Postpartum Instructions

We hope your pregnancy has gone well and that you and your baby are doing fine. If not, please talk to us. As you prepare to go home and are facing so many changes, let us offer some suggestions to make your recovery easier.

First day at home:
Enjoy the excitement of being at home. Emphasis today should be on resting. Tonight may be more stressful than in the hospital because you will be tired and yet fully responsible for the care of your new baby. With time and practice, things will get easier.

Activity during the first two weeks:
Gradually increase your daily activity so that in about two weeks you are leading a fairly normal life. We recommend daily rest periods during this time. You may shower, bathe or wash your hair at anytime after the birth of your baby. During your first six weeks, avoid hard work. It may be desirable that the number of visitors be kept to a minimum during the first two weeks; it may cause undue fatigue for you and may be detrimental to your baby’s health. You may take short trips if you desire. If long automobile rides are necessary, you should stop and get out of the car at frequent intervals. Although you may return to employment at six weeks many new mothers try to take advantage of the 12 weeks allowed by the Family/Medical Leave Act.

Bowel Movements:
After a bowel movement, wipe from front to back. If you have hemorrhoids they usually improve in the first days or weeks following delivery. Sitz baths will occasionally give considerable relief. You should relieve constipation by ample intake of fluids each day or, if necessary, take a laxative like Milk of Magnesia. A stool softener, such as psyllium powder (Metamucil) or Colace, may also be used.

Care of the Perineum:
Episiotomy/ Tear Care:
Your perineal area may cause you discomfort depending on the type of delivery you had. If it is uncomfortable after you return home, the following should be done:

  1. Sit in a tub containing several inches of plain warm water for 15 minutes two to three times a day (Sitz baths)
  2. Apply Tucks pads afterward (place in freezer and they may be more soothing)
  3. Continue to use your peri-bottle after each void while having vaginal flow
  4. Keep your stools soft as discussed above.

Lochia:
The original bloody vaginal discharge called “lochia” will gradually decrease and change to pink, then brown and finally to yellow. You may bleed for as long as six weeks, this should not deter you from keeping your six-week appointment. You may occasionally bleed heavier for short periods of time. The first menstrual period may occur before your check-up, especially if you are not breastfeeding. You should call if you are having bright red vaginal discharge bleeding that causes you to change your pad more than once per hour.

postpartum-sidebarBreasts:
During pregnancy, your breasts prepare for lactation (milk production) and after birth hormonal changes and infant sucking trigger a surge in milk supply. Nursing on demand every one to three hours for 15 to 20 minutes on each breast should empty the breasts and provide proper nutrition and fluids for your infant. Sore nipples and engorgement are common in the early stages of breastfeeding and the most frequent causes for new mothers deciding to stop breastfeeding. Proper positioning and latching with frequent nursing can help alleviate these temporary and uncomfortable symptoms. Call the lactation consultants (at Women’s Care Miffy Davis) for advice if you are having problems. During growth spurts your infant may nurse more frequently for one to two days for the milk supply to catch up with his/her needs. It is recommended that infants be exclusively breastfed for the first six months to provide optimal nutrition and protection against infections. Other benefits from breastfeeding include decreasing the risk of subsequent pregnancy and assisting with weight loss. When you are breastfeeding it is important to continue eating a well balanced diet. You actually need more calories while breastfeeding than you did during your pregnancy! It is a good idea to continue your prenatal vitamins while breastfeeding as well as a lot of fluids (64 ounces a day).

Non-Breastfeeding Mothers:
Should expect a period of engorgement treatable with form-fitting bras, ice treatments and avoiding stimulation to the breast (pumping or hot showers). Tylenol or Ibuprofen may be taken every three to four hours for relief of symptoms. Cabbage leaves placed on your breast may also relieve your symptoms. Symptoms should resolve within 24 to 48 hours although leaking of milk may continue for days or weeks.

Exercise:
You may begin two to three weeks after the baby is born. Start gradually and be consistent. Light walking for 20 to 30 minutes is a good activity. It is normal to have some swelling of your feet and legs. If moderate to extreme, elevate your legs higher than your heart several times a day. You may begin Kegel exercises two to three weeks after delivery. Kegel exercises help increase the strength of your pelvic muscles. If you desire, you may begin swimming two to three weeks after delivery.

