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Health After Pregnancy

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Revised:Friday October 10 2014

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Bringing Baby Home

Recovering from Childbirth

Normal changes after childbirth | Recovering from a caesarean section | Checkup after birth |

Normal changes after childbirth

Key Points

  • Any woman who has given birth will experience lochia (vaginal discharge).
  • You can prevent engorgement by frequently nursing your baby.
  • Contact your health provider if your temperature is higher than 38 °C (100.4°F).
  • 80% of new mothers experience the “baby blues”.

Vaginal discharge (lochia)

Lochia (vaginal discharge after giving birth) is made up of blood, mucous and tissue from the lining of the uterus. Any woman who has given birth - either vaginally or by caesarean section - will experience lochia after the baby is born.

Lochia stages

Right after your baby is born, your lochia will be bright red and might have a few clots in it. In the days (or weeks) following, it will turn a darker red; then pink; then whitish-yellow.

It's normal for vaginal discharge to become red again for a short period during or after breastfeeding. This happens because breastfeeding causes mild contractions of the uterus. Bright red blood might also reappear if you suddenly become more active.

Lochia can last from 10 days up to 5 weeks. To avoid infection use a sanitary napkin (pad) - not a tampon - during this time.

When to expect your period again

It will likely take 1-4 months for your body to be ready to have a period again.

If you're breastfeeding, it might take months before your period returns. Or you might not get your period until you stop breastfeeding.

You might still ovulate and get pregnant before your period returns. If you DON'T want to get pregnant, use a reliable birth control method as soon as you become sexually active again.

When to contact your health care provider

Contact your health care provider if your bleeding or discharge:

  • Is heavier than your normal period or heavier than you think it should be.
  • Has a bad smell.
  • Becomes bright red again after it has slowed.
  • Has clots that are larger than a "loonie" (Canadian $1 coin).

Vaginal pain/discomfort

Caring for your perineum after birth

It's normal for your perineum (the skin between the anus and vagina) to be swollen, bruised and tender after you have a vaginal birth (especially if you have stitches). This area might be uncomfortable for up to 6 weeks.

You can help your perineum heal and ease your discomfort by:

  • Keeping the area clean. Prevent infection by changing your pads often and using a peri-bottle (a squirt bottle used to clean the perineum) with warm tap water to cleanse your perineum after you go to the bathroom.
  • Applying ice packs to reduce swelling. (A sanitary napkin moistened with water then frozen makes a good ice pack).
  • Air drying the area while resting.
  • Sitting on a cushion.
  • Using a warm sitz bath (a bath where you sit in warm water that covers your perineum). Sitz baths can help relieve the itching you might feel when your stitches start to heal. You can buy plastic sitz baths at most pharmacies.
  • Resting as often as you can. When your baby is sleeping, sit down and put your feet up.
  • Talking to your health care provider about pain medications that are safe to take while breastfeeding.

When to contact your health care provider

Contact your health care provider if:

  • Your episiotomy (a surgical cut in your perineum) burns.
  • Your stitches open and begin to bleed.
  • You develop signs of an infection (fever, increasing pain, foul-smelling vaginal discharge).

After pains

After delivering your baby, you might feel strong menstrual-like cramps known as "after pains."

After pains are caused by your uterus contracting to stop excessive bleeding after birth. They're often more noticeable when you're breastfeeding and are stronger with second and subsequent pregnancies.

Your health care provider might suggest pain medications if your after pains are really painful.

Problems urinating

In the days following the birth of your baby, you might find it hard to urinate (pee) if you had a catheter or if your perineum is bruised or swollen.

Starting the flow of urine

Help yourself relax and start the flow of urine by using a peri-bottle with warm tap water and/or running the tap.

Stinging

It might sting when you urinate if you have an episiotomy or small tears in your vagina. You can take away or ease stinging by using the peri-bottle to squirt warm tap water over the area when you urinate.

Leaking

Since the pelvic floor muscles are stretched during pregnancy and childbirth, you might leak urine when you laugh, sneeze or cough. Doing Kegel exercises (exercises that strengthen and tone the pelvic floor) can help strengthen these muscles.

When to contact your health care provider

Contact your health care provider if you feel:

  • Pain and/or burning when urinating.
  • A frequent and urgent need to urinate.

Sore breasts & engorgement

When your milk comes in (2-4 days after birth) your breasts might become very full, hard and sore. This is called engorgement. You can prevent engorgement by frequently breastfeeding your baby.

If you aren't breastfeeding your baby, wearing a supportive bra day and night and applying ice to reduce the swelling can help. Don't use a breast pump, as this will produce even more milk.

Hemorrhoids & constipation

Hemorrhoids

Hemorrhoids are stretched and swollen veins around the rectum. Hemorrhoids might hurt and bleed during a bowel movement and can be painful and itchy in general.

If you're experiencing the discomfort of hemorrhoids, try lying down rather than sitting. Applying ice packs, witch hazel and over-the-counter products can also help reduce hemorrhoid pain.

Constipation

If your perineum is already sore and/or you have hemorrhoids, you might worry about having a bowel movement after having your baby.

Not eating as much and taking pain medication can lessen your urge to have a bowel movement. But it's important to avoid becoming constipated. Drinking plenty of fluids and eating high fibre foods (whole grain foods, natural bran and flaxseed, nuts and seeds, legumes, fresh vegetables and fruits) can help prevent constipation.

If you think you're constipated, talk to your health care provider about safe stool softeners.

When to contact your health care provider

Contact your health care provider if you experience:

  • Rectal bleeding.
  • Increasing problems with constipation.
  • Pain when having a bowel movement.

Excessive sweating

It's common to sweat a lot in the first few weeks after having a baby, especially at night. Sweating is one way that your body gets rid of the extra fluid it retained during pregnancy. You might also notice that you're urinating more often.

You can reduce the discomfort and inconvenience of excessive sweating by:

  • Drinking more fluids to replace what you have lost.
  • Sleeping on a towel to help keep your sheets and pillow dry.
  • Using only light blankets and sheets when sleeping.
  • Wearing lightweight clothes to sleep in.
  • Keeping a fan near your bed.

When to contact your health care provider

A higher-than-normal temperature can be a sign of infection, so contact your health care provider if your temperature is higher than 38oC (100.4oF).

The "baby blues"

Having a baby causes physical and emotional changes that can make adjusting to motherhood difficult.

You might be prepared for what happens physically after having a baby, but not for your changing emotions.

80% of new mothers experience the "baby blues" or "the blues". The baby blues usually happen 3-4 days after giving birth and can last up to 2 weeks.

If you have the baby blues, you might cry or feel sad, irritable, anxious and/or frustrated. Caring for yourself by resting when your baby sleeps, eating well and asking for help from family and friends can help with the transition to motherhood.

When to contact your health care provider

Baby blues that last longer than 2 weeks could be a sign of a postpartum mood disorder. Talk to your health care provider if the "baby blues" don't go away.

Related links:

Speak with a Peel Public Health Nurse
905-799-7700
Monday to Friday 8:30 a.m. - 4:30 p.m.
Caledon residents call free of charge at 905-584-2216


Bringing baby home | Staying healthy | Dealing with the unexpected
Your changing relationship | Becoming a dad | New parent resources | Contact us

Revised: Friday October 10 2014

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