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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.
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
a lifetime of memories to save a few minutes of time?) Have most
of your flowers and gifts taken home the night before discharge
so 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 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 the patio. Short walks are also permissible. If possible, take
a 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 your
Sitz 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
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, 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
Intercourse 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 in
adequacy 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:* Chills or a fever above
100.5 degrees (orally).
- Frequency
and burning with urination.
- Excessively
heavy or prolonged vaginal bleeding.
- Unusual
pain, swelling or tenderness in the area of the breasts.
- Unusual
pain, swelling or discharge from a cesarean section or tubal ligation
incision.
- Unusual
pain or feeling of separation of your episiotomy.
- Pain,
swelling and/or red streak in a leg.
- Fainting.
- Severe
abdominal pain.
- Severe
headaches.
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