Your Body after Pregnancy
Your postpartum body will likely be experiencing many changes. Most are normal, but some might require medical attention.
After you go home from the hospital, your family will be offered postpartum follow-up (home visit or telephone call) by a registered nurse or your midwife. Both you and your baby will be checked. Health information will be provided and any questions you have will be answered. Your doctor will also want to see you in their office in the weeks following your birth to make sure you are feeling well physically and emotionally.
After the birth, you will have vaginal bleeding or flow called lochia. It will be similar to a heavy menstrual period in the first days after the birth. It will be most heavy in the first 24 hours but then starts to decrease in amount over the next few days. It will change colour in the first few days, from bright red to brownish-red, and over the coming weeks will change to pink then whitish-yellow. It will smell similar to a menstrual period. Flow may last from 1-6 weeks postpartum. Passing blood clots is normal. Clots may be dime-sized to “toonie” sized.
Make sure you get plenty of rest during this time. Too much activity may cause the flow to increase.
Seek medical attention if you:
- Soak more than one sanitary pad from front to back in one hour or less
- Pass blood clots larger than a “toonie”
- Notice a foul smell to your flow
Caution: It is important that you use sanitary pads to catch the flow, not a tampon.
The perineum is the part of your body between your vagina and your anus. After the birth of your baby, your perineum may feel sore, bruised, and swollen. The perineum may tear during childbirth. You may have stitches. The perineum will heal, and the stitches will dissolve.
Cleaning the perineum:
- Soak in a warm tub bath or sitz bath 2-3 times a day.
- Clean your perineum after each time you use the toilet. Fill the plastic bottle you got in the hospital with warm water and squeeze the bottle to spray the water over your perineum. Gently pat dry from front to back.
- Wash your hands with soap and water before and after changing your pads. Change your pads each time you go to the bathroom, at least every four hours.
- Take pain medication as needed, your health-care provider will tell you what medication is safe to take.
- Cool the perineum area with an ice pack. This helps to reduce swelling and gives you short term relief. Never put an ice pack directly on your skin. Place your ice pack in a towel or cloth then place it on your perineum.
- Sit on a soft pillow.
Afterpains are cramp-like pains you feel in your abdomen in the first few days after birth. The uterus contracts after birth and as the uterus contracts, it causes these pains. They may be more painful if you have had more than one child.
During breastfeeding, you can experience stronger cramps that cause more discomfort. Afterpains should go away in 4 to 7 days.
Contact a doctor, midwife or nurse if you need some medication to help with the pain.
Recovering from a Cesarean Birth
A cesarean (C-section) birth is considered major abdominal surgery. You will be recovering from both surgery and childbirth. You will have vaginal bleeding, your surgical cut will be sore and may look swollen and you will have afterpains (cramping). Your health-care provider will recommend medication to help you with pain after surgery.
In the first few weeks after surgery, help caring for yourself and your baby will be needed. Talk to your partner, family and support system.
Your surgical cut needs the following care:
- The dressing covering the surgical cut is removed after your first shower.
- Leave the surgical cut uncovered and open to air dry. Your health-care provider will tell you if it needs to be covered with a dressing.
- Stitches will dissolve and do not need to be removed unless your health-care provider tells you.
- If your surgical cut is closed with staples, the staples will need to be taken out by a health care provider. This will be arranged to be done in the community before you leave the hospital.
- You may have steristrips or small plastic tapes on your cut. Leave them alone and let them fall off on their own.
- Keep the area clean and dry. Wash the area gently in the shower and pat dry. Ask your health care provider when you can tub bath again.
- Do not lift anything heavier than 10 pounds (4.55 kg) for 6 weeks.
- Check your surgical cut for any openings, redness, swelling, drainage, or pain. Talk to your health-care provider if you have any of these symptoms or if you have a fever.
- Avoid strenuous activities, such as jogging, intense cardio or weight lifting for 6 weeks or until your physician or midwife says it is okay.
Some people may feel sad or angry about having had a caesarean birth. These feelings are normal. Talk about it with someone you trust - your partner, a family member, friend, nurse, doctor or midwife.
For the first 24 hours after birth, you may find it hard to pee or may have a stinging feeling when you pee. Sometimes you may feel like you cannot tell when your bladder is full. It may help to pee in the bathtub or spray warm water on your perineum while you pee.
It is important to pee often. This helps prevent infection and reduces bleeding problems. It is normal to pee large amounts as your body gets rid of extra fluids.
You may experience some leaking of urine after your baby is born. A cough, sneeze, or laugh may cause this to happen. For most people, this gets better as you heal. You can help to control urine leakage by doing the Kegel exercises.
