Postpartum Care

Postpartum Discharge

Postpartum discharge (lochia) is similar to a heavy period and may last up to six weeks. Typically, postpartum bleeding is heavy for the first 3–10 days, then slowly decreases. You may notice a change in the color of your discharge as the bleeding tapers from red to brown to a yellow-white color.

During this time, use pads, not tampons. If you are bleeding through more than one pad per hour or notice large clots, contact your doctor.

Vaginal Discomfort

Your vaginal area has been through enormous stress and strain. While it will return (almost) to normal, this takes some time. It’s not unusual for lacerations or tears to occur with delivery. The sutures used for repair will dissolve on their own by six weeks.

Women may also experience some uterine cramping, especially with nursing, in the first 1–2 weeks.

To assist with healing, it's important to let the area rest. Avoid vaginal intercourse and tampons for the first six weeks. You may use ice the first several days after delivery.

Spraying warm water over the area before and after urinating may help reduce irritation. Sitz baths, which are shallow bath bowls for soaking the vaginal area, may also be helpful. Kits are available in most pharmacies or online. 

C-Section Recovery

It’s important your body gets the rest it needs after a C-section. Expect that it will take six weeks to heal. You will have a two-week and six-week postpartum visit to ensure the healing process is on track.

During the first six weeks, you should not lift anything heavier than your baby in a car seat. If needed, over-the-counter ibuprofen or acetaminophen can help reduce pain and discomfort.

Sore Breasts

Whether you’re nursing or not, sore breasts are common after childbirth. If you’re not nursing, your production of milk will stop over time. You may notice some pain and discomfort from breast engorgement in the interim as well as milk leakage.

To help ease the pain:

• Apply warm compresses or ice packs
• Wear a tight-fitting sports bra or ace bandage to help decrease symptoms of engorgement
• Take over-the-counter pain medicine, such as acetaminophen or ibuprofen, which may help decrease swelling or pain

If you’re breastfeeding:

• Apply warm compresses or ice packs
• Apply a lanolin cream to prevent or treat cracked nipples
• Wear a comfortable nursing bra

If you develop a fever higher than 100 degrees or note increasing redness and pain, contact your physician for evaluation of possible mastitis, which is an inflammation of breast tissue that sometimes causes an infection.

Constipation or Hemorrhoids

It may take several days to have your first bowel movement after delivery. Constipation is common during the first few weeks as your body adjusts back to normal. Over-the-counter stool softeners, fiber-rich foods, and drinking plenty of fluids will help.

You may also use over the counter hemorrhoid medications to help unless you had a fourth-degree laceration (involving the rectum).

Bladder Leakage

Postpartum bladder leakage is quite common for many women. By your six-week check-up, you should see some improvement. However, most bladder conditions improve slowly over time as your muscles and nerves recover. Expect it may take 6–12 months to see significant improvement.

If you don’t notice an improvement, a referral to see a pelvic floor physical therapist may be helpful.

Fatigue

Fatigue is a normal part of the postpartum experience. Your baby will likely wake up every two to three hours for feeding, making it difficult to get enough sleep. It’s important to try and sleep while your baby sleeps, even during the day. If possible, ask others to watch your baby for a few hours so you can rest.

If your fatigue feels more significant than expected for sleep deprivation or is significantly impacting your mood, talk to your provider.

Baby Blues and Postpartum Depression

It’s normal for new mothers to experience mood swings and negative feelings after giving birth. These emotions occur due to hormonal changes, exhaustion and fatigue, and adapting to a new lifestyle.

You may experience symptoms such as:

• Irritability
• Insomnia
• Unexplained or frequent crying
• Sadness
• Mood changes
• Restlessness

Mild symptoms that improve over time are normal. However, postpartum depression may be present if you are unable to perform daily activities because you are so overwhelmed, have thoughts of hurting yourself or your baby, or if symptoms persist or worsen over 2–4 weeks.

Postpartum depression may develop up to one year after giving birth and requires medical treatment. It’s important to speak to your doctor if your symptoms persist or are severe.