Recovering After Giving Birth
Many new mothers find themselves surprised by the changes in their body after they've given birth. Antenatal classes cover topics up to and including the birth, but sometimes they are a bit thin on the detail for what happens to your body after your baby has arrived! What's more, during pregnancy women are often so focussed on labour and childbirth that information that extends beyond that can be hard to focus on.
After you've given birth, there are several common health problems that many women experience. Postpartum health issues, teamed with general exhaustion from giving birth and looking after a baby, mean that you'll benefit from help from your partner, friends and family. To help you recover, try and get as much rest as possible. Accept any offers of help and if none are forthcoming, ask friends and family to help out. It takes most women 6 weeks to recover from giving birth, but it can take up to 6 months to feel fully recovered, especially if you had a traumatic labour.
Here are some of the health problems that are commonly experienced after giving birth and tips and suggestions for how to ease the symptoms:
If you had an episiotomy or tear during delivery, you will have had stitches. These can be painful when healing, and may feel tight up to a few weeks after delivery, depending on the severity of the cut/tear. Stitches normally take 2-3 weeks to heal, but can take up to 6 weeks if the tear or cut was particularly deep. You can ease any pain you feel by taking painkillers. Paracetamol and ibuprofen are safe for nursing mothers, but aspirin should be avoided. Put an ice pack covered with a soft cloth on the area to ease discomfort. Sitting down can be painful when you've had stitches so lie down instead whenever you can. Doing kegel exercises (pelvic floor exercises) helps the muscles regain their size and strength and speeds healing time for the perineum. Avoid stairs and lifting as far as you are able to, these activities can be uncomfortable for women who have had stitches after giving birth.
Many women suffer constipation after giving birth. This can be for a number of reasons. Sometimes medication given during delivery can cause constipation, as well having a long labour without food or drink, or an enema. If you have had stitches or an episiotomy, you might be afraid of going to the toilet in case it hurts or opens your stitches. It is extremely unlikely that going to the toilet will affect your stitches in any way, but consciously or subconsciously new mothers often hold it all in out of fear it is going to hurt. It can take 3-4 days for your bowels to open as usual, which can be very uncomfortable for new mums. Constipation can also make it more painful when you do go, as the longer you have to wait, the harder the stool will become. If you are suffering from constipation and feeling uncomfortable, talk to your doctor about taking laxatives and/or a stool softener. Also make sure you drink lots of water and eat plenty of fresh fruit and vegetables, as well as whole-grain foods to help you get back into normal bowel habits. Going for walks (if you are comfortable doing so) can also help.
Haemorrhoids are common after birth, and can be compounded if you have constipation. If you suffer from these, using haemorrhoid cream will help, which can be obtained from your chemist.
About 2 to 6 days after giving birth, your breast milk comes in. This can cause your breasts to become swollen and engorged. They often feel sore, lumpy, hard and painful. You might also have a temperature. Feed your baby as often as he wants to be fed, and your breasts will adapt their milk production according to his demand. Engorgement will soon pass. If your breasts are so engorged that your baby finds it hard to latch on, hand express or use a pump to get rid of excess milk. You can also put warm flannels on your breasts to encourage some of the milk to come out, and use a cold pack or cold flannel after feeds to ease any discomfort. Cabbage leaves also help to draw out excess fluid so try putting clean white or green cabbage leaves inside your bra. Not wearing a supportive bra can make engorged breasts more painful so ensure you're wearing a well-fitting, supportive bra, even during the night. If your breasts remain painful, you can take paracetamol and ibuprofen and continue to breastfeed safely.
Swollen ankles caused by fluid retention are quite common after giving birth. To help your ankles go back to their normal size, drink plenty of fluids, and elevate your feet when you are sitting or lying down. Walk around to help swelling go down, and massage your feet to improve the circulation. If you have swollen ankles that last longer than 4 weeks, see your doctor as occasionally swollen ankles are a sign of a more serious problem.
After labour your uterus will gradually contract back to the size it was before pregnancy. These contractions are known as 'after pains', and range from being quite intense (normally in the first few days after labour), to a relatively mild pain abdominal pain. After pains are usually more intense for women who have already had a baby, as the uterus takes longer to go back to it's normal size with each subsequent pregnancy. You might notice the pains more when you breastfeed, as your body releases oxytocin during a feed, which causes the contractions. The contractions are actually a good thing however, as it shows your body is recovering and they reduce postpartum blood loss. Gentle massage to your tummy may help to ease these pains, you can also take painkillers such as ibuprofen or paracetamol.
The 'Baby Blues'
Many new mums experience feelings of sadness and anxiety for the first few days or weeks after giving birth. These feelings are often accompanied by mood swings, irritability and being very tearful. The baby blues are caused by a combination of hormonal changes and exhaustion, as well as emotional stresses as you get used to being a mother to your new baby. They usually go away shortly after birth, so don't worry if you feel tearful and upset in the early days, accept it as part of the normal process and remember that you are no different to the majority of women.
Sometimes the baby blues turn into postnatal depression (PND). PND is more serious than the baby blues, and lasts longer. About 10-25% of women suffer from PND to varying degrees. It can cause persistent sadness, anxiety and mood swings. If your baby blues continue past a couple of weeks, or seem to get worse rather than better, seek help from your doctor as you may be suffering from PND.
Recovering From A Caesarean
Recovery time is usually longer for women who have had caesareans, and they'll need extra help at home as they have had major surgery. Women can have a significant amount of pain in their abdomen for the first few days after surgery, but after this it should subside. Painkillers are provided at hospital before the woman is discharged. Avoid stairs and lifting while you are healing, and also avoid any sudden movements, which may feel painful. It might seem impractical to restrict yourself physically with a new baby but getting others to help you and to give you chance to rest is really important in order to give you a quick recovery time. Use your hands or a pillow to support your abdomen when you laugh or sneeze. Women who have had caesareans are more likely to become constipated, so drink plenty of water and ask your doctor for a stool softener if you feel it might help.
You'll need to take care of your incision so that it doesn't get infected. Keep it clean and watch out for signs of infection such as warmth, redness, inflammation or anything oozing from the incision site. Call your doctor if you come down with a fever, even if your wound doesn't look infected.
Make sure you get plenty of rest so you can recover, but try and walk around a little bit if it isn't painful. Walking helps prevent blood clots after surgery and speeds up the healing process. From 6-8 weeks you can start moderate exercise, but you should wait until your caregiver gives you the all-clear before starting an exercise regime. For more information see our Recovering From a Caesarean article.