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How A Mother May Feel Physically After Childbirth

 

mom with newborn on chest

  • Bleeding
  • Episiotomy
  • C-Section
  • Urination
  • Bowel Movements / Constipation
  • Hemorrhoids
  • Afterpains / Cramping
  • Epidural / Spinal Site
  • Back and Hip Pain
  • Breasts
  • Faintness
  • Swollen Feet or Ankles
  • Night Sweats 

Bleeding

Normal:

  • Heavy to moderate bleeding, bright red in colour for the first 1 to 3 days
  • Light bleeding, pinkish in colour for 3 to 10 days
  • Scant bleeding, creamy yellow in colour for 10 days to 6 weeks
  • Small clots (size of dime or quarter)
  • Earthy smell
  • Bleeding may be heavier after activity or breastfeeding or after lying flat for a while
  • Regular periods may begin as early as 2 months or as late as 18 months if breastfeeding

 

What you can do:

  • Reduce your activity and rest if bleeding increases - you have done too much
  • Stay off your feet as much as possible for 2 weeks:
        • Sit rather than stand
        • Lay rather than sit
        • Avoid stairs
  • Don’t lift anything heavier than the baby
  • Change sanitary pad at least 5 times per day
  • Pour warm water over your perineum (use a squirt bottle) after going to the bathroom, then pat dry
  • Do not use tampons until after your 6 week check-up
  • Empty bladder frequently

 

When to call your health care provider:

  • If bleeding is heavier than a normal period
  • If you are saturating more than 1 to 2 pads in an hour and the flow does not slow or stop with rest
  • If you pass clots larger than the size of a dollar coin
  • If you are having bright red blood after 3 weeks postpartum
  • If you have foul smelling vaginal discharge
  • If you have lower abdominal pain 

 

  

Episiotomy

Normal:

  • Healing should occur in 2 to 3 weeks
  • Pain should decrease as time passes
  • There may be some bruising, swelling and itchiness
  • Stitches will dissolve over time 

 

What you can do:

  • Apply something cold to reduce swelling – e.g., use an ice pack, dampen and freeze a clean maxi pad and put the frozen pad in your underwear
  • Take a warm shallow bath with enough water to cover your buttocks and hips (sitz bath) to reduce itchiness
  • Use a squirt bottle to clean area. Use cool water as tolerated
  • Do Kegel exercises to help the episiotomy heal sooner (see section on exercises after childbirth)
  • Reduce your activity and rest if pain or swelling increases
  • Check area with a mirror
  • Take prescribed pain medication as needed
  • Empty bladder frequently
  • Prevent constipation (see section on Bowels) 

 

When to call your health care provider:

  • If you have a foul smelling discharge
  • If the episiotomy opens up
  • If bruising or swelling lasts more than 6 weeks
  • If pain increases over time and does not improve with rest
  • If you have an oral temperature over 38°C, chills, or lower abdominal pain 

 

 

C-Section

Normal:

  • Staples or sutures are removed 3 to 5 days after childbirth
  • Discomfort from the incision should gradually decrease
  • You can shower; don’t worry if the steristrip tapes come off

 

What you can do:

  • Consider taking medication; most pain medications do not interfere with breastfeeding; talk to your health care provider
  • Do not lift anything heavy or vacuum for 4 to 6 weeks; your abdominal muscles need time to heal
  • Rest – it may take longer to recover from a c-section than a vaginal delivery
  • Avoid driving a car for 3 weeks or as advised by your health care provider
  • Check incision with a mirror 

 

When to call your health care provider:

  • If you have an oral temperature over 38°C, or chills
  • If you have bleeding or discharge from incision
  • If your incision opens up or has a red, “hot to touch” area
  • If you have increased pain that is not relieved by pain medication and/or rest 

 

 

Urination

Normal:

