Postpartum
(First 6 weeks After Child Birth)
Immediately after the birth of the baby you may not be overcome by a gush of maternal love and instincts. You might be even be a little disappointed by the way your baby looks. This is quite normal. If it is so, as you begin to breast feed and care for your baby, as you see your baby respond to you, your maternal feelings will be aroused and a deep love for your baby will flower.
Lochia or Post Partam Bleeding
Lochia is part of your postpartum healing process, whether you give birth vaginally or by cesarean section. Its a process of shedding the extra "padding".The uterus returns to its usual size and weight in about six to eight weeks. Those six weeks, however, require care and patience as you experience period-like discharge. Mothers enter what has been referred to endearingly as “The Fourth Trimester,” a magical time when baby and mama continue almost as one. Baby sleeps and feeds; mama rests and recovers. But you know what isn’t as magical? Having the longest period of your life! This bloody flow is called lochia, which comes from the Greek word lokheíos, meaning “of childbirth.”
It is good idea to take a laxative tab like "Dulcolax" or Triphala Powder after the birth of a baby, so that you can pass the first stool with ease. Other tab that may be prescribed by your doctor could be "Calmpose" tab to make you sleep and antibiotics for your stitches, pain killers or tab for bleeding, i.e. Gynae C.V.P
After the birth of the baby and always afterwards, do not wash yourself from the anus towards the vagina after passing a stool. You could infect your stitches and make them septic or cause your self a urinary tract infection. Wash the anal area separately with soap, after passing a stool.
After a Normal Birth
After a normal vaginal delivery of the baby, you may find that you have to contend with discomfort in some parts of your body. Your breast for instance, a few days after birth would become full / swollen / sensitive as the milk comes in. Pressing out some milk when this happens will help relieve the discomfort. Sometimes you might experience mild contractions while feeding, for as you feed hormones are released that contract the uterus and encourage it to involute close to its pre - pregnant size. Practice waist level breathing to get over this discomfort.
Your perineum or pelvic floor may be sore from the stitches, so for the first four five days sitting may be a problem. It will help if you use a round rubber tube to sit upon, like the one children use in swimming pools. It will avoid direct pressure on the perineum when you are sitting, so healing with the quick and the discomfort less; specially when you sit up to breast feed the baby. If during your bath, you bathe the perineum and the whole vaginal area with a mug of warm water to which a few drops of 8 or 10 of the homeopathic medicine Calendula Q have been added, the healing will be much faster.The doctor will give you an ointment to apply, a Soframycin or / Neomycin ointment and perhaps an analgesics ointment.
Your stomach will feel jelly - like loose and unstable. You must exercise your abdominal muscle in the first few weeks to regain abdominal tone. (Post Natal Exercises) Avoid wearing a corset or binding a cloth around your abdomen. It will only get your muscles used to artificial support. The minute the support is removed, the muscle will sag.
Immediately after birth the muscles are still under the influence of relaxing hormones. The exercises you do should merely coax the muscles back to their original position from their stretched positions Special exercises are needed for this. Avoid strenuous exercises and workouts for the first 40 days. Avoid Squatting exercises. Do not lift both legs together when lying on your back. It will cause great strain in the lower back. Do not cycle in the air.
Since your muscles are in a relaxed state and your body especially your back have been over strain yourself. Get extra help for this period so that you rest and take it easy. When you work, when you wash or iron, make sure that you do so without unnecessary exertion. That is , sit comfortably on a low stool when you wash the diapers. Make sure the ironing surface is at correct height for you. You should not have to bend when you iron. or push the baby's pram or cook. Keep your elbows relaxed and do not tense your shoulders. Over strain when performing simple day to day tasks, can give rise to discomfort or pain in some of the muscles in your body. If you are unlucky this pain might stay with you even later; so make sure you do not over strain. Do not lift anything heavy. When lifting anything of moderate weight bend knees and keep the back straight as you do so. Whenever you bend down to make the bed or pick up something you may have dropped, pull in your abdomen first.
Your lower abdomen may be streaked with brown or purple lines. These lines will slowly fade to a while and become less prominent. they are called stretched marks and tends to stay getting fainter over the years.
