Blood loss at the time of delivery does not end immediately after delivery. While in the hospital, you may have noticed that you have had heavier vaginal bleeding than ever before. This will slowly taper down over the course of the next few weeks. Bright red bleeding that occurred immediately after delivery will slowly change to a darker color and eventually green and yellow. This is all a normal part of the postpartum transition of the uterus. Occasionally, a week or two after your bleeding seems to have stopped, you may have a sudden gush of bright red blood. This is the normal process of the placental site scab coming off. This too will taper off over a few days. Bleeding more than a pad an hour for more than three hours is not appropriate and we would like you to contact us immediately.
In addition to the recovery of your body from delivery, your body is also now recovering from major surgery. This includes not only the incision on your skin, but also separation of muscles and tissue covering the uterus and an incision on the uterus. We anticipate that you are going to have pain, not only at the incision site, but also from manipulation of the underlying tissues. We have prescribed pain medication for you, please take it. It is important to continue to take motrin (600 mg every 6 hours or 800mg every 8 hours) around the clock for the first 5-7 days after delivery. You will find that as you continue to heal, you will need your narcotic pain medication less frequently. Generally, by 5 days after delivery, you should be taking motrin primarily and the narcotic just every once in awhile.
There are very few restrictions to be aware of after a c-section. Most significantly, we do not want you to be driving while taking any narcotic pain medication. Narcotics can mimic the effect of alcohol and impair your ability to drive. For the few weeks after delivery, we don’t want you to lift anything heavier than 20-25 pounds. This gives your abdominal wall the opportunity to heal without undue strain. Vigorous exercise should also be avoided while healing. Lastly, avoid sexual intercourse until your 6-weeks postpartum visit.
In general, your incision was likely made across the top of your pubic hairline. Because this area sometimes falls under a fold of skin from where the previously pregnant uterus was, it requires special care. The most important thing that you can do to avoid infection of the wound is to keep it as dry as possible. You may shower, but please do not scrub the incision with soap of any kind; simply allow the warm shower water to run over the area. Once you are finished bathing, please blot the area of the incision; and, if not completely dry, use a hair dryer on the cool setting to ensure the area is completely dry. If you find that your incision falls underneath a fold of skin and accumulates some sweat, it is a good idea to place a maxi pad over the incision and change it frequently. Your incision may leak a small amount of clear or bloody fluid in the first few days after delivery, this is normal. However, leaking of pus, redness around the incision, fever (101) or opening of the wound, may indicate infection and we would like you to call us right away. Incisions are generally closed in 3 ways: stitches, steel staples or resorbable staples. If you have staples you can see externally, we need to see you back 5-7 days after surgery to take them out. If you cannot see any staples, we need to see you back in 2 weeks to check on your incision.
Most women will develop hemorrhoids during pregnancy and delivery, even without pushing. A lot of hemorrhoids will resolve on their own as your body recovers from deliveryCare of hemorrhoids can be accomplished with use of witch hazel pads, dermoplast, and over-the-counter hemorrhoid treatments. Cleansing your bottom with water after a bowel movement and blotting to dry will alleviate a great deal of discomfort associated with hemorrhoids.
Shortly after your discharge from the hospital, you likely will notice your breasts becoming sore, tender and hard. This is engorgement, or your breasts filling with milk. Engorgement is a normal process that provides milk for your baby. Using a hand held pump before latching your baby on to the breast can help relieve some of the discomfort. You can also hand express a small amount of milk while in the shower to relieve some of the pressure. The amount of milk you produce will eventually match up to the amount of milk your baby drinks, but it may take a few weeks for you and your new baby to reach this balance. Motrin is also a good choice for management of breast discomfort caused by engorgement. You may also find that your nipples are painful at the time of latching, this is normal. The tender skin overlying the nipple takes a bit of time to become toughened up. A small amount of lanolin applied sparingly can be very soothing.
If you notice redness or streaking of the breast or develop fever, chills or flu like symptoms you may be developing mastitis, an infection of the breast tissue. We would like for you to call the office right away.
If you choose not to breastfeed, it is important that for the first few days after delivery you keep your breasts tightly compressed, either with a tight sports bra or an ace bandage. Try to avoid emptying any milk from your breasts as this will stimulate your breasts to produce more milk and take longer to dry up.
The first few weeks and months of caring for a newborn can be some of the most exhausting of a new mom’s life. Fatigue is very normal in the postpartum period. Most moms (and dads) will be functioning on a lot less sleep than they are used to. It is very important that you sleep when the baby sleeps. Though it may feel like there are many other things you need to do, rest is very important to a successful recovery. If you have a baby that is awake multiple times through the night, try to take turns with your partner, so each of you can get a little uninterrupted sleep.
Swelling of the legs after delivery is very common. This happens because of the redistribution of the fluid and blood volume of your body from the pregnant state to the non-pregnant state. This may take two weeks or longer to resolve. You can help decrease the swelling by walking, elevating your legs and drinking a lot of water. Rarely, after delivery, a blood clot can form in the legs. Signs of a blood clot include warmth, swelling and redness of only ONE leg. If you suspect you have a blood clot, please contact the office immediately.If you have any questions or concerns, please feel free to contact the office. Once you are home and settled in, please call the office to arrange your postpartum visit for six weeks after delivery.