  • During pregnancy, your body stores extra fluids; after childbirth, your body gets rid of this extra fluid
  • For the first day or two, you may have pain or difficulty urinating; this is more common if you had a catheter, episiotomy, or small tear
  • You may have a stinging sensation when you pass urine if you have stitches
  • You may be incontinent (leak urine) if you cough or laugh; this will get better over time 

 

What you can do:

  • Empty bladder frequently even if you do not have the urge to void
  • Use a squirt bottle to squeeze warm water over your perineum while voiding to help take away the stinging sensation
  • Allow sink water to run; the sound of water may help the flow of urine get started
  • Drink to thirst – 8 to 10 glasses of liquid per day (limit caffeinated drinks)
  • Do Kegel exercises to help reduce incontinence (see section on exercises after child birth)

 

When to call your health care provider:

  • If you have an oral temperature over 38°C, or chills
  • If you are passing urine frequently but in small amounts
  • If you have a burning pain when passing urine
  • If you are unable to pass urine
  • If you have difficulty starting or stopping urine
  • If you have blood in your urine 

 

 

Bowel Movements / Constipation

Normal:

  • You may not have a bowel movement for the first 2 to 3 days after childbirth
  • Your first bowel movement may be uncomfortable; try not to hold back as this can cause hard stools (constipation)
  • Some pain medications can cause constipation

 

What you can do:

  • Drink plenty of fluids and fruit juice, and eat plenty of fruits, vegetables, and whole grain breads and cereals to prevent constipation
  • Take stool softeners with phylum or natural fibres; they are available over the counter or can be prescribed by your health care provider; use for one week or as prescribed by physician
  • Walking in the house can help to get the bowels moving and eliminate painful gas
  • Clean the rectal area with a squirt bottle after each bowel movement; wipe from front to back

 

When to call your health care provider:

  • If you haven't had a bowel movement by 5 days after childbirth
  • If your bowel movements are painful and hard
  • If you feel you need a bowel movement but can't

 

 

Hemorrhoids

Normal:

  • Hemorrhoids can occur after childbirth from the pushing and increased pressure during childbirth
  • Hemorrhoids can be painful and itchy
  • Hemorrhoids usually shrink and become less painful a few days after childbirth 

 

What you can do:

  • Avoid constipation (see above)
  • Apply something cold to reduce swelling – use an ice pack or dampen and freeze a clean maxi pad and put the frozen pad in your underwear
  • Take a warm shallow bath with enough water to cover your buttocks and hips (sitz bath) to reduce itchiness
  • Avoid standing for long periods
  • Use medicated pads or creams as advised by your health care provider or pharmacist
  • Consider taking a mild pain medication 

 

When to call your health care provider:

  • If your hemorrhoids become more painful or bleed
  • If you have a foul smelling discharge
  • If you feel your hemorrhoids are preventing you from having a bowel movement 

 

  

Afterpains / Cramping

Normal:

  • After your baby is born your uterus will continue to contract until it returns to its original shape and size; some women may feel these contractions, while others will not
  • Afterpains may increase with each pregnancy
  • They should fade after the first few days after childbirth
  • You may experience afterpains while breastfeeding  Mom with newborn on shoulder

 

What you can do:

  • Place a warm water bottle on your abdomen
  • Consider taking a pain medication
  • Try relaxation and deep breathing  

 

When to call your health care provider:

  • If the afterpains get worse
  • If your abdomen is tender to touch or rigid
  • If you have an oral temperature over 38°C, or chills 

 

 

Epidural / Spinal Site

Normal:

  • You may have pain and swelling at the epidural / spinal site; it should only last a few weeks
  • For the first day or two you may have pain or difficulty urinating if you were catheterized
  • You may have temporary weakness or loss of balance while walking  

 

What you can do:

  • Apply icepack to area
  • See Urination section above for what you can do if you have difficulty urinating 

 

When to call your health care provider:

  • If you have persistent or increased pain at epidural / spinal site
  • If you have persistent difficulty urinating
  • If you have persistent weakness or loss of balance
  • If you have headaches
  • If you have an oral temperature over 38°C, or chills 

