Physicians for Women > Patient Education > Postpartum

Congratulations on the birth of your new baby. We have enjoyed being a part of your pregnancy and look forward to seeing you and your child have a healthy transition.

The recovery from child birth typically takes 6 – 8 weeks. During this time, your body goes through tremendous changes. We hope to provide you with information to make this transition as smooth as possible.

If you have any questions, please do not hesitate to call.

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Activity

During the postpartum period, we recommend that you try to restrict your activity. Rest is a very important part of your recovery. Rest whenever you can. It is important to try to sleep when your baby sleeps. Resist the urge to do household chores while your baby is sleeping. Napping will help reduce the fatigue of those sleepless nights associated with having a newborn. Try not feel obligated to entertain those family members and friends whose company drains your energy. It is okay to walk up and down stairs when necessary. Try not to carry anything heavier than the baby in his or her carrier. Driving is allowed when you are no longer fatigued and off all pain medication. Try to limit strenuous activity such as exercise until after your 6 week check up.

Afterbirth pains

As your uterus reduces its size to its pre-pregnancy state, you may experience cramps in your lower abdomen. This process is called involution and takes 4-6 weeks to complete. This discomfort is often most noticeable during nursing. Gently massaging your lower abdomen or lying face down with a pillow under your abdomen may help. A pain reliever like ibuprofen is a safe and effective remedy.

Bathing

Showering daily will help make you feel better while you recover. Avoid deep bath tubs for at least 3-4 weeks after delivery. Lochia (the body’s natural cleansing mechanism) continues for up to 6 weeks after delivery. Douching is not advised until lochia has resolved.

Birth Control

Having a baby causes damage for the pelvic floor muscles. As a result, you need time to heal. We don’t recommend you have intercourse until after your 6 week visit. Because of the hormonal changes associated with childbirth, the use of hormonal contraception is not recommended for the first 6 weeks. We typically discuss family planning options at that visit.

Breast Care (bottle feeding)

Wear a tight fitting bra or sports bra. Avoid nipple stimulation. If your breasts become engorged, apply ice packs. An over-the-counter pain reliever may help. Try to avoid very hot showers as this may stimulate more milk production.

Breastfeeding

Wear a well fitting maternity bra. Soap may cause your nipples to get dry and cracked. Use plain warm water to wash. Regular use of lanolin cream applied to the nipples may prevent cracking. If nipples do become dry and cracked, try feeding more often. Express a little milk before putting the baby to the breast to get flow started. You may put the baby on the less sore breast first. Vary feeding position to avoid pressure on the same portion of the nipple. Let your nipples dry in warm air. Leave them exposed when you can. Once your milk comes in, engorgement may become a problem. Feed or pump more frequently to relieve engorgement. Taking a hot shower and/or using over-the-counter pain reliever may be helpful as well. If you have a high fever, redness, or soreness and it may be a sign of a bacterial infection in the breast. If you notice a scaly redness, extreme soreness, pain during nursing, this may be a sign of yeast infection in the breast. In either case, please call for evaluation and recommendation on treatment.

Caesarean Section

Having caesarean section usually requires a longer recovery time. It is advisable to try to return to normal activity with some restrictions.

1. No lifting anything heavier than your baby in his or her carrier for 6-8 weeks.
2. No driving until you are able to apply your brakes without feeling any pain. You cannot take pain medications and drive (typically about two weeks).
3. No strenuous exercise until you are medically cleared at your 6 week postpartum visit.
4. It is okay to walk up and down stairs in a limited fashion.
5. No cleaning or vacuuming until after your 6 week postpartum visit.
6. It is important to keep your incision as dry as possible during the first 6 weeks.

These restrictions are very important to follow. The abdominal incision is a weak spot until it heals. Following are some signs of complications to look for:

1. Severe pain in the incision site.
2. Swelling and redness of the incision site.
3. Bleeding or foul smelling discharge from the incision.
4. Fever of greater than 100.4.

Your incision is essentially maintenance free. There are a few precautions to follow. Do not take a tub bath for the first 6 weeks postpartum. The sutures used in the abdominal incision will dissolve over a 4-6 week time period. While they are dissolving, you may notice some itching.

Constipation

Constipation is a fairly common problem in the immediate postpartum period. Lots of fiber and fluids are important dietary modifications. Whole grains, fresh fruits and vegetables are good sources of natural fiber. Walking can aid in good digestion and circulation. Pharmacologic intervention with a stool softener and a bulk laxative may be helpful if dietary remedies aren’t helpful.

Depression

The postpartum blues is a condition that many women experience after the birth of a child. Many factors contribute to loss of euphoria associated with pregnancy.

1. Hormonal changes
2. Fluid-salt imbalance (typically takes 7-10 days to resolve)
3. Lack of sleep
4. Feelings of inadequacy or self doubt
5. Changes in relationship with spouse
6. Family pressures
7. Physical exhaustion of childbirth

Diet

Maintaining a well balanced diet remains important. Keep taking your prenatal vitamins. If you are breastfeeding, they need to be continued until you are done breastfeeding. Breastfeeding also increases the need for water, calories and calcium. Caloric intake needs to be increased by 1000-1500 calories per day. This can be done by adding two dairy servings, one protein, and one vegetable per day. You should try to drink 6-8 glasses of water per day.

Exercise

During the immediate postpartum period, you will probably lack the time or energy to exercise. As you begin to figure your new baby out, you may like to get back to an exercise routine. For the first few weeks, you may want to limit your physical activity to a light walk. As your body heals, you can begin to add more strenuous activity working toward a full exercise program approximately 4-6 weeks after delivery. If you had a caesarean section, returning to a full exercise program is not recommended for 6-8 weeks after delivery. Remember to include pelvic floor exercises in your daily exercise regimen. These may be resumed soon after delivery.

Hemorrhoids

Hemorrhoids are common after vaginal delivery. They can get worse after delivery. Plenty of fluids and the judicious use of stool softeners can ease constipation. Over the counter remedies such as Tucks pads, Preparation H, and Anusol HC may be helpful. Please check with us if you had a significant (third or forth degree) tear, prior to using any rectal suppositories.

Lochia

Lochia is the vaginal discharge that occurs as a result of delivery. It typically starts as bright red blood, turns pink, and eventually becomes clear. It typically lasts 4-6 weeks. You may use sanitary pads during this time. Tampon use is not recommended. Initially, flow may be quite heavy. If you are soaking more than two pads in 30 minutes, call the office. Your first menstrual period may return approximately 4-10 weeks after delivery. If you are breastfeeding it may not return for months after delivery. The return of normal menstrual cycles varies from person to person and pregnancy to pregnancy.

Perineal Care

Vaginal delivery can be traumatic to the pelvic floor. This may take 6 weeks or more to heal. Delaying intercourse until after your 6 week visit will allow us to assure proper healing. When you do become sexually active once again, use plenty of lubricant and take it slow. If you have stitches, the perineum can be kept clean with a spray bottle, shallow tub baths or sitz baths. Having a routine for perineal care can speed up the healing process. Sitz baths or shallow tub baths can be done three times a day and after bowel movements.

Postpartum Visit

Your postpartum visit should be scheduled for approximately 6 weeks after your delivery. This visit allows us to assure that the healing process is progressing normally. It also gives us an opportunity to make sure any complicating factors during your pregnancy have resolved as well. At this visit, we can also discuss your family planning options.