Postpartum Recovery
Uterus Involution. The uterus returns to its normal size within the first six weeks after birth. While you’re in the hospital, nurses will massage the uterus to aid this process, and they may recommend you continue for a few days after discharge. Your uterine contractions may be uncomfortable for a few days, especially while nursing your baby.
Lochia. Bloody discharge will flow from the uterus after birth. In the first few days, it may be very heavy (soaking a pad in a few hours), and you may pass clots as large as a quarter. Within ten days, flow will be lighter, and will be pink or brownish. Lochia may continue for six to eight weeks. After it has reduced, if it begins to increase again or becomes redder again, it can indicate that you’re being too active, and need to find a way to rest more.
Do not use tampons for lochia.
If you are not breastfeeding, you may begin menstruating in four to eight weeks. If you are breastfeeding, you may not menstruate for several months.
Sexuality after a Baby: You can resume cuddling and pleasurable touching immediately after birth, or as soon as you’re interested. It’s generally recommended to avoid intercourse until your perineum has healed (especially if you had stitches for a tear or episiotomy), your vaginal discharge has declined, and you feel like you’re ready. This might be six weeks or more after the birth. Your vaginal tissues may be dry after birth, so using a water soluble lubricant is advised.
Some women begin ovulating again shortly after birth, and you are capable of becoming pregnant before your first menstrual period arrives, so be certain to use condoms or other contraceptives. You can consult with your doctor about appropriate methods.
If you are breastfeeding, your breasts may leak milk during orgasm. This is due to release of oxytocin, associated with both orgasm and breastmilk letdown reflex, and is a normal part of postpartum sexuality.
Bowel Movements, Urinating, Care of the Perineum, and Hemorrhoids
B.M. You may become constipated after delivery because of relaxed muscles and a sore perineum. Doctors may prescribe stool softeners, and you should also eat fruits, vegetables, high fiber cereals, and drink lots of water. It may help to support your perineum by gently pressing toilet paper against your stitches during bowel movements.
Urinating. Urinating may be difficult for the first few days because of soreness and swelling around your urethra, especially if you had a catheter. It may help to: drink lots of liquids, or pour warm water over your perineum to help start urine flow.
Care of the Perineum. If you had an episiotomy or a tear, your stitches will dissolve in 2-4 weeks, and perineum will heal in 4-6 weeks. After you urinate, clean yourself by pouring warm water over your perineum, and carefully patting it dry with toilet paper.
Using ice packs on your perineum off and on for several days can help reduce swelling. Sitz baths can help: sit in a clean tub of warm water for ten to twenty minutes. Kegel exercises will help promote healing, reduce swelling, and restore muscle tone in your perineum. Lie down and rest as often as possible.
Hemorrhoids. Common in the first month after birth. To promote healing: avoid constipation, try kegel exercises with the muscles around the anus, witch hazel pads, and sitz baths may help.
Doctor’s Visits: If you have had a cesarean section, you will typically have a follow-up with your doctor about two weeks after birth. Otherwise, you will typically have a postpartum appointment six weeks after the birth to assess your recovery.
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