Now the hard part’s over, right? We certainly hope that your pregnancy and labor and delivery have gone smoothly, and we offer the following suggestions to help you get through the next several weeks as easily as possible.
Nothing puts a better start to a day than a good night’s rest, and nothing keeps you up more than a newborn. Be a little selfish, and try to rest when the baby does. Let others help! Remember that they’ll get to sleep while you’re up with the new arrival.
Care of Stitches
If you had an episiotomy or vaginal tear, these stitches will dissolve on their own and need little additional care. Keep the area as clean as possible. Warm sitz baths or tub soaks two times a day will ease some of the soreness. Cesarean section stitches will likewise dissolve over time. These wounds should be kept dry and clean. You may shower after a C-section; just pat the wound dry afterward. No dressing or bandage is necessary.
Vaginal bleeding after your delivery will vary day to day but will end for the most part by four to five weeks postpartum. Especially with breastfeeding, however, intermittent and unpredictable bleeding can occur, though this will usually not be very heavy or prolonged. You may use a tampon four weeks after delivery, but douching is not recommended. If you are breastfeeding, regular periods may not begin again until after weaning.
This is a common problem in the postpartum period and should not be ignored. Breastfeeding, narcotic medications, lack of exercise and episiotomy pain can all make constipation worse. Drink lots of fluids, eat fruits and bran cereals, and if needed, use over-the-counter stool softeners such as Colace. If a laxative is needed, try a mild one such as Miralax or Milk of Magnesia.
Begin exercise again gradually but deliberately after delivery; pregnancy and childbirth have probably taken more out of you than you think. However, don’t consider yourself an invalid. You may begin walking and light exercise as soon as you feel comfortable doing so. Sit-ups and specific abdominal exercises should be deferred for at least six weeks in C-section patients, but then they are encouraged.
If you are breastfeeding, remember to drink lots of fluids to replace what is being used for making breast milk. The quantity of your milk may decrease if you are especially tired or dehydrated. Take your prenatal vitamins while you are nursing, and eat a well-balanced diet including plenty of calcium and protein .
If you have decided to bottlefeed, you should wear a very supportive bra day and night for at least the first week or until breast swelling has decreased. If painful engorgement occurs, ice packs can be helpful. Do not do anything to stimulate the breasts, such as expressing or pumping milk or even allowing the shower to strike them during bathing.
Our concern with resumption of driving is that you be completely ready to drive well. This is less likely if your stitches are still uncomfortable, if you are requiring pain medication, or if you are exhausted. Therefore, wait until it is totally comfortable to ride before considering driving. This may be up to several weeks. Remember, we are concerned not only about you and your new baby’s safety but also everyone else on the road.
You should wait six weeks after delivery to resume intercourse. Even though you may be breastfeeding, use something for birth control. Condoms should be used every time you have intercourse until your postpartum visit. At that time, long-term plans for contraception can be made with your doctor.
Regular and Extra-strength Tylenol (or equivalent acetaminophen) may be used per the package instruction. Generally, ibuprofen is most effective. Doses up to 600 milligrams four times a day (three of the over-the-counter 200 milligram-strength tablets) may be taken if needed though you should find you need less over the first week. If you’ve had a C-section, you may be sent home with a prescription for narcotic tablets. Use these in addition if the above doses of ibuprofen are not giving adequate relief. You should let us know if these suggestions are not giving sufficient relief.
Once again, congratulations! Parenthood is a challenge but a rewarding one. With a good helping of common sense and the above suggestions, things should go well. However, some new mothers feel especially overwhelmed by their new duties. These feelings can be accentuated by lack of sleep, hormonal changes, and even by well-meaning comments of others. Postpartum “blues” are very common. These feelings may become severe, and outside help may be necessary to get things back on track. Do not hesitate to contact us if you think you need help. We may always be reached in case of this or other medical emergencies by calling our office number, 314 432-3669.
Your postpartum check-up appointment should be scheduled for about six weeks after delivery.