Postpartum Blues:
It is common to have postpartum blues. This is a normal response to many of the hormonal changes, stress and lack of sleep that go with raising a newborn and physically recovering from the birth. Activities that can be helpful include:

  • Getting more sleep
  • Try to find time for your own needs, including recreation and social activities with friends, family and your partner. A short period away from infants who are requiring your constant care and attention can be very helpful.

Please pay attention to your symptoms. It can be helpful to seek a counselor’s assistance during this time. Don’t hesitate to talk to your doctor about any symptoms or scary thoughts you might be having. Wellmama is a service in Eugene/Springfield that leads free support groups for women who want to talk about the stresses of new family and get support.

If you or someone you know is in crisis and needs immediate help, please call the National Suicide Prevention Hotline 24/7 at 1-800-273-8255.

“After Pains”:
The “after pains” may be bothersome for first time mothers and more intense with subsequent babies, especially during breastfeeding. Tylenol or ibuprofen every three to four hours will alleviate the discomfort. Expect cramping to continue for the first several days after birth.

The First Menstrual Period:
Will often occur within the first two months, however, you may not have periods while nursing. The first period may be unusually heavy or prolonged. If you are concerned about this, please call the office.

Sexual Intercourse:
We recommend waiting at least three to four weeks before resuming sexual activity. Condoms are safe during this time. Due to hormonal changes and the birth process, you may experience vaginal dryness and painful intercourse. This can be relieved with the use of a vaginal lubricant, such as Astroglide. Do not depend on breastfeeding to adequately prevent pregnancy.

Postpartum Depression:
Postpartum depression is not uncommon and you should call your physician if you find yourself in a downhill spiral marked by:

  • Prolonged crying spells.
  • Thoughts of harming yourself, the baby or others.
  • Severe anxiety.
  • Inability to function or care for your newborn or yourself.
  • Depressive symptoms lasting longer than two weeks.

Please pay attention to your symptoms. It can be helpful to seek a counselor’s assistance during this time. Don’t hesitate to talk to your doctor about any symptoms or scary thoughts you might be having. Wellmama is a service in Eugene/Springfield that leads free support groups for women who want to talk about the stresses of new family and get support.

If you or someone you know is in crisis and needs immediate help, please call the National Suicide Prevention Hotline 24/7 at 1-800-273-8255.

Follow-up Appointments:
Your postpartum visit will be six weeks after delivery. In some circumstances, your physician may recommend a visit two weeks after delivery. Please call and make this appointment soon after you are discharged from the hospital.

Your postpartum visit will consist of a pelvic exam, a pap smear may be performed and contraception will be discussed as well as any issues or concerns.

Please Call Us If You Have Any Of The Following:

  • Fever with or without chills (temperature of 100.4˚ or higher).
  • Any difficulty with urination (burning, frequency).
  • Vaginal bleeding that is excessive (soaking more than one pad per hour).
  • Sudden extreme weakness or loss of consciousness.
  • Swelling, redness or tenderness in one area of the breast or leg.
  • Anything that troubles you.

If You Had a Cesarean Section:
Your course after leaving the hospital should be one of progressive activity and exercise. Your incision will not reach its maximum strength for approximately four to five weeks, so try not to overdo it. Usual activities such as walking, climbing the stairs and light housework are permissible but no heavy lifting for approximately six weeks. You may drive within 10 days after leaving the hospital. Do not drive if you are taking narcotic pain medication (Percocet, Vicodin). Your incision should be kept clean and dry and should be left either uncovered or loosely covered. Tub baths or showers are permissible, but be sure to let the wound dry thoroughly in the air following completion of your bath. If there are small bandage strips on the wound, these may be gently removed in five to seven days after you return home. As with a vaginal delivery, we recommend waiting at least three weeks before having intercourse. When intercourse is resumed remember your contraceptive needs. With time, your incision will become less sensitive. It is common to feel thick ridge beneath the incision, this will gradually disappear. Some numbness and/or itching around the incision are common and do not indicate a problem. Should you develop redness of the incision, increased pain and tenderness or temperature elevation, please let us know right away.

Congratulations on your New Arrival from the Physicians and Staff of Women’s Care.