Post Natal complication
he Aloe vera decoction 5ml mixed with honey 2ml is given to women twice a day continuous after delivery for one month to prevent post natal complications. It act as a energizer.
How to hold a Baby
At times you may be troubled with piles after child birth. You might feel itchy around the anus. When piles are greatly aggravated, they may even bleed. If you splash an anal area with cold water than dab it dry , it will relieve the itching. Avoid spicy foods. A number of women found internal and external application of ointment Proctosydyl very comforting.
You must make sure you do pelvic floor exercise, so that you regain the tone of those muscles and do not end up loosing control of passing urine, or slackening of the muscles.
Although you will loose some weight at birth. it will take you time to regain your figure. Give yourself eight months to a year. If you are considerably overweight you will have to work at it.. At birth your weight loss will be the weight of the placenta, the baby, the amniotic fluid. Over the weeks following the birth you will loose a lot of extra fluid content of your body.
Postpartum Belly
Wondering how to get rid of your postpartum belly? We’ve got a new mom weight-loss timeline, with tips for shedding the extra pounds faster.
Post Delivery
Exercises for Mother
During delivery the vagina and pelvic floor muscles have been stretched and may have become lax. The ideal way to regain their strength is to do Kejel exercises. Contract the pelvic floor muscles, and hold for a count of 5, then relax. Do not hold your breath while doing this. Do this exercise 24 hours after normal delivery, at least three times a day for about 6 weeks a day.
Exercise after a normal delivery : When you lie down to exercise, always do so without a pillow.
Day one or two
Exercise 1
Lie on your back with knee bent, feet resting on the bed. Breath in slowly and deeply, breath out. Do this every day, between each exercise and at the end.
Exercise 2
Lie with your legs straight and slightly apart. Bend and stretch your ankles. Bend and stretch your toes. Roll your feet round in circles in both directions.
Lie on your back with knee bent and feet resting on bed. Tighten your buttock muscles and pull in your abdomen so that your back is pressed against the bed. Hold this position while you count six then relax. Exhale and repeat. Do five times, always exhaling before you start.
Repeat the above exercises and exercise 4 which will strengthen the muscles supporting the womb and help keep it in its right position.
Exercise 4
This can be done sitting or lying down. Exhale, pull up the muscles through which your baby was born, thus tightening your vaginal muscles i.e. you contract just as you would when you try to stop the flow of urine. Hold the contraction while you count six; then relax. Exhale. Repeat. Do five times, always exhaling before you start.
Day 4 to day 7
Exercise 5
Lie with your right knee bent, and right foot on bed, left leg straight.. Slide the heel of your straight leg down the bed, as far as possible, then slide the whole leg up the bed. Only four waist muscles must work. Repeat with the other leg. Do four times with each leg.
Exercise 6
Lie with your knee bent and feet on your bed. Draw in your abdominal muscles, reach across your body to place one hand on the opposite side of the bed, on level with your hips. Return to the starting position. Now do this with the other hand. Do a total eight times.
In the afternoon sleep on your stomach. Take a pillow under your head and below your breasts to avoid discomfort.
After a Cesarean Section
After the birth of your baby by abdominal surgery under general anesthesia you will be on a intravenous drip for some hours. The first thing to strike you after you come out of general anesthesia could be the discomfort of your abdominal scar. You would then be introduced to you baby. You should do some deep breathing, as much as you can comfortably manage. It will help to exhale the anesthesia out of your tissues and make you feel better.
It is common after surgery to feel that you have a collection of mucus in your throat. Some women say 'I have just developed a bad throat'. The discomfort in the throat is caused as a rubber tube inserted in your wind pipe during surgery, so that if you vomit while under anesthesia you do not inhale it into your lungs. It may cause a lot of dryness in the throat and make you want to cough. if you feel dryness in your throat, cover your mouth with a wet towel as you breath or and put a couple of drops of water in your mouth, to prevent dryness.When dryness does not bother you any longer, suck some cough drops or rock sugar to soothe the throat.
The sooner you cough up the phlegm from your throat, the better you will feel. You have to learn to cough in your throat like singers before a vocal recital. Clear your throat and cough out.This will be more effective when taking cough syrups.The sooner the throat gets cleared, the better you will feel. While in pregnant practice coughing in your throat, rather than from your abdomen.