You may not have a bowel movement (“poop”) for up to three days after the birth. You may feel anxious about your first bowel movement. Do not worry. Your stitches will not break. Take lots of time, relax, and let your body do the work. Placing a stool or books under your feet to help position your knees higher than your hips can help.
To help promote regular bowel movements:
- Drink lots of fluids.
- It helps to move around and walk.
- Eat foods with lots of fibre - fruit, vegetables, cereal, and whole grains.
- If the above suggestions do not work, talk to your pharmacist about using stool softeners that can be bought at the drug store.
- If you have stitches, you may find it comforting to put gentle pressure on the perineum with a cool, clean, cloth while you have a bowel movement.
- Call your health-care provider if you have not had a bowel movement by the 4th-5th day after the birth of your baby.
Hemorrhoids are painful swelling of veins in the anus. Constipation, pregnancy, and pressure from birth can cause them. They can feel itchy, painful, and sometimes may bleed. Hemorrhoids usually shrink and disappear a few weeks after the birth.
To get relief from your hemorrhoid discomfort:
- Good perineal care is important.
- Sit or soak in a warm tub of water or a sitz bath 2 to 4 times a day.
- Apply hemorrhoid cream or medicated pads to the area. Ask your health-care provider about brands you can use.
- Rest on your side when possible and do not sit or stand for long periods of time.
- Try to keep your bowel movements soft.
- Contact your doctor, nurse, or midwife if the pain does not go away within a few days of trying the relief measures listed above.
A few days after delivery, your chest may begin to feel heavy, swollen and tender as your milk comes in.
If you are breast/chest feeding it is important to watch for any signs of engorgement, plugged ducts or mastitis as you may experience these discomforts.
Engorgement is when your milk over fills the breast/chest caused by poor latching, missed feeds, separation from breastfeeding/chest feeding parent and baby or when your milk volume increases by day 3-5.
Signs and Symptoms
- Swollen breast/chest
- Tender to touch
- Warm, reddened and sometimes throbbing breast/chest
- Nipples may be flattened
- Slight fever around 38°C (100.4°F)
To manage your symptoms, you can:
- Breastfeed/chest feed often, at least every 2 hours
- Complete hand expression, video of BC Women’s Hospital + Health Center
- Gentle massage allowing the milk to drain
- Take Tylenol and Advil as needed
- Apply cool compresses between feedings
- Use a pump to empty your breast/chests if unable to breastfeed
- Apply green cabbage leaves
Your breast/chest is filled with many milk ducts, when one of these becomes blocked and stops milk flow, it is a plugged milk duct.
Signs and Symptoms
- Painful and hard lump(s)
- The lump will not go away after breast/chest feeding
- Little warmth to the area
- Low grade fever 38°C
- Generally feel well
To manage your symptoms, you can;
- Breast/chest feed often at least every 2 hours on the sore, plugged side
- Gentle massage while feeding
- Make sure baby is properly latching
- Be sure to empty your breasts/chest with hand expression or pump if it feels full after feeding
- Have a warm shower and put on warm compresses
Mastitis is inflammation of the breast/chest and most common within the first 6 months of feeding. This happens when bacteria has entered the breast/chest through the nipple likely from sore or cracked nipples. Call your Healthcare provider if you think you have Mastitis.
Signs and Symptoms
- Painful area on the breast/chest
- Area may be red and warm to touch
- Fever, chills and or body aches (flu-like symptoms)
- Often feel unwell
After discussion with your healthcare provider, to manage symptoms, you can;
- Take Tylenol and Advil prior to feeding if necessary
- Breast/chest feed on the sore side first
- Wear a well fitted bra
- Try different feeding positions
- If your doctor prescribes antibiotics, it is important to take them
- Drink lots of fluids
If you are not Breast/Chest feeding
The milk in your breasts will be reasorbed by your body. The heavy, swollen feeling in your breast/chest will go away in 3-5 days. For comfort, it can help to;
- Wear supportive undergarments for the breast/chest
- Apply cool compresses
- Hand express until comfortable.
- Take pain medication as needed.
After birth, it takes time for your body to return to its pre-pregnancy weight. Healthy eating combined with regular activity will help you lose weight gained in the pregnancy. Start exercising slowly. Be patient. Breastfeeding frequently and for six months or longer increases maternal weight loss.
Sleep and Rest
Rest is important for your physical health and emotional wellbeing. Your body needs rest to help you have strength and energy. Tips to help include:
- Accept help from others and ask for help when you need it.
- Try to rest or sleep when the baby sleeps.
- Rest when you have your partner at home or have visitors that can watch your baby.
- Use feeding times to rest. Put your feet up or sit in bed.
- Let household tasks wait.
- Try not to take on extra or new tasks.
- Stay away from heavy exercise until six weeks after birth.
