Postpartum Instructions for Mom

During these days of recovery remember to SLOW DOWN and enjoy your time with your new baby. Nursing and cuddling often will facilitate bonding and milk production. Both parents are encouraged to spend a lot of time skin to skin with your baby. You cannot spoil a newborn, hold your baby often...remember this baby spent nine months close to your heart and they grow quickly, cherish every moment.

Rest:

Birth is hard work! It is essential that you rest as much as you can at the beginning of your recovery in order to make the rest of your recovery easier and shorter. Stay in bed with your baby for the first week and do nothing but care for your baby. Do not lift anything heavier than your baby. After the first week gradually go back into your normal routine listen to your body cues if it causes discomfort stop doing what causes discomfort. Try to arrange help with meals, cleaning, laundry and care for older children.

Uterus and Bleeding:

Your uterus should be firm and no higher than your belly button. Massage your uterus at least every 4 hours after birth to keep your bleeding minimal and urinate often to keep your bladder empty. Expect heavy discharge for the first 12-24 hours. Bleeding will slow down and usually stop by the 2nd or 3rd week postpartum. You may also have a few clots especially if lying down for a while. Call 911 and contact your midwife if you fill a menstrual pad less than 30 minutes. Nurse your baby and massage your uterus until help arrives this will help contract the uterus.

Perineal Care:

Use your peri bottle filled with warm water to rinse your perineum while you are urinating to ease any discomfort. After using the restroom rinse the peri bottle. Pat dry and do not wipe especially if you had a repair. Ice pack (left on for 20-30 min.) can be applied to the perineum and are usually very soothing this may help reduce swelling and soreness. If you tore try to keep your legs together to facilitate healing and allowing air to reach perineal area will also help. If you had stiches avoid taking a bath for 2 weeks.

Elimination:

Your bladder may feel numb following birth and it may be 24 hours before normal sensation returns. Make a habit of attempting to empty your bladder every 2 hours even if you do not feel the urge to urinate. Make sure you are drinking plenty of fluids and eating whole gains, fruits and vegetables for fiber. It is normal to fear the first bowel movement after birth “Don’t worry it is not painful” stay hydrated and take in good amount of fiber to keep your stool soft. Notify your midwife with any difficulty urinating or having a bowel movement.

Breast Care:

Do not use any alcohol, soap or other drying agents on your nipples. You can use Lansinoh, Vitamin E oil or Bag Balm (from feed store) if your nipples are sore and dry. Try to let your nipples air dry and change out nursing pads often. Your milk should be in by day 3 if you are engorged and it is difficult for baby to latch, hand express milk or stand in a warm shower allowing water to run over your breasts to facilitate let down. If you notice a tender spot on your breast that is painful to touch notify your midwife especially if you develop flu like symptoms and temperature.

Nutrition and Hydration:

In addition to recovering from the birth your body is preparing to make breast milk for your baby. Maintain your pregnancy diet and supplements ADD an additional 500 calories every day to your diet. Drinking lots of fluids is also important; drink at least 8 ounces of water every time you nurse your baby to facilitate milk production. Inadequate nutrition and dehydration will lead to fatigue and a slow recovery.

After pains:

After pains are the contractions of the uterus that occur after the delivery of the baby and are usually more noticeable while breastfeeding. Nipple stimulation of suckling causes the release of oxytocin which causes uterus to contract. These contractions hasten the return of the uterus to a non- pregnant state and while they can be painful they are normal and extremely beneficial. In women who have had more than one child after pain are more severe for the first few days requiring one to use relaxation techniques and breathing. It is safe to take 3 Ibuprofen every 6 hours or 2 Aleve every 6 hours if pain is hard to manage.

Exercise:

After 6 weeks you may resume some physical exercise. Begin walking and gradually increase your activities slowly resuming your normal routine.

Birth Control and Intercourse:

Do not resume sexual intercourse until 6 weeks after delivery. It is important to wait until your body has had sufficient time to heal before introducing anything into the vagina. Breastfeeding is not an entirely effective method of birth control. Discuss options with your midwife at your 6-week postpartum visit.

Kegels:

Resume your Kegel exercises the day after delivery. However wait 2 weeks if you have stitches and are healing.

Baby Blues:

It is not uncommon for new moms to experience some slight feelings of depression or sadness even if their birth was “perfect.” These feelings are known as the baby blues. Make sure you get plenty of rest and follow your postpartum instructions. If you or your family think that the feelings you are experiencing are more severe or persist beyond 2 weeks please let your midwife know.

Follow up visits:

Postpartum visits are 2 days, 2 weeks and 6 weeks. Your midwife will come to your home 2 day’s postpartum to perform a complete postpartum visit and check on your recovery she will notify you when she will arrive. All other visits will be at her office. Don’t hesitate to see your midwife if you need additional visits notify her with any concerns.

Call 911 and notify your midwife in case of emergency or if

• Your bleeding is so heavy that you fill a pad in less than 30 minutes

• You have difficulty breathing

• Severe pain of any kind

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Areas of concern notify your midwife...

• Temperature-fever above 100.4 after drinking fluids

• Pulse greater than 100 per minute while resting, occurring twice in 1-2 hours

• Uterus remains soft “boggy” and does not respond to massage

• Heavy bleeding (soaking large pad in less than 2 hours after the first 24 hours)

• Passage of tissue or foul smelling discharge

• Persistent passage of clots larger than a golf ball

• Fainting, severe headaches, severe pain in abdomen, legs or chest

• Spots before eyes

• Feelings of despair

• Great anxiety or inability to cope