Postpartum Care

Guide to the Postpartum Experience

We are pleased to offer this simple guide to make your postpartum experience a more pleasant and Postpartum Carerewarding one. You may have already read about the postpartum period in your personal book on maternity care. Remember that every patient and her experiences are different.If any material outlined in this guide or in your book on maternity care seems unusual, please do not hesitate to discuss it with us.

Personal Care

Discharge from the hospital

Make going home a pleasant and relaxed experience. Arrange for the newborn's clothing to be brought to the hospital a day or two before discharge. This will allow you to get everything just right. Be sure the person taking you home is relaxed and at ease. (Why spoil lifetime of memories to save a few minutes of time?) Have most of your flowers and gifts taken home the night before discharges that Mom and Dad can concentrate on the newborn and on each other.

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Arrival at home

Plan your arrival at home well in advance. Many spouses assume that discharge from the hospital means you are ready to assume all physical and emotional responsibilities for maintaining the nest. In many cases this assumption is correct. However, in a good many more it is totally false. In order to avoid problems, make a list of what needs to be done and delegate this list to a responsible person.Your job for the first week at home should be as a supervisor only.You need this time to concentrate on your personal needs and on the needs of your newborn.

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The first week

It usually takes about 8 weeks until you completely return to normal.On your return home you may walk upstairs but take them slowly.As the week progresses, you will find your speed going up and downstairs increasing. Try not to become a track star too quickly. Remain near the house most of the time during this very important first week. If it is bright and sunny outside you may sit on the porch or the patio. Short walks are also permissible. If possible, take short nap each afternoon and retire early each night. Do your best to restrict your visitors to family and close friends. Enjoy a well-balanced diet, but remember if you are nursing, both alcohol and nicotine do enter the breast milk and can have a negative effect on the newborn.

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The second week

You may markedly increase your physical activity during the second week. Short trips out of the house may be routine. You may ride in the car for short distances as you please. You may also get into the full swing of exercising in order to tone your abdominal muscles.

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The third week

During the third week you may essentially do as you please except for heavy lifting and climbing. You may drive your car for medium trips. You may engage in more strenuous exercising.

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The fourth week

By the fourth week you can assume all routine physical activities except for the most strenuous types. You may drive your car routinely.You may have intercourse unless you have persistent vaginal bleeding or unusual discomfort from your episiotomy or your cesarean section incision.

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Personal Care

Stitches

If you have an episiotomy or other sutures, be sure to use yourSitz baths 3 or 4 times each day as you were directed to do in the hospital. Continue this care for approximately 7 days after arriving home. You may also take a mild analgesic such as Tylenol to relieve minor discomfort from your episiotomy or surgical incision. After each bowel movement and after urination rinse your perineal region in the Sitz bath and gently pat dry with a soft facial towel.

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Breasts

Nursing mothers should continue all routine breast care as instructed in the hospital. Be sure to continue the Lanolin cream application to the nipples. Should your nipples become unusually cracked and demonstrate unusual bleeding, please call us. If you should develop any unusual tenderness or reddening in one area of your breasts you should call the office at once since they may represent an area of mastitis. If you are not breast feeding you may experience fullness and discomfort in your breast the 2nd to the 4th day after delivery. Wearing a well fitting, supportive bra or breast binder will help.Ice packs may also be applied. It is important to remember not to stimulate or pump your nipples; this will only aggravate the problem.The discomfort will go away in approximately 36 hours.

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Vaginal Discharge

Vaginal bleeding and discharge will last from 4 to 8 weeks after delivery. At first, the bloody discharge will increase with increased physical activity and with nursing. However, by the end of the third week the vaginal discharge will become thick and yellowish in color.You may douche after 4 weeks, but you should not use vaginal tampons until after your postpartum office visit.

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Menstruation

There is no way of predicting when the first menstrual period will occur after delivery. Non-nursing mothers usually begin to menstruate within 6 to 8 weeks after delivery. However, it may take as long as 12 weeks to reestablish a menstrual pattern. If you are nursing,your periods may not return for several months after you have stopped breast feeding. It is important to remember that ovarian function may begin soon after delivery. This means that you may become pregnant even if you do not have a period. The first period after delivery is often abnormal. This flow may be shorter or longer than before you delivered, but gradually your menstrual cycle should return to what was normal for you. If your first menstrual flow after delivery is excessively heavy with the passage of large, bright red clots,we would request that you call the office immediately.

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Hemorrhoids

Hemorrhoids may continue to be somewhat troublesome for several weeks after childbirth. Continue to use Sitz baths 3 to 4 times day for approximately 20 minutes each time and continue to apply the ointment as prescribed for you in the hospital. Avoid constipation by reestablishing proper dietary habits, including adequate amounts of water, roughage, and fruits. If this regimen does not establish normal bowel function, we would suggest the use of Metamucil (one large tablespoonful in a glass of cold water each night and each morning), or Senokot (one rounded teaspoonful in a glass of cold water each night). This regimen should reestablish normal bowel function within approximately 3 days.

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Bathing

You may take a shower or tub bath any time after your arrival at home.

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After pains

After pains are caused by the uterus contracting and relaxing and help your uterus to return to a pre-pregnant size. The contractions are generally mild with first babies and stronger with subsequent babies but they last only a few days. Changing your position, lying with a pillow under your abdomen, keeping your bladder empty, and taking mild analgesics, are all ways to be more comfortable.

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Sexual intercourse

ntercourse may resume at approximately 4 weeks postpartum unless you have continued vaginal bleeding or problems with your episiotomy or cesarean section incision. Remember that it is possible to become pregnant any time after delivery whether or not you have restarted your period.

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Exercise

Many women are surprised and disappointed to see that after delivery their abdomens are flabby and sometimes look as if they are still pregnant. Doing simple exercises will certainly help to correct this problem. After a vaginal delivery you may begin to exercise your first week at home. Exercise after a cesarean section should begin the second week at home. In both cases, you should start your exercise program slowly and work into a full program over a period of approximately 2 to 3 weeks. As your program time increases you will feel your abdominal muscles tone up and this will surely give a gigantic boost to your morale.

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The maternity blues

The maternity blues is a completely normal phenomenon. It may begin approximately one week after delivery. You may first begin to notice that you have frequent mood swings. You may also notice that you feel somewhat "down" and may even have feelings of inadequacy as well as feelings of being overwhelmed with all of your new responsibilities. You may cry for no apparent reason as well as having other uncontrollable emotional outbursts. These are normal feelings that will eventually go away. Talk about them with your spouse so that he knows how you feel and can help you. If you continue to feel depressed, consult us directly.

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Postpartum office visit

If an appointment has not already been scheduled please call the office and make an appointment to be seen in the office in 4 weeks if you have had a cesarean section and in 6 weeks if you have had a vaginal delivery.

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Special instructions

Please call the office at once if you have:

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