Following the birth of your baby the postpartum period begins. It is the most critical period of pregnancy for both Mum and Bub. From the immediate time following the birth and up to six months down the track there are many physical and emotional changes that take place.
Immediate post birth period
Early skin-to-skin contact is recommended for all healthy babies. This benefits both mother and baby in a number of ways including improved breastfeeding rates and a smooth transition to the world outside the uterus.
Pain in this early period stems from operative births, such as caesarean section, perineal tears or swelling and afterbirth pains. Simple measures such as ice to the perineum, heat packs and simple pain relief remain our first line of management.
Bleeding is monitored closely to ensure that the uterus contracts well post birth, reducing blood loss. After two days of quite heavy bleeding, the blood loss or lochia substantially decreases to a peach to red mucousy loss. The uterus continues to involute, returning to its ‘normal’ size over the next six weeks.
The first six weeks
Monitoring of signs of delayed postpartum haemorrhage continue as bleeding from a relaxed uterus, retained placenta and infection can occur days to weeks post birth. To reduce the risk of infection, it is recommended to use sanitary pads and avoid intercourse, pools and spas until your bleeding has settled.
Breast milk commonly ‘comes in’ around Day 4 for first time mums and a little earlier for subsequent pregnancies. Often this time coincides with hormonal changes, which may contribute to the ‘blues’ (but the blues can occur at any time). If they are not settling or hinder your ability to do daily activities then further review should be sought to ensure early diagnosis and management of postnatal depression and associated conditions.
Prior to discharge from the hospital, we encourage physiotherapy review to assist with your changing body in the postnatal period. This can help to prevent any injury due to laxity of connective tissue and muscles, reduce impact on the pelvic floor and encourage a return to usual activities.
Six weeks to six months and beyond
All women recover at different rates from the numerous changes that have occurred over the nine months of pregnancy. Rest is important to ensure adequate healing and reduce further damage. Jumping back into exercise too early can potentially increase damage long term. If you are a keen athlete or love the gym, linking in with a Women’s Health physio will be important to plan your return to exercise.
Though the days can disappear in the midst of looking after your baby, don’t forget to look after yourself! Stock the freezer ahead of time with easy meals. Don’t be shy in asking for help or accepting help when offered. Friends and family are always happy to bring a snack or meal as payment for newborn cuddles and will usually be happy to watch the baby so you can have a nap.
Whether considering more children in the future, don’t forget contraception. There are numerous options including hormonal and non-hormonal, short acting, long acting and permanent. Talk to your obstetrician or GP about your needs.
If you are finding this period difficult, please seek assistance, see your GP and talk to your family and friends. Call the hospital, your obstetrician or the paediatrician. We are all here to see you through this very special, life changing time.
By Dr Kylie Isaacs. Kylie is an Obstetrician and Gynaecologist that cares for women through all stages of their life. Find her at www.drkylieisaacs.com.au or Phone 5444 4433.
For more birth tips, try What is a Doula and do I need one? and 5 simple tips for a (mostly) comfortable pregnancy.