Postpartum Instructions
Congratulations on your new baby!
This handout is designed to help promote a safe and comfortable recovery from your delivery. Please read this through and keep it available for reference. Remember, you are always welcome to call the office and talk to our Resource Nurse if you have any questions or problems.
Overactivity when you return home may cause increased vaginal bleeding, pelvic discomfort, and general weakness, and, as a result, may slow your recovery. We have included some suggestions to help you plan your first days at home with your new baby.
REST/ACCEPT HELP. It's most important for a comfortable recovery after delivery. Household chores can be done initially by relatives, husband, or friends. You may gradually increase activities over the first three weeks at home, but stop short of becoming fatigued. It is best to discourage a lot of visitors or long visits for the first couple of weeks.
POSTPARTUM BLUES. During your first few weeks at home, you may experience periods of being overwhelmed and depressed. This is due to both hormonal changes and fatigue. Feel free to contact our office if these feelings are upsetting to you or seem persistent.
BATHING. There are no restrictions on bathing and showering. For episiotomy (stitches) or perineal discomfort, we recommend sitting in a clean tub of moderately hot water for 10 minutes 3to 4 times a day to decrease the discomfort and irritation. Do not use any bubble bath, bath oils, or baking soda in the bath water.
EXERCISE. The muscles you are interested in “toning up” are abdominal, pelvic, and back muscles. You should begin the pelvic squeeze exercise in the hospital. This involves tightening and contracting the muscles around the vagina as if you were trying to cut off your urine flow in midstream. The squeeze should be repeated 10 to 20 times, two to three times a day.
Take special care to bend your knees and lift with your legs rather than with your back when lifting your baby out of a crib or on to a changing table or when lifting older children.
The following instructions are examples of additional exercises that you can begin after childbirth; these are designed to assist in strengthening back muscles but are also appropriate for toning pelvis, abdomen, and buttocks during the postpartum period. You may begin them as energy and comfort allows, but remember to start slowly and gradually increase your exercise level. See Chapter 12 (pg. 205-209) Your Pregnancy & Birth.
BREAST FEEDING. All babies require different amounts of time to nurse. Any time from as little as 5minutes to as long as 30 minutes at intervals from 2 to 4 hours can be normal, but initially you may want to limit nursing time somewhat to reduce breast tenderness. Here are some helpful tips:
Make sure the baby takes the nipple and as much of the areola (darkly pigmented area) as possible in his/her mouth. Use a pillow(s) to support the baby so that he/she is facing the nipple and at the same level as the breast.
Hold your breast so that your baby can breathe easily while nursing.
Gently remove the baby from your breast after nursing, first breaking the suction by inserting your finger into the corner of his/her mouth.
Burp your baby between changing breasts.
Start the next feeding on the breast with which you stopped at the prior feeding.
Expose your nipples to the air to dry them after feeding. Clean your nipples only with water, DO NOT use soap. Ordinary tea bags, wetted, squeezed out and applied to the breast, may be very soothing to sore or cracked nipples.
Eat an adequate, well-balanced diet and increase your fluid intake by a quart a day.
Wear a well-fitted nursing bra to provide support and to add to your comfort. Avoid underwire bras.
The Childbirth Center nursing staff and lactation consultants are available to help you develop these techniques during your stay in the hospital. Also feel free to contact Mother Baby Center or Option Care for further help..
BREAST ENGORGEMENT. If you are not nursing, there may be some filling of the breasts with milk after you are home, and the breasts may become swollen and tender. If this happens and if you are uncomfortable, apply ice bags to the breasts, wear a tight bra or breast binder, and take acetaminophen (Tylenol or equivalent) every four to six hours as needed. Avoid stimulation of the breasts - don’t express milk or massage your breasts. If you are very uncomfortable, notice red streaking on the breast, or have a temperature greater than 101 degrees, please call our office for assistance.
VITAMINS AND IRON. Continue prenatal vitamins daily while breast feeding. If not breast feeding, you may finish any vitamins you have left by taking one daily. If you are anemic, you will be instructed to take iron for two to three months following delivery whether you are breast feeding or not. Otherwise, you may finish up the iron you have left, at a dose of one daily.
INTERCOURSE. Intercourse should be delayed for two to three weeks until your heavy bleeding ceases and your stitches are comfortable. Be sure to use contraceptives when you start sexual relations again. Remember, you can get pregnant even while breast feeding if you don’t use contraception. Foam and condom together are recommended. A previously fitted diaphragm may not be effective since it may be the wrong size. Birth control pills can be started after delivery or in six weeks after your milk supply is established (if you are nursing).
LAXATIVES. Occasionally, moms require laxatives or stool softeners for a short time after the baby is born. Mild, non-irritating laxatives such as Milk of Magnesia or stool softeners such as Metamucil, Fibercon, or Citrucil may be used. Drinking lots of fluids, especially if breast feeding, and eating high roughage foods (vegetables, fruits, bran products) will help prevent constipation.
LOCHIA. There may be a bloody vaginal flow for up to six weeks after delivery. As long as this does not become heavier than the heaviest day of your menstrual period, it is normal. Contact us if your flow does seem heavy. Vaginal tampons or douches should NOT be used for two to three weeks after delivery. Use sanitary pads instead.
SIX-WEEK CHECKUP. The six-week exam is already included in your obstetrical fee and is important to check that your pelvic organs and health are back to normal. Contraceptive methods will also be discussed and begun at this time if you desire. Please call the office soon after you are home from the hospital to make this appointment. Should any problems or questions arise in the interim, please do not hesitate to call.
Once again, we congratulate you on you new addition to your family!
TELEPHONE NUMBERS
Phone numbers to have handy are:
Medical office: 671-4944 (8 a.m. to 5 p.m)
Business office: 671-4947 (9 a.m. to 5 p.m.)
Night & Weekend Emergenc:y 715-2441
Childbirth Center, St. Joseph Hospita:l 738-6360