- Difficulty in laughing and smiling
- Although it can be difficult, try to get enough sleep, eat well and exercise, and enjoy your baby as much as you can. This period in your life will not last forever.