Postnatal Care Questions
This Q&A will give you a general outline of what to expect and look out for during your postnatal care. Depending on your personal circumstances some of it may vary. If you don't find what you are looking for we'll gladly answer any question at your next visit. Please note, the content on this page is not intended to be a substitute for professional medical advice or treatment.
The postpartum period begins immediately after the birth of your child and extends for the next 6 weeks. During this time your body, including your hormone levels and uterine size, returns to pre-pregnancy conditions.
Your obstetrician will tell you when you need to return for a checkup. At these visits, the progress of your postpartum recovery will be checked and options regarding for contraception may be reviewed. For a normal delivery, it is usually 6 weeks. A follow-up appointment may be scheduled sooner if there were any problems during your pregnancy. If you had a C-section, your provider will want to see you 1 to 2 weeks after the birth of your baby and again at 6 weeks after the birth.
When you go home after delivery, try to get extra rest and avoid fatigue. However, with caring for and feeding a new baby, there is not much time to rest. Get help from friends and family with household chores so you will have extra time to care for the baby and yourself. Because you must feed the baby day and night, you may need to change your sleeping schedule to get enough rest. Try to sleep while the baby sleeps. Morning and afternoon naps can be very helpful.
If you had a normal delivery without any problems, you can resume most of your normal activities right away. You should still take it easy and avoid heavy lifting, vacuuming, and a lot of stair climbing for the first couple of weeks.
If you have had a Cesarean section (C-section), you will need to avoid heavy lifting for 6 weeks and you should not drive a car until you are confident you can hit the brake firmly and without hesitation (usually about two weeks) and are no longer taking narcotic medication.
Lochia, or menstrual bleeding after birth, normally will last between 2 and 6 weeks with it gradually tapering to a dark pink staining. Bleeding is rarely heavier than a heavy period. You should use pads for the first 6 weeks, not tampons, so that you do not increase your risk of infection. If you notice any large clots or heavier bleeding, you may be doing too much and need to slow down.
If you are bottle-feeding your baby, you may start having menstrual periods 3 to 10 weeks after delivery.
If you are breast-feeding, there is no specific time when your periods will start again. It may not happen until after the first 6 months of breast-feeding, but it could happen earlier. Some women do not get their period again until they stop breast-feeding.
If the bleeding continues to be heavy, please call us as the uterus may not have the tone it should, may have an infection or may contain a piece of placenta that did not expel itself. You may also notice a distinct smell; don't be concerned unless you have other symptoms like elevated temperature or abdominal pain.
If you delivered the baby normally through the birth canal, pain in the area between your rectum and vagina is common. To relieve the pain and prevent infection, you may try first:
- Sitting in a warm bath
- Putting cold packs on the area
- Putting warm water on the area with a squirt bottle or sponge
It is also important to wipe yourself from the front to back after a bowel movement to prevent infection.
If sitting is uncomfortable, you may want to buy a doughnut-shaped pillow at your local drugstore to help ease the pressure when sitting.
For pain relief after a vaginal delivery or cesarean section, you may take ibuprofen along with any prescription pain medication you were given upon discharge.
In addition to heavy bleeding, call us if you are experiencing burning with urination, increasing pain, temperature over 100.4°F, depression for more than 2 to 3 days, or incisional redness or tenderness.
Breast milk usually comes in about 2 to 4 days after your delivery. This may make your breasts very large, hard, and sore. This will get better once you start a breastfeeding routine. If you are not breastfeeding, your breasts may become large and painful while you are waiting for your milk to dry out and you may benefit from wearing a well-fitting support bra and putting ice packs on your breasts. Breastfeeding is recommended and both our affiliated hospitals have lactation consultants available to assist with questions. Breast pumps may be useful, especially for the working mother or premature infant. If breastfeeding is not chosen, or discontinued, we recommend using an iron-fortified formula.
Sore nipples may be relieved with ice packs and regular feeding from both breasts. Avoid prolonged feeding sessions and ensure a good latch. Keep your nipples as dry as possible between feedings. Apply ointment (such as bagbalm, cool tea bags, vaseline, and A&D) to any cracks. Blocked ducts are usually felt as a hard, firm mass without a fever. Gentle massage, hot packs, and frequent feeding from both breasts are the best relief. Mastitis, or breast infection, causes a red, warm and painful mass associated with a temperature over 100.5°F. Should this develop, contact our office immediately. The usual treatment is antibiotics and hot packs. Avoid massage but do continue to breastfeed to decrease the chance of an abscess developing.
Weaning can be accomplished at any time. Planning ahead is helpful, beginning with a gradual decrease in the length and number of feedings. Avoid hot showers or any stimulation to the breast area that would encourage milk production. Continue to wear a good support bra, apply ice and bind the breasts tightly. Medication is not recommended to stop breast milk. You may use ibuprofen to decrease discomfort.
Many physical and emotional changes happen when you are pregnant and after you give birth. These changes can leave you feeling sad, anxious, afraid, or confused. These feelings are called the "baby blues" and usually start right after the baby is born and go away within a week.
However, for some women, these feelings do not go away and they may get worse - when this happens it is called postpartum depression. Postpartum depression occurs in about 10% of all postpartum women and can start right after the baby is born or begin weeks later. Women who are at most risk of postpartum depression include first time moms, women with prior history of depression, and those women with less support. Postpartum depression can be a serious problem and needs treatment involving counseling, anticipatory guidance, support from others, and possibly antidepressant therapy.
If you are feeling depressed, let your obstetrician know.
During birth, you lose about 12 to 14 pounds. However, this may still leave some weight to lose, depending on how much weight you gained during pregnancy.
Losing this weight takes time. Losing the weight slowly is healthy and natural. It takes most moms 8 to 12 months to return to their normal weight. The key is to eat healthy and exercise. Exercise is one of the best ways to lose weight, get more energy, relieve stress, and get back into shape. Unless you had a C-section, difficult birth, or other pregnancy problem, you can usually start exercising as soon as you feel up to it. After the first few months of eating right and exercising, you can begin a healthy weight-loss program if necessary.
If you are breast-feeding, you should make sure you are still eating at least 1800 calories a day. Because breastfeeding uses a lot of calories, it usually helps women lose their pregnancy weight.
If you have had a C-section, you can usually start exercising after 6 weeks. Walking and gentle stretching and strengthening exercises are the best exercises to start with.
You should not resume intercourse until 6 weeks after you deliver, as this is the time it takes for your uterus to return to normal size. It is normal to feel uncomfortable at first when you start having sex again after childbirth.
Talk to your obstetrician about methods of birth control you can use after the birth of your baby. The method that may be best for you depends on the type of delivery you had, how you are recovering, and if you are breastfeeding. Learn about your postpartum contraceptive options during your pregnancy. These options include but are not limited to birth control pills, condoms, or long-term birth control options, for example: IUDs (Mirena® and ParaGard®), and vaginal contraceptive ring (NuvaRing®) and others.. Most of these are safe even if breastfeeding.