Caring for yourself after delivery

Lawren Honken, MD

Obstetrics and Gynecology

Your new bundle of joy is finally here, and while your focus is on your new baby, you need to heal well to be able to care for your baby. “Women who have just given birth need time to rest and properly recover from childbirth,” said OBGYN Lawren Honken, MD. “It’s a joyous time, but it is also a time of healing and adjustment for new moms and families.”

Dr. Honken shared some tips to help with recovery and beginning this new journey as a mom.

General care

• “Baby blues” or feeling overwhelmed and even sad is normal for the first two weeks postpartum. Reach out to others around you and find support in friends or family who have been through it. If you have persistent symptoms of depression or anxiety, contact your doctor’s office. If you have thoughts of harming yourself or others, go to the nearest emergency room.
• If you had a cesarean section, lift nothing heavier than your baby for six weeks. While this may be hard to do, now is the time to take advantage of others offering to help.
• It is not unusual to have hot flashes and night sweats, but if they do not resolve with time, see your doctor to have medical problems ruled out. Breastfeeding may contribute to this due to lower estrogen levels.
• It is also not unusual for your hair to thin or fall out. You will not go bald and your hair will grow back.
• Swelling in your legs and feet may get worse before it gets better. If one leg becomes bigger than the other, red and painful to touch, contact your doctor’s office or go to the nearest emergency room.
• You are able to get pregnant even before your period returns (yes, even with breastfeeding). Make sure you have a solid contraception plan. An interpregnancy interval (time from delivery until your next conception) of 18 months is recommended to decrease the risk of preterm birth.
• Back pain is common from joint relaxation and muscular changes. For pain, you can safely take Motrin, 800 mg, as well as Tylenol, 650 mg. Both are safe with breastfeeding.
• You need a comprehensive postpartum visit no later than 12 weeks postpartum (and may need a visit as early as one to two weeks postpartum), especially if your pregnancy was complicated as some disorders are associated with increased risk of heart or metabolic diseases.

C-section care

• Keep the incision area clean by showering daily, and letting warm soap and water run over it. Pat it dry. You may cover it if you need to leave the house, but otherwise leaving it open to air will help it heal.
• Steri-strips (the small surgical Band-Aids) may be removed in seven to ten days, if still attached.
• If the incision becomes red, hard, develops drainage that looks like pus or looks infected, call your doctor immediately.

Vaginal bleeding

• It is normal to have bleeding after delivery, and this may last for up to 6 weeks.
• Bleeding may be heavy at first, but the amount should decrease over time and the color should change from bright red to brown/pink and then to clear.
• You will notice increasing cramps after each pregnancy and each time you breastfeed.
• Bleeding can increase with changing positions and passing clots is normal.
• Report any unusual pain, foul odor, or bleeding so much you are saturating more than one pad an hour to your doctor.

Diet

• Maintaining a healthy diet is important, and you need up to an extra 700 calories a day if you are breastfeeding.
• Limit fast foods, processed foods and sweets as much as you can.
• Eat plenty of vegetables, whole grains, fruits and lean meats.
• Drink plenty of water. You can add fruit to it to make it more appetizing.

Perineal care/bathing

• Continue your pericare at home – your postpartum nurses will be your best resources.
  • Fill a plastic squirt bottle with warm water and rinse the vaginal/perineal area with the squirt bottle after using the bathroom.
  • Always clean from the front to the back after using the bathroom or during your shower.
  • You may lightly pat dry with toilet paper. You may even want to use a wet washcloth when you first get home so the toilet paper doesn’t stick.
  • Apply Dermoplast spray to your laceration up to four times a day, if ordered by your doctor.
  • You can use Sitz baths as well.
  • Witch hazel pads may be used by patting against the affected area and then discarding. You can also place them on a pad/panty liner and wear them in your underwear.
  • Once you get home, you can apply an ice pack or a pad. Be sure to use a clean pad every time you use the restroom to promote healing and prevent infection.
• Do not put anything in the vagina for six weeks: no sex, douching or tampons. Wait for your six week postpartum check-up or your doctor’s approval before beginning these again.
• Showering daily is advised. Avoid tub baths for two weeks after delivery or until you can get in and out safely.
• Avoid swimming pools, spas or lakes until your postpartum check-up.

Breast care

• If you are breastfeeding:
  • Breastfeeding is hard for almost everyone. Do not be shy about seeing a lactation specialist. Obtain the lactation specialist’s contact number prior to hospital discharge or contact your doctor’s office and see them soon and often.
  • If your nipples are sore, get evaluated sooner rather than later to assess your baby’s latch and your anatomy. Expressing some milk and leaving it on the nipples will help protect them.
  • Wear a supportive bra that is not too restrictive.
  • Focus on breastfeeding and bonding with your baby – let everyone else help with other things (like dishes).
  • Drink lots of water and eat plenty of healthy food. You can’t make milk if your nutrition is not adequate.
• If breasts have hardened areas, redness, pain or you have a fever over 101.4 F, contact your doctor.
• If you aren’t breastfeeding:
  • Continue to wear a supportive bra for several weeks. Binding the breasts is not required, but a good sports bra works fine.

Exercise

• You can begin doing Kegels right away. Pelvic floor physical therapy may also be helpful, and you can discuss this with your doctor.
• Exercise and a healthy postpartum diet is important and can prevent future risks related to weight, such as diabetes and high blood pressure. Decreased risk of postpartum depression has been found with early return to exercise.
• Light exercise such as walking or doing things around the house is okay immediately postpartum. Listen to your body. Strenuous exercise should be postponed until your six week postpartum check-up or your doctor’s approval.

Elimination

• Do not let your bladder get too full. Empty your bladder every three to four hours to help prevent a bladder infection.
• You may have burning with urination immediately after birth due to the vaginal area healing, but if you are concerned you have a bladder infection, call your doctor immediately.
• You also may have loss of urine with laughing, sneezing and coughing, or even when your bladder gets full. This is normal while healing postpartum. Kegels will help with this, and you may need pelvic floor physical therapy in the future.
• Avoid constipation – eat plenty of fiber and stay well hydrated with water. A stool softener like Colace, 100 mg, twice daily can be used as well as daily Miralax or Metamucil. These are safe for breastfeeding moms. You can use topical hydrocortisone for hemorrhoids. Avoiding constipation will help hemorrhoids as well.

If you are experiencing any complications or have any questions post-delivery, please contact your doctor.