The internal stitches on your abdomen will dissolve, but the external stitches may need to be removed a week to ten days later. On the other hand, the external stitches may also be the dissolving kind. You will have to take it easy to allow the healing to take place.
On the second day the nurse will come to change the sheets of your bed. It will be better if you get out of bed while she is doing so. Sit up in bed, by having your bed shifted to a sitting position. Place palm on either side of your body and lift your body up and gradually move your self to the edge of the bed. Gently swing legs off the bed on the foot stool or floor, hold the pillow in front of the abdomen for support, stand up and go and sit on a sofa / chair. Go gently back to bed when it is made. The whole exercise will make you feel much better by the end of it, since it will give an impetus to circulation of the blood.
If you first delivery is by a cesarean section for a non recurring factor like a failed induction of fetal distress, then the second delivery could be a normal delivery. If the first delivery is by cesarean section from a recurring factor like a malformed pelvis, then the second delivery will also be a cesarean section. Once you have had a cesarean, all future labour should take place in a hospital. A uterus with a scar is watched carefully throughout pregnancy and labour. Rupture of uterus is a serious, but rare complication, occurring only in 0.5% cases Signs to be watched are for fresh unusual vaginal bleeding and pain over the scar.
The following are gentle exercises to be done after cesarean section :
Exercise 1
Lie on your back.
Breath in slowly and deeply, breath out.
Do five times at least twice a day.
Exercise 2
Lie with your legs straight and slightly apart.
Bend and stretch your ankles.
Bend and stretch your toes.
Roll your feet around circles in both directions.
Exercise 3
Can be done sitting or lying down. Exhale, pull up the muscles of the pelvic floor, thus tightening your vaginal muscles i.e. you contract just like you would when you try to stop the flow of urine. Hold the contraction while you count six, then relax. Exhale, repeat. Do five times, always exhaling before you start.
Postnatal exercises
Exercise after the removal of the stitches on the seventh and eighth day after a Cesarean section and for the same days after a normal delivery when you are up and about all the day.
Exercise 1
Stand with legs crossed at ankles, press thighs, contract between the legs as you would when you tried to stop the flow of urine, Pull in the abdomen and also tighten buttock and anus hold it all tight for the count of four, then relax. Repeat six times, always exhaling before you start.
Exercise 2
Stand with your back against the wall. Tighten buttock muscles and pull in the abdominal wall and try to get lower part of your back to touch the wall. (The exercise can also be done lying on bed. Same as exercise 3 after a normal delivery.) Repeat six times. Always exhaling before you start.
Exercise 3
Standing, pull one leg at the hip so that one leg is shorter then the other. Keep the knees straight as you do this , and lift foot off the ground. Repeat with the other leg. Do four times, and build up to eight times. (Can be done lying down as in exercise 5)
Exercise 4
Stand with feet together, knees together, thighs pressed together. Move along the floor as if 'twisting' For a short distance. Do once.
These simple exercises done for the first forty days will do your figure miles and miles of good which even strenuous workouts later will not be able to achieve.
Exercise 5
While breast feeding and after, do shoulder and breast uplift exercise.
Bleeding
After the birth of the baby vaginally or after a cesarean section you will have a longish period lasting a week or several weeks (may be four to six weeks). Thereafter you may not have a period for several months, specially if you are breast feeding.
The first period that occurs is usually longer and heavier than normal period. It could last seven days or more. Thereafter your regular cycle will set in. When the first period occurs is totally unpredictable. With breastfeeding it could come after three to four months, or after six to nine months. In women who do not breastfeed, the period could start on the 28th day after the birth of a baby. The post delivery discharge could be brownish / pink / occasionally red (when exertion is undertaken.)
Not having a period need not mean that you are pregnant. Neither does it mean that since you are not getting a period you cannot become pregnant.You must use some contraceptive in consultation with your doctor. As soon as you feel you have healed vaginally, you can resume intercourse. This might take a maximum of forty days or six weeks. You can use some lubricant like petroleum jelly.
When you go for a checkup to the doctor you must inform him of her of any discomfort you might have with your bowel movements,, passing urine, or piles. Pelvic or pelvic floor discomfort would also need investigation.
