Mother’s Care and Well-being after Birth

Reasons to call your health-care provider fever over 38oC (100.4oF) prolonged or increased pain (especially in legs) foul smelling vaginal discharge burning, frequent or difficult urination cough or shortness of breath very heavy bleeding clots bigger than a plum fainting or dizzy spells flu-like symptoms – chills, achy all over severe headache not helped by pain medication postpartum blues lasting longer than two weeks Call the ambulance if . . . Blood loss is excessive, i.e. more than one saturated pad/hour and bright red in colour. It is better to seek help and/or advice rather than worry.

It will take time for your body to return to it’s normal state. It is important to be patient and have realistic expectations of what your body will look like and what it will do after the birth.

Rest

After a hospital birth you will probably go home 24-48 hours after you have your baby. Get plenty of rest the first two weeks. Care for yourself and the baby, but do not expect too much of yourself. You will need someone to help with the housework (cooking, cleaning, laundry, shopping and caring for older children) for at least a week. Try to rest or sleep when the baby sleeps. Limit visitors to a few close friends or relatives who will help. Fatigue decreases your ability to cope with the new responsibilities.

Baths and Showers

If you had a vaginal birth, your perineum (the area between the vagina and anus) gradually becomes less swollen and tender. You can sit in shallow warm water (1 – 2 inches / 2.5-5 centimetres) in the tub for 10 to 15 minutes, several times a day. This will help to heal the stitched area (if you have an episiotomy or tear), keep your perineum clean, and decrease discomfort from hemorrhoids or stitches. Clean and rinse the tub well before you use it. Do not have a full bath for a few weeks. Sitting in deep water increases the risk of infection. Take showers instead. Showers are also helpful in relieving the discomfort of engorged breasts.

Bowel Movements

You probably will have your first bowel movement within 3 days after delivery. This can be a challenge if you have hemorrhoids or stitches. To avoid hard bowel movements, drink 4-6 glasses of water each day, and eat a diet high in fibre: raw fruits and vegetables, bran and whole grain products.

Hemorrhoids

These are grape-like lumps around the rectum that can be painful, swollen or itchy. They are like varicose veins. You can apply witch hazel compresses (e.g., Tucks) to hemorrhoids for relief. Freezing a damp feminine pad and putting it in your underwear can also make them feel better.

Cramps/Afterpains

After your baby is born, the uterus contracts and shrinks back into the pelvic area. Afterbirth pains are usually not very painful with the first baby but increase with each birth. You may feel them more strongly during breastfeeding, as the baby sucks. This causes uterine contractions. The deep breathing exercises that you learned during prenatal classes can be useful now. Try using a heating pad.

Vaginal Bleeding

Generally, the first 24 hours after birth, your bleeding will be like a heavy period. By the third day, it will be thinner, and lighter in colour. By the tenth day, it is often a pale pink, watery fluid, spotting enough to require a light pad. Bleeding can continue for 2-6 weeks after delivery. Breastfeeding causes the uterus to contract, and you may have increased flow just after a feed. Increased activity can also increase bleeding. If bleeding becomes bright red and heavy you may need to call your health-care provider (see other reasons to call your health-care provider in box on this page).

Periods

Your period may be delayed for several months if you are breastfeeding exclusively. You usually ovulate and become fertile about two weeks before your first period. See section on Resuming Sex and Pregnancy prevention on page 25 for more information about birth control.

Cervical Cancer Screening

Cervical cancer, which is cancer of the cervix, is almost entirely preventable through regular screens (Pap tests). Most cervical cancers are diagnosed in women who have never been screened or have not been screened regularly.

The Ontario Cervical Screening Program recommends that women who are or have been sexually active have a Pap test every three years starting from age 21.

Your healthcare provider will have more details about how often you should have screens done.

What to expect from your 6-week postpartum check-up –

• Weight and blood pressure measurement.
• PAP test and blood work may also be completed at this time.
• Discussing complications you may have experienced during your pregnancy, weight loss goals, breastfeeding plans, any activity restrictions, and birth control.

Tampons

You should not use tampons until after the 6-week postpartum check-up with your health-care provider. There is an increased risk of infection with tampon use. During the first 6 weeks after the baby is born, the vagina may feel uncomfortable.

Comfort Measures for Non-Breastfeeding Mothers

If you stop breastfeeding early, your breasts stop making milk within a few days to a week. If your breasts are engorged, and you are not breastfeeding, ice packs may help to reduce the swelling. Wear a supportive, well fitting bra. Do not pump your breasts, as this will cause you to make more milk. You can hand express small amounts of milk if needed for comfort.

Special Care after C-Section

Do not lift anything heavier than your baby until after your six week check-up with your Health Care Provider. He or she will give you further instructions at that time. Do shower during your hospital stay, showering is encouraged, with the dressing removed. You do not have to have the clips or stitches out before you can shower. Rest when you are tired and focus your attention on yourself and your baby in the first few weeks.

References:

• Cancer Care Ontario (online), 2015
• Best Start Prenatal Key Messages (online) 2016
• Mayo Clinic (online), 2016