In the past nine months, your body has changed to prepare you to give birth to your child. Now, various mechanisms are kicking in to help you regain your pre-pregnancy condition and functioning (Gagnière, Diane et al., p. 13, 2001).
This period, known as post-partum, lasts for about six weeks, but adjusting emotionally and socially to your new role can take as long as one year.
You must therefore be patient and allow your body and mind the time it needs to adjust to these many changes.
The following are the physical and emotional changes you can expect to see during this period, and the personal care
recommended.
POST-NATAL BLEEDING
The vaginal bleeding that follows child birth consists of blood and tissue from the uterus. This discharge will be bright red and a little heavier in the first two days than your regular period. It will gradually diminish, and change from red to pink and eventually a yellowish-white.
The bleeding usually lasts from two to six weeks. It is important to change your sanitary napkin often, every 3 to 4 hours, and to wait for your first period to begin before using tampons.
In the first few days, the discharge may contain small clots. This often occurs in the morning, after you have been lying down for a few hours.
Bleeding may also increase during breastfeeding due to uterine contractions.
UTERINE CRAMPS
After your child is born you may experience cramping. This is normal and helps your uterus return to its pre-pregnancy size.
Cramping is more frequent in the first week and occurs more often in women who have had more than one child. It often happens during breastfeeding because the hormone responsible for releasing mother’s milk is the same
hormone that causes uterine contractions: oxytocin (Health Nexus Santé, p. 3, 2011).
Here are a few suggestions for relieving the pain:
- Practice breathing techniques and relaxation;
- Lie face-down;
- Take a warm bath;
- Apply heat;
- Take an analgesic if necessary (acetaminophen and/or ibuprofen).
PERINEUM
The perineum is the area between the vagina and anus. It can remain sensitive and sometimes sore for a while after a
birth, especially if you required stitches (Institut national de santé publique du Québec, p. 169, 2012). The stitches dissolve on their own and disappear within two weeks. Full healing of the tissue takes from four to six weeks. - You can apply an ice pack to the perineum for 20 minutes every two or three hours, especially in the first 24 hours, to reduce swelling and relieve pain.
- Warm baths or a sitz bath (shown to you in hospital) is also recommended two or three times a day for about 15 minutes.
- It is extremely important to wash the perineum with gentle, scent-free soap and dry the area well. To avoid infection,rinse the area with warm water after each urination or bowel movement, and pat yourself dry from front to back to minimize irritation and discomfort.
- For pain relief, you may have to use a cream prescribed by your physician or midwife and take an analgesic.
- Kegel exercises are important to restore muscle tone in your perineum. These exercises involve contracting your pelvic floor muscles, as though you were holding in urine or gas. These exercises not only reduce swelling and discomfort, they also speed up the healing process.
- HEMORRHOIDS
- Hemorrhoids result from the swelling of blood vessels in the anus and rectum. They commonly occur during the late stages of pregnancy and while you are pushing during labour. They often resolve on their own in less than two weeks. Here are a few tips for relieving the discomfort of hemorrhoids:
- Take a sitz bath two or three times a day for 15 minutes;
- Apply a topical cream or ointment as recommended by your physician or midwife;
- Do pelvic floor muscle exercises (Kegel);
- Eat a high-fibre diet to relieve constipation;
- Drink plenty of water;
- Avoid standing for long periods of time;
- Sit on a pillow with your feet raised on a stool.
URINARY FUNCTION
In the first few days after delivery, you may experience some difficulty in urinating due to swelling of the perineum, tearing near the urethra or the use of a urinary catheter during your labour. Try to urinate often to avoid over filling your bladder (Health Nexus Santé, p. 7, 2011). A distended bladder can prevent the uterus from contracting properly and cause a heavier blood flow.To help you begin urinating, try:
- Turning on a tap;
- Squirting warm water on the perineal region using a squeeze bottle;
- Urinating in the shower or on a bath seat.
Some women may experience temporary urinary incontinence (accidental urine leaks) caused by weak pelvic floor muscles. To help you tone up these muscles, Kegel exercises can help. - BOWEL FUNCTION
- Women usually go without having a bowel movement for two or three days after their baby’s birth. This may be caused by weak abdominal muscles, pain medication, sluggishness and reduced food and liquid intake during labour.(Health Nexus Santé, p. 7, 2011).
- To help return your bowel function to normal, try the following:
- Drink plenty of liquids;
- Eat a high-fibre diet;
- Engage in mild forms of exercise such as walking;
- Massage the abdomen;
- Take a stool softener as needed (100 mg of docusate sodium (Colace), twice a day).
C-SECTION WOUND CARE - The incision must be cleaned gently with mild, unscented soap, rinsed and thoroughly dried. The wound is left exposed to the air unless your physician asks that it be bandaged.
Staples are removed before your discharge unless your physician instructs that they be removed at his or her office a few days later. Wound closure strips (small white adhesive bandage) are applied after the staples are removed. They detach in 7 to 10 days. Remove them yourself after 10 days if they do not come off on their own.
Once you are back home, continue to carefully clean the incision, even when closure strips are used. Pain, swelling and bruising around your incision is normal. This will last a few weeks and then gradually fade.
Source: Hôpital Montfort.
