Postpartum Care

Written by Christine Case-Lo
Medically Reviewed by George Krucik, MD, MBA on June 12, 2013

What Is Postpartum Care?

You’ve been concentrating on a healthy pregnancy and delivery, but you may not have thought about care after delivery. Right after a woman gives birth, her body goes through huge changes. Problems can happen and it’s good to know how to have a healthy postpartum phase.

The postpartum period lasts from right after the delivery to eight weeks after you’ve given birth.

Immediately after giving birth, you will be checked over frequently looking for signs that your body is going through the correct changes and that you don’t have complications. After you go home from the hospital, taking care of yourself is crucial. Any symptoms of infections or complications should be discussed with your doctor. You will have a postpartum doctor’s appointment between six to eight weeks after giving birth.

Immediately After Delivery

Your experience after delivery will depend on whether you had a vaginal birth or a C-section (Cesarean section).

For a vaginal birth without significant complications, a new mother typically spends one night in the hospital. Exhaustion is normal. The medical staff will check you frequently to assess your blood pressure, heart rate, and how much you are still bleeding.

Complications from delivery will be addressed. If you’ve had tearing or an episiotomy (a procedure that widens the vagina opening for childbirth), the wound may burn. Large tears take time to heal. You may have an increase in bleeding due to a piece of the placenta that remains stuck inside the uterus, and minor surgery may be required for removal.

A nurse may press on your abdomen often to check if your uterus is becoming firmer and shrinking. Breastfeeding as soon as possible will help this process. You may still have mild contractions as your uterus changes. If you’ve had an epidural, it may be left in for a short time after birth to help with pain.

Vaginal bleeding is normal. As the uterus gets firmer and smaller, the amount of bleeding decreases. If you have very large clots come out, soak a large maxi pad within an hour while off your feet, have a high fever, or if there’s a strange odor to your bleeding, you may have complications and require further treatment.

Due to the pressure on your bladder during pregnancy, labor and delivery, it can take time before you are able to easily urinate after delivery. Pouring water over the vulva can help speed up recovery of this reflex. Urinary tract infections are a possible complication, and if it hurts to urinate or you want to urinate very frequently or feel urination is incomplete, talk to your doctor.

The perineum is the area between the vagina and the rectum. It stretches a lot during a vaginal birth and it will be swollen and painful. Ice packs are usually available in the hospital to wear in your undergarments against the area.   

For women who’ve had a C-section, they will stay in the hospital for two to three days while recovering. A C-section is a surgical procedure, and you will have pain from the surgical site. You may feel groggy, nauseous, or even itchy from the medications you received. It may hurt to sit up and nurse your baby, but it is important to try and do so. Ask for help!

Just as with a vaginal delivery, the healthcare staff will assess your blood pressure, heart rate, and vaginal bleeding. Your uterus size and firmness will also be checked. Complications like heavy bleeding and infection will be watched for.

You may not be able to eat for up to eight hours after a C-section, and only have sips of water or ice chips. The catheter placed during surgery to allow you to urinate will be removed within one day. Try to sit up, with help, several times a day, as moving somewhat will speed the healing process. You will be given pain medication for pain management.

Postpartum Care at Home

Your body is still going through huge changes, and you will be tired. Sleep while your baby sleeps, and make sure you are getting enough to eat and drink. Getting plenty of fluids is very important for healing and letting your milk come in.

Just after you get home, continue to soothe the vulva and perineum with a spray bottle of warm water. After 24 hours, you are also able to take a shallow warm bath. Ibuprofen and other over-the-counter pain medications may help with pain, but ask your doctor before taking anything.

A new mother will continue to bleed for up to eight weeks. This vaginal blood is called lochia. There may be some small clots, but don’t worry—this is normal. If you see large clots, detect a bad odor, or your bleeding increases significantly, call your doctor.

Due to damage to the bladder and urethra, you may occasionally leak urine when you cough, sneeze or laugh over the next few months. Kegel exercises can help you regain control over these muscles and reduce this problem.

Having a bowel movement may be painful for a few days after childbirth. A careful diet with plenty of fiber helps keep stool soft. You may be given stool softeners to take at home. Some women may experience fecal incontinence, which is a problem controlling the bowels. Kegel exercises can also help with this complication.

Hair loss and skin changes may occur. These symptoms are normal hormonal processes and will get better over the next six months.

Breastfeeding can be a challenging but a rewarding experience. Infections and discomfort are possible, and soreness is likely. If you have problems, seek the advice of a lactation consultant.

Baby blues are a normal hormonal reaction. A few days after giving birth, you may feel very emotional and sad. If this continues for a long time, or you feel unable to care for your baby, ask for help and contact your doctor. You may have postpartum depression, a treatable illness.

Exercise can help you heal and get your energy to return, but you need to take it easy initially. Talk to your doctor about appropriate activity levels.

Potential Problems

Certain problems like exhaustion or light bleeding are normal, but some problems need medical attention. Heavy bleeding or large clots are one such complication. Others include:

  • deep vein thrombosis or blood clots in the legs
  • postpartum depression: long-term sadness that can prevent you from taking proper care of yourself or your baby
  • infections, such as: C-section wound, episiotomy or perineum tear, endometritis (womb infection), mastitis (breast infection)

If you experience heavy bleeding, chills, fever higher than 100.4 degrees, racing heart, or trouble breathing, call a doctor or 911.

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