Postpartum Mood Disorders
For you and your baby’s well-being, it’s important to be aware of your mental health while pregnant and after giving birth. While you may expect to feel happiness and joy, it’s also perfectly normal to experience feelings of sadness, depression or anxiety.
According to MotherFirst (2010), Saskatchewan’s Maternal Mental Health strategy, 20 per cent of people experience severe depression or anxiety during pregnancy or after childbirth. This means that 1 in 5 people experience poor mental health related to pregnancy and childbirth. While some feelings are considered normal, other feelings and behaviours might mean that you should reach out for support. Visit Maternal Mental Health for more information.
Family Planning and Birth Control
You can have sex again when you are physically and emotionally ready. Physically you should avoid sexual intercourse until your flow (bleeding) has stopped and intercourse is not painful or uncomfortable for you. You can become pregnant again as soon as you start having sex. It is important that you talk about birth control with your partner and health-care providers.
Although you do not have to eat perfectly after the birth of a baby, eating well will help with your recovery and make you feel healthy. Choose foods from a variety of food groups. Drink plenty of water and make sure to drink when you feel thirsty.
If you are breastfeeding, your health-care provider may suggest that you eat more calories each day. Eating a variety of foods can help you get all the nutrients you need to make milk for your baby. Your body needs protein, carbohydrates, and fats for energy. Examples of good sources of nutrients include:
- Unsaturated fats like olive and canola oil, nuts, and fish.
- Carbohydrates from whole grains, fruits, vegetables, legumes (peas, beans, and lentils), and low-fat milk products.
- Lean protein such as all types of low-mercury fish, poultry without skin, low-fat milk products, and legumes.
A daily multivitamin containing folic acid is recommended to meet your nutritional needs during breastfeeding. Your health-care provider can help you find the one that is right for you. Your health-care provider may also recommend you eat more iron-rich foods. Ask your health-care provider for more information if you need to take an iron supplement.
A well-balanced vegetarian diet can provide all the nutrients you need for a healthy pregnancy and recovery from birth. Pay close attention to make sure you are getting enough protein, vitamin B12, calcium, vitamin D, zinc and iron in your diet daily while you are breastfeeding.
Exercise after Childbirth
Exercise can help you reduce stress, make you feel healthier and give you more energy. For exercise after childbirth try:
- Relaxation, breathing, stretching and pelvic floor exercises. They are safe to start right after having your baby.
- Walking is a great way to start exercising. Start slowly and increase the length of walks as you regain your energy.
- By six weeks after delivery, you can start exercise classes or sports that you were involved in before your baby was born. Ask your doctor, nurse practitioner or midwife before you begin any exercise programs.
- Stop exercising if you feel pain, lightheadedness, dizziness, and/or nausea. If your vaginal flow returns to bright red bleeding, stop exercising and take a slower pace next time.
After childbirth, learn to do Pelvic Floor Exercises (Kegels). During birth, the perineal muscles stretch. Vaginal delivery can stretch, weaken and tear the pelvic floor muscles. Regaining the strength of these muscles is important for bladder and bowel control and also for the support of the pelvic organs. Pelvic floor exercises help to heal these muscles and make them strong again.
Kegel exercises are should be done daily:
- Lie, sit or stand.
- Tighten the muscles of your perineum - imagine you are peeing and you try to stop the flow.
- Hold for 3 to 10 seconds, and relax for 3 to 10 seconds.
- Work up to doing these 10 times in a row, 3 times a day.
Saskatchewan Pelvic Floor Pathway is a program for people coping with incontinence (leaking of urine or feces), and vaginal prolapse (pressure or visible bulge of tissue at the opening of the vagina). Referral from a physician, nurse practitioner, or midwife is required.
In rare circumstances, you may need to seek urgent medical attention. If you have one or more of the following symptoms after giving birth, contact your doctor, midwife, nurse practitioner or HealthLine 811 right away or go to the hospital.
- Fever over 38° C or 100.4° F
- Fainting or dizziness
- Problems seeing, such as blurring or spots in front of your eyes
- Not coping well and thinking of hurting yourself, your baby or others
- You cannot catch your breath for any clear reason
- Sudden, very heavy bleeding or discharge, soaking more than one sanitary pad in an hour or less, clots bigger than a “toonie” or bleeding that does not stop dripping into the toilet.
- Painful, reddened breasts and flu-like aches, fever and chills
- Painful, cracked or bleeding nipples
- Vaginal discharge that smells bad
- Burning, stinging or difficulties when you pee
- Vaginal flow that lasts longer than 6 weeks
- Hot, swollen surgical cut site (incision) from a caesarean birth or a surgical cut area that becomes more painful, red, separates or starts to drain
- An increase in pain around your vagina, perineum or lower stomach
- Bad cramps or a sore abdomen that never goes away
- Red, uncomfortable or swollen legs