Physical Facts and Comfort Measures, Birth to 6 Weeks

The first 6 weeks following your delivery is still part of the childbearing cycle. Called the postpartum period, it brings many changes as your body adjusts to a non-pregnant state.

Facts and Comfort Measures

Lochia is the bloody vaginal flow during the first few weeks after delivery. Lochia usually disappears or is just a slight, brownish discharge at about three weeks after delivery. It should not have an offensive odor. Notify your provider if:

  • There is any increase in the amount of vaginal discharge
  • The discharge changes from brown back to red
  • You have vaginal odor or discomfort

Following the birth of your baby, your uterus returns to a size close to its pre-pregnancy size through the process of involution. This process takes about six weeks to complete. In the beginning you may experience cramping, or "after birth pains". These are usually more severe if you had twins or triplets, if it is your second or third baby, or if you are breast feeding. For relief:

  • Keep your bladder empty
  • Take a mild pain reliever as prescribed by our doctors and nurses
  • Perform breathing and relaxation exercises

If you experience excess perspiration, which is common in the postpartum period:

  • Shower often to keep clean and dry
  • Stay well hydrated by drinking water and other fluids

To relieve perineal discomfort and vulvar / vaginal hematoma (blood filled tissue):

  • Take a sitz bath and regular warm baths as prescribed by our doctors and nurses
  • Sit on a foam mattress, cushion, or pillow or lie on your side whenever possible
  • Apply an ice pack
  • Use medication as prescribed by our doctors and nurses

For relief of itching and soreness of hemorrhoids:

  • Use a pain relief ointment as prescribed by our doctors and nurses
  • Eat high fiber foods such as fresh fruits, vegetables, and whole grains to prevent constipation
  • Drink plenty of fluids (at least six 8-ounce glasses daily)

For vaginal discharge:

  • Change pads every one to three hours and/or each time you empty your bladder
  • Practice good personal hygiene (wipe from font to back after urinating)
  • Shower daily

For relief and prevention of edema (swelling):

  • Wear support hose
  • Avoid crossing your legs when sitting
  • Drink plenty of fluids (at least six 8-ounce glasses daily)
  • Elevate your legs when possible

To prevent or relieve constipation:

  • Drink plenty of fluids (at lest six 8-ounce glasses daily)
  • Eat recommended daily amounts of fresh fruits, raw vegetables, and whole brain or whole grain cereal
  • Use a stool softener or laxative only if prescribed
  • Exercise regularly, after checking with your provider
  • It is common for newly delivered mothers not to have a bowel movement in the first few days postpartum. If this becomes a problem, notify your midwife/doctor.

Stretch marks (striae) may never go away completely, but they usually change to fine silvery white lines.

Women lose an average of 12 pounds at the time of delivery, representing the weight of the baby, placenta, and amniotic fluid. You may return to your pre-pregnancy weight by the end of your postpartum period or soon thereafter. Appropriate exercise and a healthy diet will play a large part in your weight loss. Do not become overly concerned if it takes you longer to lose the weight gained during your pregnancy.

To avoid fatigue:

  • Take naps while your baby is sleeping
  • Establish an early bedtime hour to make up for sleep missed during nighttime feeding
  • Limit visitors, especially during the first few weeks after delivery
  • Do only light household chores
  • Accept offers for help with cooking, cleaning, and errands
  • Practice relaxation techniques
  • Take time for yourself

Exercise and other activity

Daily activities and household chores can be resumed gradually. For a vaginal delivery perform only very light household chores during the first two weeks, and avoid lifting heavy objects for about six weeks. Talk with your provider about activity levels after a Cesarean birth. If you attempt to do too much too early, you may experience an increase in vaginal discharge.

Unless otherwise recommended, you can usually begin driving within one week if you have delivered vaginally. If you had a Cesarean birth, your provider may recommend:

  • Shower rather than take a tub bath until there is no risk of infection
  • Don`t begin exercise recommended
  • Many hospitals and community centers offer special postpartum exercise classes

Breast Feeding

If you are breast feeding, your breasts will become full and tender within two or three days after delivery, as they naturally prepare to supply milk, or lactate. As the colostrum turns to milk, the breasts become larger and fuller. For many women, the condition is noticeable but not bothersome. For others, it may be very uncomfortable and even painful. It is common for the breasts to become swollen and tender, with some women complaining of throbbing and hardening. If your engorgement is severe enough, the nipple may flatten, making it hard for your baby to latch on. The swelling and tenderness will usually start to disappear in one or two days. It`s important to nurse your baby often during this time, in order to relieve the pressure and fullness. Otherwise, the condition may worsen. Breast feeding experts suggest several possible measures to relive the symptoms of breast engorgement and to make you feel more comfortable. You may need to try more than one to see which works best for you:

  • Wear a well fitting supportive nursing bra, even during the night
  • Wear cotton nursing pads to protect your clothing from leakage
  • Take warm showers or apply washcloths for soothing relief
  • Nurse frequently, every two or three hours, even if you have to wake your baby. Be sure to use both breasts at each feeding
  • Gently massage your breasts while nursing to encourage the milk to flow and to speed emptying
  • Just before nursing, express a small amount of milk prior to feeding to relieve pressure. This will help your baby to "latch on"
  • Ice packs may be used to reduce discomfort and internal swelling, apply cold packs to the breast after nursing

Prolonged engorgement may lead to breast infection (mastitis). The most common symptoms are high fever, chills, fatigue, increasing breast soreness, swelling, warmth, and redness. Prompt medical attention is necessary. If you have any of these symptoms, report them to our doctors and nurses.

Soreness or tenderness of the nipples can occur at any time during the breast feeding period, especially during the first week. Extreme pain is NOT normal. If you are in pain, ask for a consultation with a certified lactation consultant. If soreness continues, they may become irritated or cracked. There are several comfort measures that may be helpful:

  • Apply ice to the nipple just before the baby latches on
  • Begin nursing on the side that is less sore (if there is one), since babies usually nurse more vigorously at the start of a feeding when they are most hungry
  • Restrict nursing time to about ten minutes per side if you are sore during the entire feeding, as shorter, more frequent feedings are easier on the nipples
  • Release the baby`s suction hold carefully before removing the baby from the breast.
  • Air-dry the nipples after each feeding. Leave the nipples exposed to the air as much as possible between feedings (especially if your nipples are cracked).
  • Use ointments sparingly. Avoid putting any preparation on the tip of the nipple unless cracking is severe. Your nipples are naturally protected and lubricated by sweat glands and skin oils; so let nature do its job.
  • Change nursing pads after each nursing and when they become wet
  • Vary your nursing position so a different part of the nipple will be compressed at each feeding
  • Check baby's latch and position
  • Alternate the breast on which your baby nurses first at each feeding. One way to remember this is to pin a safety pin to your bra to remind you which breast to start with at the next feeding.

Reprinted by Pregnancy.org, LLC from Her HealthCare.