Postpartum Recovery: Things to Know Before You Give Birth
Page Updated on
July 28, 2007
I know you're thinking that all you have to do is give birth and like magic you're back to normal, but that's just now how it goes. Sadly, pregnancy books don't even tell you everything about recovering from birth. You've just endured forty weeks of sharing your body with another person and passed a human through a very small exit; expect recovery to take some time. Some women feel back to normal only a few hours after having a baby. I knew one woman who even went back to work the same day! Others are miserable for the first couple months. Here's what you may get to look forward to if you have a vaginal delivery.
First a safety note.
Infections can develop a few days after your give birth, which is usually when you're back at home. Call your doctor immediately if you develop a fever over 100 degrees F or if you have any of the warning signs in the contents below.
Some people get chills and shivers immediately after delivery. This goes away within a few hours and is more annoying than a concern.
I can't pee!
Immediately after the birth of your baby (and the initial bonding period) you may be asked to urinate. Your urethra will most likely be swelled shut, and a good pee just isn't going to happen for awhile. The problem with this is that your body doesn't stop producing urine, so your bladder just keeps getting fuller and stretching out, which the doctors call distended. If you can't urinate on your own after about eight hours, your doctor may use a catheter to do it for you.
You want me to move after all of that?
You may be asked to get up and walk around even though you're sure that you couldn't take a single step. You need to move a bit soon after birth and throughout your entire healing process to keep from getting blood clots, but don't try to do too much too soon. Notify your doctor if there is any tenderness, swelling, or redness in your legs (or anywhere else, but in the legs is most common) because it could be a sign of a blood clot.
It hurts down there!
Your vagina, perineum, tail bone, and anything else down there will hurt in a way that you have never experienced before. It's all been stretched, crushed, and stressed more than you can imagine, so it's going to feel sore and swollen. Ice packs and sitz-baths will help. Numbing sprays can help with any stinging or burning, and witch hazel wipes help as well. This can last for a couple weeks. It's not fun.
Ouch! Stitches and tears.
If you've had stitches or tears, they will hurt while they're healing. Use a bottle of warm water (called a peri-bottle, which the hospital will probably provide for you) to clean yourself and soothe the pain. If your urine causes burning when it touches tears and stitches, use the peri-bottle while you pee to dilute your urine (or you can even pee in the bathtub filled with warm water...it's gross, but you won't care!). Drinking lots of water helps to dilute your urine too. Sitz-baths help some. Whatever you do, don't wipe over your stitches! Wiping over your stitches is just painful. Don't even think about doing it. You can gently (very gently) blot your stitches dry after cleaning yourself with water. Witch hazel pads (like those used for hemorrhoids) can help cut down the sting, but remember to blot instead of wipe. You can also put witch hazel pads directly on your sanitary pad. You can also use a numbing spray, but it can get tricky trying to point the can in the right direction while holding it upright. This can last for a couple of weeks. Make sure you call your doctor if it feels like things aren't healing correctly (e.g. not intact, lots of swelling when it should be going down, any type of puss or ooze, etc.)
Blood. Blood. And more blood.
You will definitely have heavy bleeding. It's called lochia and starts off heavy and bright red and turns brown then pink then yellow and finally white or clear and with such a light flow you can get away with just changing your underwear frequently. You'll probably go through lots of big, super-absorbent pads at first. Don't use tampons! Tampons are painful to insert and will probably cause an infection; plus they won't absorb all that blood anyhow. Bleeding can last anywhere from a couple weeks to six weeks. Bleeding longer than six weeks or going through one or more pads per hour are warning signs to look out for, and a foul smell can be a sign of infection. Also, not having a discharge of lochia is a bad thing too, and while you're expected to be tired, be aware of any extreme fatigue and paleness or unusual pulse or blood pressure that could be caused by a loss of blood. Notify your doctor immediately if you have any of these warning signs.
I feel like I've been hit by a truck.
You're entire body has just endured an incredible task. Every muscle in your body has had an intense workout. You will most likely be achy, stiff, and sore from head to toe. This usually goes away after the first week or two. Ibuprofen is the best pain killer because it's an anti-inflammatory (unlike acetaminophen). Talk to your doctor about medications and dosages (especially if you're breastfeeding), but when I went through this the dosage was two 200 mg pills (400 mg total) every four hours. Believe it or not, walking can help as well. Some of the soreness is caused by a build up of lactic acid in the muscles, and aerobic activity (walking is an aerobic activity) helps to burn up that acid and reduce the pain.
I look like I've been hit by a truck.
All of that pushing puts a strain on your entire cardiovascular system, so some blood vessels may pop during delivery. It's typically harmless if you don't have any cardiovascular problems and leaves you with bloodshot eyes and bruises that normally appear on the face but can pop up anywhere.
The wonderful world of cramps.
