A postpartum crash course
You may have spent months educating yourself about the changes in your body during pregnancy and childbirth — reading books, taking classes, creating birth plans, etc.
But what about after the delivery?
The postpartum period can be intense, and you may feel unprepared for the challenges ahead. Relax, and don’t despair. The top ten things you can expect follow.
1. There will be blood. After your baby is born, you will have vaginal bleeding, which will be heavy during the first few days. Called Iochia, this blood goes through three main stages: rubra (heavy and red), serosa (lighter and pink or brownish) and alba (white or clear). Typically, bleeding after week four or five will be scant, and all bleeding should stop completely by week six.
2. You will be sore. Your perineum or incision might be sore, but other muscles will need TLC, too. You can expect the same muscle soreness you might have after a tough workout. Menstrual-like cramping — specifically when you breastfeed — may also be present as your uterus contracts. Typically, ibuprofen (or a low dose of narcotics) will offer significant relief, but be sure to consult your provider before taking any pain relievers. Ice on your perineum and/or heat on your lower abdomen may also help.
3. You’ll still have a belly. It takes six weeks for your uterus to return to its nonpregnant size, so your body will not immediately bounce back to how it looked and felt prior to pregnancy. Be patient with this process, and trust in the tincture of time.
4. Breastfeeding might not be intuitive. It’s a learned skill — for both you and your baby. Initially, women create colostrum, a yellowish substance full of fat and calories. While small in amount, it is sufficient for most babies in their first days of life. It is normal for milk to come in between postpartum day two and day five and, the more your baby breastfeeds, the sooner that will happen. Full-term, healthy babies are usually equipped to lose a few ounces while they wait for that transition.
Your nipples may be sore initially. Emollients such as lanolin and coconut oil can offer relief. A lactation consultant may be helpful if you notice blisters or bleeding, as this may be a sign of an incorrect latch.
5. Everybody poops. And that includes you. The first bowel movement is often anticipated with dread. Many women are constipated in the days following delivery, so it’s common to be given a stool softener while in the hospital. Continue taking this medication until you feel that your bowel regimen is normal. In addition, stay well-hydrated and maintain a high-fiber diet. You are very unlikely to disrupt your stitches or incision with your first bowel movement, but avoid straining if possible, and allow your body time. Your first bowel movement might not happen until you are in your own home, where your body is better able to relax.
6. Don’t worry about sweating it. In the first few days after delivery, it’s not uncommon to sweat and urinate more than usual. Your body is getting rid of the fluids acquired during pregnancy and any you may have received during labor. You may experience cold sweats and dramatic swings in body temperature. If you’re breastfeeding, it’s also common to run a low-grade temperature (below 100) because of hormonal shifts. Most symptoms are temporary and resolve in a few days to a week.
7. It really does take a village. Don’t be afraid to ask for help, and be specific about which kind might be most useful to you. Do you need help folding clothes, doing dishes, running errands — or do you just want someone in the house with you while you shower or nap? Also, don’t be afraid to create boundaries. While you may have visitors, you should not play hostess in those early days. So, if you know a particular guest will require work on your part, just say no.
8. Learn balance. Your most important jobs once home are to prioritize bonding with your baby, recovering and staying sane. Don’t overdo it in the early days. Getting outside and having contact with other adults are important and can provide a supportive community, but it is also essential to rest. Listen to your body when it comes to increasing your activity.
9. It’s absolutely fine to cry. Baby blues affects 80 percent of postpartum women. It is caused by hormonal shifts that can make you feel unexplainably tearful in the first few days after delivery. Add to that sleep deprivation and the challenges of motherhood, and you’re bound to be overwhelmed at times.
Remember to take care of yourself. Make sure you are well-hydrated and well-nourished. A warm shower can lift your spirits and make you feel ready for the rest of the day. It’s common to feel isolated, so new-moms’ groups, visitors and walks outside can give you energy and perspective. Contact your provider if your emotions are overwhelming you, if you are having feelings of hurting yourself or your baby, or if you are finding it difficult to function.
10. It will get better. You will not always be this swollen, sore, weepy, overwhelmed or tired. However, while you are in the thick of it, remember that you are not alone and there is support. Surround yourself with friends and family who will make you feel less burdened and remind you that things will improve.
Sarah Kleinman, CNM, is a Certified Nurse Midwife in Boston who delivers babies at Beth Israel Deaconess Medical Center.