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Healing after birth

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Your baby’s finally here, and you’re excited, but you’re also exhausted, uncomfortable and on an emotional rollercoaster. No matter how you birthed your baby, the physical changes of the postpartum period are immediately visible, unlike the gradual changes of pregnancy.

What to expect

Tender breasts

Your breasts may feel full and tender for several days when your milk comes in and your nipples may be sensitive at first. You will have colostrum in your breasts until the mature milk comes in within three to six days after delivery. If you have any breastfeeding problems, talk to your midwife, or a lactation specialist. She can advise you on how to deal with any breastfeeding problems.

Relieve clogged milk ducts with breast massage, frequent feeding, feeding after a warm shower, and warm moist compresses applied throughout the day. Tender breasts will feel better as soon as your breastfeeding has found a rhythm.

Read: Haemorrhoids in pregnancy

Constipation and haemorrhoids

The first postpartum bowel movement may be a few days after delivery, and sensitive haemorrhoids, healing perineums and sore muscles can make it extremely uncomfortable. Although common, haemorrhoids are unexpected.

Alternating warm sitz baths (sitting in just a few inches of water and covering the buttocks, up to the hips, in the water) and cold packs can help with haemorrhoids. It also can help to sit on an inflatable doughnut cushion. Ask your doctor about a stool softener, but don’t use laxatives, suppositories, or enemas without your doctor’s permission.

Episiotomy

If your perineum (the area of skin between the vagina and the anus) was cut by your doctor or if it was torn during the birth, the stitches may make it painful to sit or walk for a little while during healing. It also can be painful when you cough or sneeze. Continue sitz baths using cool water for the first few days, then warm water after that. Squeeze the cheeks of your bottom together when you sit to avoid pulling painfully on the stitches.

Use a squirt bottle with warm water to flush the area when you use the toilet, and pat yourself dry. After a bowel movement, wipe from front to back to avoid infection. Reduce swelling with ice packs or chilled witch hazel pads.

Episiotomy: what you need to know

Hot or cold flashes 

Your body’s adjustment to different hormones and blood flow levels often wreaks havoc on your internal thermostat. Wear layered clothing and always have a glass of water handy to cool you down.

Urinary or faecal incontinence

The stretching of your muscles during delivery can cause you to inadvertently pass urine when you cough, laugh, or strain or may make it difficult to control your bowel movements, especially if you experienced a long labour.

This often resolves gradually as your body returns to its normal pre-pregnancy state. Encourage the process with Kegel exercises, which help strengthen the pelvic floor muscles. Wear a sanitary pad for protection. Let the doctor know about any incontinence you experience.

"After birth pains"

After giving birth, your uterus will continue to have contractions for a few days. These are most noticeable when your baby breastfeeds. You will have a heavy and bright red vaginal discharge called lochia.

It is the tissue and blood that lined your uterus during pregnancy. Initially heavier than your period and often containing clots, it gradually fades to white or yellow and then stops within a few weeks. Wear thick maternity pads.

Swelling 

This may take place in your legs and feet for a while. You can reduce this by keeping your feet elevated whenever possible.

Weight 

Your postpartum weight will probably be about six to seven kilograms below your full-term weight (the weight of the baby, placenta, and amniotic fluid), before additional water weight drops off within the first week as your body regains its balance.

If you have had a caesarean birth

After a caesarean section (c-section), most mothers and babies stay in the hospital for about three days. You will be encouraged to get up and walk very soon after the procedure. Moving around can speed your recovery and help prevent constipation and potentially dangerous blood clots.

During your hospital stay, the nurses will monitor your incision for signs of infection and also monitor your movement, how much fluid you’re drinking, and bladder and bowel function. Discomfort near the incision can make breastfeeding somewhat challenging. Ask your nurse or the hospital’s lactation consultant to guide you on how to position yourself and support your baby so that you’re comfortable.

How to: Get in shape after your c-section

Sometimes trying to breastfeed when you’re in pain might make the process more difficult. Don’t refuse medications for your post-surgical pain.

It takes around four to six weeks for a c-section incision to heal. Fatigue and discomfort are common. You are not only post-partum, but also post-surgery!

Take it easy 

Rest when possible. Try to keep everything that you and your baby might need within reach. For the first few weeks, avoid lifting from a squatting position or lifting anything heavier than your baby.

Support your abdomen 

Use good posture when you stand and walk. Hold your abdomen near the incision during sudden movements, such as coughing, sneezing or laughing. Use pillows or rolled up towels for extra support while breastfeeding.

Drink enough fluids 

Drinking water and other fluids can help replace the fluid lost during delivery and breastfeeding, as well as prevent any constipation.

Take medication as needed

Most pain relief medications are prescribed with breastfeeding in mind. 

Avoid stairs and lifting 

until your doctor says these activities are are okay. 

Don't drive 

until your doctor says it’s okay. Also wait until you can make sudden movements and wear a safety belt properly without discomfort.

Avoid sex

Doctors usually recommend waiting four to six weeks to have sex to reduce the risk of infection, increased bleeding, or re-opening healing tissue. Begin slowly, with kissing, cuddling, and other intimate activities. You’ll probably notice reduced vaginal lubrication (this is due to hormones), so a water-based lubricant might be useful.

More about: Bringing sex back after baby

Try to find positions that put less pressure on sore areas and are most comfortable for you. Pain is greatest in the first few days following surgery and should gradually subside. Your doctor will advise you on precautions and considerations to take after surgery.

Whether you had a vaginal delivery or c-section, it’s important to know when to contact your health care provider.

Make the call if you experience 

Any signs of infection 

such as a fever higher than 38°C, severe pain in your abdomen, or redness, swelling and discharge at your incision site or episiotomy/tear site.

Breast pain

accompanied by redness or fever. 

Foul-smelling vaginal discharge 

Painful urination 

Bleeding 

that soaks a sanitary napkin within an hour or contains large clots. 

Leg or pain swelling 

It took your body months to prepare to give birth, and it takes time to recover. If you’ve had a caesarean section, it can take even longer because surgery requires a longer healing time. If it was unexpected, it may also raise emotional issues.

The first few days at home are exciting and emotional, but also a time to rest and recover. You need to focus your energy on yourself and on getting to know your new baby. Even though you may have requests for visits from family and friends, limit visitors and get as much rest as possible.

Don’t expect to keep your house perfect. You may find that all you will do is eat, sleep, and care for your baby .Learn to pace yourself from the first day that you arrive home.

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