Postpartum Care Guide
Guide to the Postpartum Experience
We are pleased to offer this simple guide to make your postpartum experience a more pleasant and rewarding 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.
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. Have most of your flowers and gifts taken home the night before you’re discharged so you can concentrate on the newborn and each other.
Arrival at Home
Plan your arrival at home well in advance. Many times, a significant other may 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.
The First Week
It usually takes about eight weeks for you to completely return to normal. On your return home you may walk up stairs, but take them slowly. As the week progresses, you will find your speed going up and down stairs 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 patio. Short walks are also permissible. If possible, take a short nap each afternoon and go to bed 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.
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.
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.
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.
If you have an episiotomy or other sutures, be sure to rinse your stitches with warm water 3-4 times per day. Continue this care for approximately seven 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 with warm water and gently pat dry with a soft facial towel.
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 second to fourth day after delivery. Wearing a well-fitted, 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.
Vaginal bleeding and discharge will last from four to eight 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 four weeks, but you should not use vaginal tampons until after your postpartum office visit.
There is no way of predicting when the first menstrual period will occur after delivery. Non-nursing mothers usually begin to menstruate within six to eight 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.
Hemorrhoids may continue to be somewhat troublesome for several weeks after childbirth. Continue to rinse with warm water three to four times a 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, high fiber foods 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 morning), or Senokot (one rounded teaspoonful in a glass of cold water each night). This regimen should reestablish normal bowel function within approximately three days.
You may take a shower or tub bath any time after your arrival at home.
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. To become more comfortable you could:
- Change your position
- Keep your bladder empty
- Lay with a pillow under your abdomen
- Use a heating pad on your lower abdomen
- Take mild analgesics
Intercourse may resume at approximately six 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.
Many women are surprised and disappointed to see that after delivery their abdomen is flabby and sometimes looks 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 two to three 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.
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 and also have other uncontrollable emotional outbursts. These are normal feelings that will eventually go away. Talk about them with your significant other so that they know how you feel and can help you. If you continue to feel depressed, consult Women’s Health Center of Lebanon directly.
Postpartum Office Visit
If an appointment has not already been scheduled, please call the Lebanon office at 717.273.8835
or the Palmyra office at 717.832.0554
and make an appointment to be seen in the office in four weeks if you have had a cesarean section and in six weeks if you have had a vaginal delivery.
Please call the Lebanon office at 717.273.8835
or the Palmyra office at 717.832.0554
at once if you have:
- Chills or a fever above 100.5 degrees orally
- Excessively heavy or prolonged vaginal bleeding
- Frequent and burning urination
- Pain, swelling and/or red streak in your leg
- Severe abdominal pain
- Severe headaches
- Unusual pain or feeling of separation of your episiotomy
- Unusual pain, swelling or discharge from a cesarean section or tubal ligation incision
- Unusual pain, swelling or tenderness in the area of the breasts