Recovering after a normal delivery

Congratulations! So your bundle of joy has finally arrived and you must be super excited, happy and anxious all at the same time. However, while you may want to cherish every minute of your time with your newborn baby, do not forget to take care of yourself in the process. You have gone through immense changes during these nine months, both physically and emotionally. So, don’t expect to feel normal within a few days. Instead, give your body the time that it deserves to recover from pregnancy & childbirth so that you have a smooth start to your journey into motherhood. Most women need 6-8 weeks to recover after a normal delivery, but some may take longer. Also, every pregnancy is different, so postpartum recovery is also different for everyone.

Let us have a look at what to expect during your recovery period, along with some tips to help you heal faster:
 

1. Breast Tenderness

Apart from being able to grow another life inside it, the female body also has the capacity to nurture the new life once the baby is born. A mother’s milk is the recommended source of nutrition for all babies, at least for the initial six months of their lives. However, many women feel some soreness and tenderness around the nipples during the initial few days of breastfeeding. The most common reason for this is improper latching by the baby.

• Make sure that the baby latches on to the whole nipple & areola while suckling. This means that ideally, the entire dark area around the nipple should be in the baby’s mouth while breastfeeding.
• Also try not to change your baby's position while breastfeeding. Make sure that you’re sitting up in a comfortable position with your back straight while breastfeeding so that you don’t shuffle too much & do not upset the baby.

Your breasts might also feel heavy, warm or lumpy due to the sudden excessive production of milk. These signs usually go away on their own within a few days as the baby’s milk demand increases. However, sometimes the breast engorgement may become excessive and cause pain. Here’s how you can relieve it:

• Take a warm shower or apply warm towel or water bottle on your breasts to relieve breast soreness. This will also help in releasing the milk easily.
• If needed, you can express out the breast milk by pressing over the breast tissue starting from the underarm & topmost region and pressing towards the nipple.
• Alternatively, you could use a breast pump to suck out the excess milk.

2. When will the cramps go away!

Frustrated that you are still experiencing cramps that remind you of your time in labor? Don't worry; it's just your uterus trying to get back to its original position and size. These are called “after pains.” The intensity of the pain may vary from dull to sharp pain and they typically last for a few seconds and then are relieved.

Most women experience afterpains while breastfeeding. The reason behind this is the release of the hormone oxytocin, which triggers uterine contraction. You can use a warm compress over the area to get some relief, however, avoid using any hot fomentation in the abdominal area around the stitchline if you have had a caesarean section. These pains start fading away soon; however, consult a doctor if you notice that the cramps are getting worse with time.
 

3. Vaginal soreness

During childbirth, women may get a vaginal tear, or the doctor may make a small incision called Episiotomy, between the vagina and anus so that the baby can come out easily. It might take a few weeks for this wound to heal. There will be some soreness in the vaginal area even in the absence of a tear or incision. Here are a few steps that you can take to reduce the discomfort:

• Sitting on an ice pack for few minutes can help relieve the pain.
• After using the toilet, use a squirt bottle to rinse the area with warm water. Make sure that you wash the area with the water flowing from front-to-back ie from the vaginal area towards the anus area and not the other way round.
• For five to ten minutes, soak in a warm bath just deep enough to cover your buttocks and hips at least three times a day. This should be especially done after you have passed stools.
• Take a pain reliever that is available over-the-counter after consulting your doctor.
• Use a soft cushion or pillow under your buttocks when you sit up for prolonged duration. You can also use a doughnut pillow and sit on it to avoid putting direct pressure over the stiches.
• Use an antiseptic cream or ointment over the stiches as prescribed by your doctor.
• Avoid any sexual intercourse till the time that the stiches heal completely.
• Avoid constipation & straining while passing stools until the stiches have healed. Use a laxative or stool-softener as advised by your doctor if you have constipation.

4. What’s all this blood about?!

Vaginal bleeding and discharge are normal after giving birth. This is called lochia. Initially, the bleeding may be heavy, but it will soon thin out. This is just your body getting rid of the excess tissue and uterine lining after the delivery. Normally your bleeding should not be very heavy and should stop within six weeks.

Consult your doctor immediately if you notice any of the following symptoms:

• Continuing to have heavy bleeding or soak one or more pads in an hour.
• If you notice that your bleeding is getting heavier even after a week of giving birth.
• When you start seeing large blood clots with the bleeding.
• If there is a foul smell or discoloration of the vaginal discharge/bleeding.
• If you have fever ≥ 100^o F.
• If you begin to feel light-headed or dizzy.