You may walk up and down the stairs, but no more than is absolutely essential, that is keep it to a minimum. Get as much rest as possible, sleep for two hours in the afternoon. Go back to bed after the early morning feed at 5 to 6 a.m.
Post Partum Abdominal Pain Causes
Lower abdominal pain postpartum is usually caused by after pains, constipation or C-section healing. While uncomfortable, it is typically not dangerous.
After pains
After delivery, the uterus contracts and shrinks back to its normal size. As this happens, it can cause some lower abdominal cramps that are referred to as after pains. These pains can feel like menstrual cramps. If they are severe, contact your healthcare provider for an evaluation.
Most women will experience the most intense of these pains in the first week after giving birth. However, the uterus can take as long as six weeks to return to its pre-pregnancy size.
The pains will typically be stronger when your baby is breastfeeding as nursing stimulates the release of oxytocin, a hormone that triggers the uterus to contract. If you are a first time mom your after pains will likely be less severe than a mom who has given birth more than once will have less muscles tone in the uterus.
Remedy
You can't prevent after pains, and it's important that your uterus contracts and goes back to its pre-pregnancy size. You can, however, treat after pains by applying a warm heating pad or hot water bottle. If your doctor gives you the OK, you might want to take an over-the-counter pain reliever such as Motrin (ibuprofen) or another non-steroidal anti-inflammatory drug (NSAID).
Constipation
Abdominal discomfort during the postpartum period can also be caused by constipation. There are several potential causes of constipation after giving birth and figuring out which one is behind your symptoms will help you find the best way to manage it.
Possible reasons you are constipated in the postpartum period include:
- Low-fiber diet
- Hormonal changes
- Stress
- Reduced physical activity after delivery
- Vaginal tears or a bruised perineum (the area between the anus and the vagina) from labor
- Hemorrhoids (which are common during pregnancy as well as during the postpartum period)
- Pain at an episiotomy site.
Medications are another potential culprit of constipation after delivery. Anesthesia and opioids used for post-labor pain can cause constipation or make it worse. Certain vitamins, such as iron, can also contribute to or worsen constipation.
Constipation usually improves in the post partum period - as opposed to during pregnancy when the uterus is pressing on the colon.
Remedy
Eating lots of fiber (for example, fruits, vegetables, beans, legumes, nuts, and whole grains) and drinking plenty of water during pregnancy and in the postpartum period are critical steps to preventing constipation. Getting enough fiber and staying hydrated might be all you need to ease your postpartum bowel woes. If not, exercise can also help.
Before you start doing any physical activity, make sure you ask your doctor if it is medically safe for you to do so. When you can return to exercising will depend on the type of delivery you had and how active you were before and during pregnancy. Start by taking short walks. You can put your baby in a stroller or carrier and head out for some fresh air (which will be good for both of you).
If you have hemorrhoids, taking warm sitz baths might help. You can also soothe pain in the vaginal or anal area with an over-the-counter pain reliever (again, check with your doctor or pediatrician first—especially if you are breastfeeding) or by using ice packs.
If you haven't had a bowel movement for more than a couple of days, let your doctor know, they might recommend that you take a fiber supplement, stool softener or laxative.
C-Section Healing
Following a Cesarean birth (C-section) , it's common to experience mild cramping as the incision and internal wounds are healing. It's also normal to feel some pain or soreness around the incision—especially in the first few days.
Remedy
The best thing you can do after a C-section is to ensure you get enough rest and avoid putting too much strain on your abdomen. Lift nothing heavier than your baby. If you had a C-section, be sure to take pain relievers as prescribed and directed by your doctor during your post partum recovery.To allow time for your incision to heal, ask friends and family members to help out with meals, housework, and other tasks—just make sure that they don't hinder your need for rest.If possible, hire professionals to take care of bigger tasks like yard work, shopping, and cleaning. That will give you the time and energy to focus on your healing and your new baby.
When to Call the Doctor
If your pain is intense, persistent, or not alleviated by the suggestions above, call your doctor. If you experience any "red flag" symptoms, seek immediate medical care. These signs and symptoms can indicate complications such as infection and hemorrhage.