Your uterus has to shrink back to it's normal size, and it does this by contracting (just as it did to push the baby out). Each contraction hurts. Fortunately, it doesn't hurt as much as labor pains. Instead it feels like cramping. It's especially noticeable during breastfeeding because your body produces oxytocin during feedings which stimulates the contractions. Ibuprofen works well for this. It can last up to six weeks.
I'm so exhausted.
Why wouldn't you be exhausted after everything that you just went through? Get lots of rest. Sleep whenever the baby sleeps because you won't get a chance while she's awake. (Ok, maybe take a shower during one of the naps, but ignore the messy house and sleep, or at least lay down.) If you're in a hospital, sleep may be more difficult because people keep coming in to check your vitals as well as your baby's, but all of that is necessary to ensure that you or your baby don't develop an infection or have any other complications.
If you didn't get them during your pregnancy, that doesn't mean you're out of the clear. Pushing the baby out can cause you to develop hemorrhoids, painful, itchy varicose veins around your anus. They can cause anal bleeding, and these sometimes grape-sized lumps are terribly unattractive. Eat lots of fiber and try stool softeners if you discover that you have developed these horrid little things. The last thing you'll want to do is get constipated or pass hard stools. Use hydrocortisone creams to reduce the swelling and lubricants (such as A & D Ointment) to reduce friction pain (friction happens just from your butt cheeks rubbing together, so no xxx jokes). If it doesn't get better after a couple of weeks (note, I didn't say "totally healed," just "better" or "improved") talk to your doctor about it.
Yes, yet again you may become constipated. Eat those prunes and lots of fiber. Don't forget to drink lots of water. Moving around can help too.
Along with constipation is gassiness. This will also work itself out, but try to eat small frequent meals and avoid gas producing foods in the meantime.
Hey look! The room is spinning.
Changes in blood volume may cause you to get dizzy and light headed. Get up and down slowly, and try to find things to grab onto for balance if necessary.
Oh, my boobies are killing me.
Fortunately the pain isn't immediate, but it will happen whether or not you breastfeed. If you don't breastfeed, your breasts will become engorged, and you'll need to use ice packs and pain killers until your body realizes that you aren't going to breastfeed. Just don't express the milk because your body will just make more milk. If you do breastfeed, you'll probably be focused on the nipple pain caused be the frequent sucking of your baby (that pain will go away as your nipples toughen up, usually about a week or two). Plus, when your milk comes in, your body won't really know exactly how much to produce, so chances are it will produce too much, and you'll become engorged. Feeding the baby takes care of that problem. Whether or not you breastfeed, you need to be aware of any warm, tender, or red areas on your breast which may be a sign of infection.
Now I can't stop peeing!
So you finally got to urinate after delivery, and now you can't stop. Your body has been retaining fluid, and now it's time to let it all out. Once again it's time to play "I must be within 50 feet of a bathroom at all times." This goes away after a couple of weeks. Keep drinking your water.
Laugh, sneeze, cough, and dribble.
Along with frequent peeing, you may also experience incontinence because your bladder muscles are in a bit of shock after the ordeal and while everything starts moving back into place. Wear a panty liner. If you have a lot of urine leakage, you may need to start investing in incontinence pads. Talk to your doctor about it if it doesn't go away by the end of the normal recovery period. Unfortunately, some women never get their normal bladder control back, but have hope because many do.
Is it hot in here?
Another way that your body tries to get rid of excess water is by sweating, so don't be surprised if you suddenly have episodes of sweating or hot flashes.
Help! I'm going bald.
No, you won't go bald, but you will lose some hair. While you're pregnant the amount of hair you shed daily normally is reduced due to hormones. After the delivery of your baby, those hormonal balances resume and your body starts shedding hair again. It may seem like a lot, but I promise you won't go bald.
What? No boom boom?
No sex until your doctor gives you the okay. You probably won't feel like doing much anyhow for awhile. (Sneaky hint: Some of us don't have partners who completely understand how we may feel after giving birth, and this may cause some arguments. Even if your doctor says you're ready for sex again and you just don't feel like it, feel free to lie to your partner and insist that the doc said you aren't ready. If you have a really cool doctor, have him/her write a "no sex" note.)
Postpartum Emotional / Behavioral Disorders
This includes, but is not limited to, postpartum depression/anxiety, postpartum obsessive compulsive disorder, postpartum panic disorder, post traumatic stress disorder, postpartum bipolar disorder, and postpartum psychosis. Postpartum blues is not considered a disorder because most women get it and it goes away by itself, but I include it under the disorder category anyhow. It is incredibly important that you learn about these disorders before you give birth so you can quickly recognize when you have a disorder and treat it as soon as possible (and no, you are not allowed to do the "it won't happen to me" or "I'll just deal with that if it happens" excuses; nobody thinks it will happen to them, and everybody thinks "It can't be that bad" until they end up going through it and are suddenly living a nightmare and think they are going crazy or just a horrible mom). The longer you wait, the more emotional damage it does to your children and to your relationship with them. For more information about postpartum emotional and behavioral disorders, see Postpartum Disorders.