5. Unable to control your pee

As you push your baby out during a normal vaginal delivery, it leads to stretching of the pelvic floor muscles. These muscles assist in maintaining normal bladder and bowel control. When they get overstretched during labor, they may transiently lose their tone & functionality to some extent. It's possible that you'll unintentionally leak urine as a result of this. One in every three women goes through this. So, don't worry. Give it some time and work towards improving your muscle tone. You can try doing some Kegel exercises that will help tone your pelvic floor muscles and improve your bladder control.
 

6. Water retention

Throughout the nine months of pregnancy, your body was storing a lot of fluid to meet the demands of increased blood volume & circulation. Now that your baby is out, your body needs to get rid of this excess fluid. However, this takes some time. As a result, you will notice some swelling on your body, especially around your ankles and feet. It will also cause you to pee a lot. It should typically go away within a week of having your baby.

Consult your doctor if you notice that:

• The swelling is increasing with time.
• If there is painful swelling over the legs, especially if it is tender in the calf region on stretching the ankles.
• If there is redness or inflammation in the region of the swollen limbs, or if the area feels warm to touch.
• If the swelling in one leg is more than the other and is painful to touch.
• If your movements are getting limited or painful because of the swelling.

7. Hemorrhoids and bowel movements

Hemorrhoids refer to the dilatation, prolapse and enlargement of the veins in the rectum. This can happen during pregnancy and also during labor while pushing your baby out. Hemorrhoids can lead to bleeding or experiencing pain after passing motion. If this makes you too afraid to go to the washroom after childbirth, here are some steps to ease your pain:

• Discuss with your doctor & use a hemorrhoid cream or suppository to treat your hemorrhoids.
• Use a stool softener for easy bowel movements, but consult with your doctor before taking them.
• Try soaking the affected area in warm water for a few minutes.
• Drink plenty of fluids and eat food items rich in fiber.

8. Hair loss

During pregnancy, you may have had a lush growth of hair due to the hormonal changes that prevent hairfall. So, as the hair growth continues & hair fall is reduced, you get a thick mane of hair during those 9 months. The hair growth cycle has 3 phases:

• Anagen- Growth phase.
• Catagen- Intermediate phase.
• Telogen- Hair fall.

During pregnancy, the hormonal changes lead to the hair being trapped in the anagen phase. After delivery, as the hormones recede, the hair move rapidly to Telogen phase and you experience excessive hair loss. Don’t worry, this usually resolves within 6-8 months after delivery and your hair growth / fall cycle stabilizes. In the meantime,

• Keep yourself well hydrated & well nourished.
• Take a healthy, nutrient rich diet.
• Take your Vitamin, Zinc & Iron supplements after medical advice.
• Use a gentle, natural shampoo.
• Keep your hair clean & hygeinic.

9. Skin changes

The skin changes of pregnancy, including the stretch marks, dark pigmentation, acne etc gradually regress over the next 6-8 months. Remember, the stretch marks become lighter but do not completely vanish. Keep yourself well hydrated, use a good moisturizer that suits your skin and consume at least 2 seasonal fruits and green vegetables, bean, legumes daily.
 

10. Feeling all over the place?

Have you been feeling moody and anxious lately? Feel like you can start crying at the drop of a hat? The hormonal changes, the stress of pregnancy and giving birth can do that to you. Your hormones are all over the place. This is called the typical “baby blues”and is experienced by almost 70-80% of new mothers. Taking care of a newborn is no joke. It takes a toll on all new mothers, especially if there is no help available. You might start experiencing these symptoms within a few days of having your baby. In most cases, they go away within two weeks. You can try the following to help overcome your postpartum blues:

• Take out at least half an hour for yourself daily and indulge yourself in an activity that you enjoy.
• Make sure that you get adequate sleep even though it may be in breaks & small periods while your baby sleeps.
• While you get used to looking after the baby, do not forget to take care of your own nutrition & rest to ensure your optimum recovery.
• Do not hesitate to ask for help in looking after the baby, involve your spouse, family and friends whenever possible so that you can take some time to rest and recover.
• Remain as physically active and engaged in constructive activities as your medical condition allows. It helps even if you can indulge yourself in doing something meaningful for your own satisfaction for even half an hour in the day.

If you notice that you are not feeling any better even as the days go by, it is time to see your doctor. You could be going through postpartum depression if you suffer major mood changes, loss of appetite, excessive weariness, and a lack of joy in life soon after giving birth. Do not suffer in silence. Talk to your doctor and loved ones. There is help out there.

Lastly, do not forget your postpartum checkup. During these visits, your doctor will do a thorough physical examination and also evaluate your emotional well-being. Open up to your doctor about everything that you are going through after having the baby. You are not expected to know everything as a new mom, so don't shy away from clearing your doubts. Proper information, guidance & a little help from your doctor goes a long way in ensuring a smooth postpartum recovery.