Postpartum expectations

Bleeding for the first 6-8 weeks following delivery is normal. It is called Lochia (LOW-kee-uh). It will begin as very heavy, bright red bleeding that will gradually diminish to a dark red, brown and then to a more yellowish color until finally beginning to look like normal vaginal discharge. During this time period, nothing at all should be introduced to the vagina. Only wear pads, no douching, and no sexual intercourse until the lochia flow has stopped and you have been cleared by your provider. Once the lochia has stopped, only then you will know the lining of your uterus has completely healed and there is less chance of getting a uterine infection.

Medications/Comfort Items

Ibuprofen (Advil) 800mg will be brought to you every 6 hours in the hospital, along with some crackers. This medicine will help with cramping, and will also help with inflammation “down below.” Most women find the ibuprofen is enough to manage their pain, but if you are still experiencing a lot of pain, ask your nurse for something else (usually taken in conjunction with the ibuprofen). You will be sent home with a prescription for the 800mg tabs of ibuprofen. If you prefer not to have that prescription filled, you can take 4 regular Advil/store-brand ibuprofen tablets (double check to be sure they are 200mg each).

Percocet is a narcotic pain medication that some women are offered if the ibuprofen is not enough. Most women who have a c-section will be encouraged to take this medication as they are weaned off their epidural pump following surgery. Because this medication is a narcotic, beware of constipation. You may go home with a prescription for Percocet as well. If you did not take it in the hospital, you may choose not to have it filled.

Senokot is a gentle vegetable-based laxative that may be offered. You can find it over the counter at your local pharmacy. It is generally well-tolerated (doesn’t cause intestinal cramping) and takes effect within about 12 hours, so it’s usually given in the evening.

Colace is a stool softener that many women take during pregnancy to help ward off constipation. I often recommend taking both Senokot and Colace during the first several days postpartum to help with those first few postpartum bowel movements. You may wish to take Peri-Colace, which is a combo medication of Senokot and Colace (all-in-one). Once things have healed up, soreness has subsided, and you are eating/drinking somewhat “normally”, you may wish to stop taking these medications. Both can be taken on an as-needed basis in the future.

Epifoam is a foam medication received in the hospital, which you use on stiches on the perineum. It helps numb the area. You may wish to ask your doctor if Dermaplast (over the counter) is an acceptable alternative, but if you use Epifoam in the hospital, you will have enough to take home with you.

Witch hazel or Tuck's pads can be used to help shrink hemorrhoids. Both can be found at your local pharmacy. To make a “padcicle,” soak a pad (one received from the hospital, preferably) with witch hazel. Place the pad in a clean Ziploc bag and put it in the freezer. Once frozen, remove it and wear it as normal. Many women find this very comforting for their swollen, sore bottoms – especially if you liked the ice pack in the hospital! It is recommended that you use an ice pack on your bottom for the first 24 hours. You may prefer to do it intermittently during that time, which is fine. You may find that the ice helps significantly and wish to wear ice packs more often than not for the first several days – that’s fine too!

Sitz baths can also be found at the pharmacy, but the hospital may offer you one as well. This plastic tub is placed directly on the toilet rim (seat up) and you sit on it as it circulates warm water on your bottom via a tube connected to a bag you fill from the sink. This helps clean your bottom, may encourage urination, and will help with healing. Many women find it very comforting. Follow this with an ice pack! (Insert sigh of relief!)

You will be given a peri-bottle in the hospital. Fill it with warm water. Squirt it on your bottom as much as necessary to help encourage urination. Once your bladder is empty, squirt your bottom again gently with as much water as necessary (you may need to have your partner get you a refill!) to help clean your bottom. Then PAT your bottom dry with hospital wash cloths or toilet paper.

Tip: If you have an upstairs master bathroom, you may consider asking your nurse for a second peri-bottle, so you can keep one upstairs, and one in your main downstairs bathroom.

Here are a dozen postpartum suggestions and must-have items for comfort and support.

Baby Blues/Postpartum Depression

Partners can get postpartum depression and baby blues too!

Be very open and honest with one another. Sometimes partners may feel left out as the main caretaker of baby gets very busy with the feed-change-sleep cycle of a newborn. Partners can help by bringing mom snacks and water (SO MUCH WATER – breastfeeding parents are VERY thirsty!) Partners can bond with baby by changing diapers. While you’re changing the diaper, kiss baby’s tummy, sing to baby, talk to baby – as baby gets older, you can blow raspberries on baby’s tummy (in the early days, it may trigger baby’s startle reflex). Other things to help with bonding: give your baby a bath (or bathe WITH baby!), read stories to baby. Offer to get baby ready for bed while your partner showers or rests for a while.

It’s SO important for BOTH of you to seek out support from other parents – not just friends, but other people who have kids and “get it.” Find a support group NOW so you know who/where to turn to for help. You can always call your doula if you need suggestions! If you already have a therapist, consider creating a postpartum wellness plan while you’re still pregnant.

Don’t be ashamed to ask for help. Being a new parent is extremely overwhelming, and no matter how much you prepare, there is simply no way to be fully prepared! Every baby is different, and each parent’s reaction to the new baby is different – and ever-changing! Some days it is completely overwhelming and exhausting. Other days, it’s so natural, easy, and overwhelming in a good and beautiful way! All these feelings are completely normal.

Perinatal depression and anxiety can affect anyone, regardless of social class, race, and even sex.

Know the risk factors. Learn the warning signs and symptoms of postpartum depression and anxiety and where you can get help.

Visitors

This is no time to entertain! So many other cultures around the world have family doting on the mother every second of the postpartum period. Did you know the first 3 months of baby’s life is considered the “4th Trimester?"

Moms in other cultures aren’t expected to lift a finger during this time. Have guests bring meals, hold the baby while you shower, vacuum your living room, fold a load of laundry, walk the dogs, or simply sit and talk with you if that’s all you need. Of course, never let anyone in your house if they are ill!

Intimacy

You’re parents now! Crazy, isn’t it?! But you know… before you became parents, you were lovers. You were partners. You were best friends. Find ways to nurture that relationship. Walk to the mailbox and hold hands. Set aside time to actually talk to one another. If you feel like you can leave the baby with a trusted family member or friend, even for a short period, go have a quick “date” at McDonald’s! Anything that can help the two of you nurture your relationship.

Once you are cleared for intercourse by your doctor or midwife, and you feel ready to resume intercourse, understand it will be different at first. If you are breastfeeding, there is a huge fluid shift in your body to help make baby’s milk. Therefore, you will likely need your lubrication of choice. Take things slowly and let your partner know if you need to stop and try again another time. Partners, be understanding.

From one of our team members: "I once told my husband, I promise I will come back to you. It takes time – like maybe 2 months of time."

Be aware that the same hormone that was responsible for your contractions, oxytocin, is also responsible for your milk letdown. Oxytocin is considered the “love hormone” and is released during breastfeeding, as well as sex. If you’re not wearing anything to cover your breasts, you may spray your partner with milk.