 

 

Back and Hip Pain

Normal:

  • In preparation for childbirth, hormones caused the ligaments and cartilage of your pelvis and back to soften; this may cause some discomfort during pregnancy and after childbirth
  • For days or weeks after childbirth, you may have lower back pain from the baby pressing against the tailbone during delivery; if a woman’s tailbone was fractured during delivery, it may take weeks to months for it to heal
  • You may also have hip pain from the delivery for a few days or weeks after childbirth

 

What you can do:

  • Consider taking pain medication
  • Try sitting on a partially inflated donut shaped pillow
  • Apply ice to the area
  • Don’t bend over to lift - use legs to lift
  • Change position regularly 

 

When to call your health care provider:

  • If the pain interferes with your ability to walk or roll over 

 

 

Breasts

Normal:

  • Whether you are breastfeeding or not, your breasts will start to produce milk on the 2nd to 4th day after childbirth; they may become very full, sore and hard 

 

What you can do:

  • Wash breasts daily – avoid using soap
  •  If you are breastfeeding:
      • Feed the baby at least every 2 to 3 hours
      • For information on what a good latch looks like and sounds like, click here to link to Dr. Newman’s Video Library
      • For more information on breastfeeding click here to link to “Breastfeeding Your Baby”, a resource developed by the City of Toronto 
  •  If you have been breastfeeding and need to stop suddenly:
      • Apply ice packs or cabbage leaves to your breasts for 20 minutes at a time
      • Wear a bra that supports well
      • You can express enough milk to feel comfortable several times throughout the day; by expressing milk less and less often, your milk supply will slowly decrease
      • Drink to thirst
      • Avoid salty foods
  • If you plan not to breastfeed at all:
      • Try ice packs or cabbage leaves for 20 minutes at a time
      • Wear a bra that supports well
      • Do not empty or pump your breasts, as this will cause more milk to be produced
      • Drink to thirst
      • Avoid salty foods 

 

When to call your health care provider:

  • If you have an oral temperature over 38°C, or chills
  • If your breast has a localized area that is hard, red or painful for more than 24 hours and is not helped by breastfeeding, pumping, massaging or changing nursing positions 

 

 

Faintness / Swollen Feet or Ankles / Night Sweats

Normal:

  • During pregnancy, your body stores extra fluids; after childbirth, your body gets rids of this extra fluid; it takes a while for your cardiovascular system to adjust
  • You may feel faint for a day or two after childbirth
  • You may have swollen feet or ankles or have night sweats for a few weeks  

baby's foot

 

What you can do:

  • Do not restrict fluids, drink to thirst
  • For faintness:
      • Don’t change your position quickly – e.g., getting out of bed, getting up out of a chair
  • For swollen ankles and feet:
      • Put your feet up on a stool as often as possible
      • Avoid crossing your legs when sitting or standing for long periods
      • Avoid ankle or knee socks
  • For night sweats:
      •  Wear cotton clothing  

 

When to call your health care provider:

  • If the faintness last longer than a few days, you may need to be checked for anemia
  • If one foot is swollen more than the other
  • If swelling increases and extends up the leg past the ankles
  • If you have a red or painful lump in your calf

 

 

Reference: 

Murkoff, H., Eisenberg, A., & Sandee, H.  (2002). What to expect when you’re expecting.  New York:  Workman Publishing.

 Lalonde, A. B., and Schuurmans, N.  (2006). Healthy Beginnings: Your handbook for pregnancy and birth, 3rd edition. The Society of Obstetricians and Gynaecologists of Canada and Best Start.

 Calgary Health Region. (2004). From Here Through Maternity. Calgary: Print West Calgary.

 Simkin, P., Whalley, J., Keppler, A. (2001). Pregnancy, Childbirth and the Newborn: The Complete Guide. New York: Meadowbrook Press.


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