Postpartum symptoms that require emergency medical attention include:
- Excessive or bright red vaginal bleeding
- Fever
- Nausea and/or vomiting
- Pain that is severe, persisting, or worsening
- Redness, tense skin, drainage or swelling around a C-section or perineal incision
- Abnormal vaginal or rectal discharge
- Tender areas on your sides
- Headache
- Chest pain or difficulty breathing
The postpartum period is one of adjustment and healing. Even when you have help, it is not always easy—physically or emotionally. Try to be proactive about treating your symptoms and resting as best as you can.
Make sure that you follow up with your obstetrician or midwife for your post partum appointment, within three weeks of birth It is recommended that a second, comprehensive postpartum visit no later than 12 weeks after birth). This is an important time to discuss your recovery, which should include your mental and physical health, contraception, and any other questions or concerns you have.
C-section healing
Pain may take 3-8 months for subsiding. One should not lift heavy weight.
Pain after childbirth and during the postpartum period is very common as your body recovers from pregnancy and delivery. It's especially common to have some pain during the first few days and weeks after you have your baby if you have a C-section or an episiotomy . After pains ,headache or sore breasts can also cause discomfort.
If you're breastfeeding , you may be wondering if you could or should take something to ease the pain. Here's what you need to know about the safety of taking over-the-counter painkillers while you're breastfeeding .
Motrin and Advil
Motrin and Advil are brand names for the medication known as ibuprofen. Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID). NSAIDs can bring down an elevated temperature, reduce swelling in the body, and relieve pain.
Uses
Ibuprofen is best known as an over-the-counter medication for the treatment of fever, muscle pain, and headaches. Doctors also prescribe it for many uses.
Ibuprofen is used to treat the pain and discomfort associated with uterine contractions (after pains), an episiotomy or a c-section . Additionally, it can help to relieve the pain of engorged breast , plugged milk ducts, mastitis,and sore nipples. Ibuprofen is also used to treat infants and children. Your child's pediatrician may prescribe ibuprofen if your baby gets sick or develops a fever. (If your baby is less than 6 months old, ask your doctor before giving OTC ibuprofen.)
Safety When Breastfeeding
Motrin and Advil are considered safe for breastfeeding moms to use. Actually, ibuprofen is probably the best medication to choose for pain relief while you're breastfeeding. Even though this medication does enter into the breast milk, the amount that passes through to the baby is so small that it is nearly undetectable. This small amount would only be a fraction of the average dose that your child's health care provider would prescribe to your baby for the treatment of a fever.
Ibuprofen will not make you or your baby sleepy.
Dosage
The recommended adult dose of ibuprofen is 200 to 400 milligrams every four to six hours.
Post Natal Depressions
It is common to have mood swings, after the birth of a baby Some women feel positive while other might feel negative. When a women is over depressed, it is called post- partum psychosis. A women suffering from post partum depression will cry easily, sleep with difficulty, be tired and irritable, experience fear or a feeling of inferiority or inadequacy.
At times a women feels resentful that from being a pampered pregnant women she is now a responsible mother. Depression may also creep in when you feel overly depressed about the kind of birth experience you have had or when you are overburdened with work and have no help to tide over this physically taxing phase in your life.
Occasionally the reality of baby care might be overwhelming. As one mother helplessly exclaimed, 'But my baby smells shitty and vomitty.' You baby simply does not look and smell like the advertisements suggest. It will be better if you do not discuss your feelings with unsympathetic persons. But do discuss them with a trusted friend. It is healthy not to bottle up these negative emotions.Take things easy. Do not worry too much about homework. There is no harm if things go unattended for a short while.
If depression persist consult a sympathetic family physician or sympathetic homeopathic doctor. Alternatively you can consult a psycho - therapist or psychologist. Discussing your feelings with them will help tremendously in removing a psychological knot in your mind and unblock a lot of energy so that you will feel and function better.
Depression can occur in a perfectly healthy women. It can be caused by a sudden withdrawal of hormones from your body after the birth of the baby. The doctor might prescribed some artificial hormones for a while, the doses of which he will gradually taper off. Alternatively, the doctor may prescribe anti- depressant drugs.
Resuming Work
As per central government rules a women is entitled to 4 and a half months paid maternity leave. She is also allowed to take any leave after that period.
Family Planning
Seek proper advice on family planning at the first post natal check-up.
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