It is normal to have questions about the time after the birth of your baby. This is known as the postpartum period. It begins with your baby’s birth and lasts until your body has healed from childbirth. You may experience emotional, as well as physical, changes during your postpartum period, and it will be important for you to get adequate rest. This pamphlet will let you know some of what to expect during this time.

While Still at the Hospital

• What to expect: Your nurse will check your temperature and blood pressure, perineum, uterus, and the amount of vaginal bleeding. Education is important during your hospital stay. Your nurses will show you how to care for yourself and your baby. Be an active partner in your recovery by asking questions.
• Activity: Your nurse will give you guidelines about getting out of bed and walking around. The first few times you get out of bed, you may feel lightheaded or dizzy. Call for help the first two times you need to get out of bed. If you become dizzy or faint in the bathroom, use the emergency call light to get help. These precautions are for your own personal safety.
• Showering: Most new mothers are up and about 4 to 6 hours after delivery. Many enjoy a shower to help them relax after a long labor. Ask your nurse when you may take a shower and for extra linens. You may want to wear a hospital gown for the first 24 hours, as your lochia (vaginal blood) flow may be heavy and can soil your clothing.
• Meals: You will probably feel exhausted and hungry after giving birth to your baby. Drink lots of water to help replace fluid lost during the birth process.
• IV’s: The intravenous line (IV) may remain in your arm for several hours after you deliver. It helps replace fluid in your body. A medicine, Pitocin, may be put into the IV solution. This medicine helps tighten your uterus and decrease bleeding.
• Going Home: Be prepared to wear maternity clothing when you leave the hospital. Your abdomen will still be “swollen” and you will still look pregnant.

Physical Changes

• Uterus: After your baby’s birth, the uterus tightens firmly to the size of a large grapefruit. Immediately after giving birth your nurse may aggressively massage the uterus to help it contract and shrink down. Over the next several weeks, the uterus will continue to shrink to its non-pregnant size. Your uterus will be checked at your postpartum doctor’s visit to make certain it remains hard and firm. If your uterus becomes soft and spongy, vaginal bleeding may increase.
• Vaginal bleeding: Bleeding from your vagina after delivery is known as lochia. Vaginal bleeding will usually last for 2 to 6 weeks after delivery. During the first 24 hours, the bleeding is like a heavy menstrual period. You also may pass small clots, a watery liquid, or uterine lining that looks like clear skin. The discharge will decrease daily and change from red to pink, to dark brown, and then to clear. You will be given sanitary pads to use while you are in the hospital. Do not use tampons.
• Breasts: In 3 to 5 days after delivery, your breasts will fill with milk. They may leak at times and may become tender if they overfill with milk. This is known as engorgement.
• Common discomforts: In the first weeks of motherhood, you may have some of the following discomforts. Your health care provider can suggest ways to relieve these common discomforts. They include sore muscles around the vagina (perineal area) or stitches, cramping, sore breasts, difficulty passing urine, hemorrhoids, fatigue, constipation, and back & hip pain as your muscles readjust to the absence of the baby’s weight.

At Home

• Activities: You should take it easy and be sure to get adequate rest following the birth of your baby. Many women want to resume their normal activities right away, but this is not advised. Physical activity should be limited. You should limit your lifting to the weight of your baby and car seat. Exercise and other strenuous activities should be avoided during the first 3 weeks (longer if you had a cesarean delivery). You should also not drive a car if you are taking prescription pain medication.
• Pain control: Take pain medication as prescribed by your doctor. Ibuprofen is recommended too (unless you are allergic) because of its ability to reduce inflammation. You can take Ibuprofen with most prescription pain medications, but please check with your doctor or nurse.
• Constipation & Hemorrhoids: Some women may become alarmed after delivery when they do not have a bowel movement that first day. It can take 2-3 days before your bowel function returns to normal. Prescription pain medication may cause constipation. Stool softeners, like Colace or Milk of Magnesia, are okay to use even if you are breastfeeding. If you think you may have a hemorrhoid, we suggest Tucks pads for comfort. Keep your bowels soft by eating a high fiber diet, drinking lots of water, and using stool softeners as needed.
• Mood changes: It is more common than you think for women to experience anxiety, irritability, anger, sadness, and fatigue after delivery. For some women, these feelings can linger and become a more serious condition called Post-Partum Depression. Post-Partum Depression can occur at any time, days or even months, after delivery. If you feel that you are depressed, call your doctor for an appointment.
• Post-partum doctor’s appointment: You should have an appointment with your doctor 4-6 weeks after your delivery (sooner if you had a c-section). This appointment will be to check the size of your uterus, evaluate you for adequate healing, and to discuss birth control methods (if needed).

When to Call Your Doctor

If you have any of the problems listed blow, take your temperature, and then call your doctor’s office immediately:

• Heavy bleeding or passing blood clots larger than a golf ball is not normal. Vaginal bleeding will decrease every day. Bleeding will change from a red color to pink to dark brown, and then to clear. This discharge will continue for 2 to 6 weeks. If you pass bright red blood clots and/or have the need to change your pad more often than every 2 hours, your bleeding is heavy.
• Chills with a fever of 101 degrees or more.
• Frequent and/or painful urination.
• Blood in your urine.
• Swelling and/or pain in your legs or feet. (C-section patients should expect swelling in both legs.)
• Dizziness, headaches, and/or blurred vision.
• Soreness, pain, red spots, or red streaks on the breasts.
• Severe and persistent pain in the abdomen, vagina, or in the area of stitches.
• Vomiting.
• Foul-smelling vaginal discharge.
• Drainage from an incision or sudden opening of an incision.
• Feeling like you cannot cope with the care of yourself and the baby. Excessive crying, anger, or feeling overwhelmed are all signs of post-partum blues.

**If you have any questions or concerns, call your doctor’s office. They will be happy to help you.**

Sex After the Birth of Your Baby

You may have concerns about resuming sexual activity after the birth of your baby. Your body goes through many changes during the postpartum period. Sex with your partner may be uncomfortable at first. Do not be afraid to talk to your partner about your concerns.

• Vaginal bleeding: Your body needs time to heal. You may have sex again after your vaginal bleeding, or lochia, stops and your stitches have healed. Healing of the uterus, cervix, and vagina takes place during the first 4 to 6 weeks after delivery.
• Vaginal tenderness or dryness: You may have tenderness in your vagina and perineum. Encourage your partner to go slowly. After delivery, the level of estrogen in your body decreases. Estrogen helps to lubricate the vagina during sex. The level of estrogen remains low in women who are breastfeeding. You can use a water-soluble lubricant, like K-Y liquid or Astroglide, to help add moisture.
• Breast tenderness: Let your partner know if your breasts are tender. Discourage your partner from touching your breasts during the post partum period if you are bottle-feeding. Touching helps stimulate milk production. If you are nursing, breastfeed you baby an hour before having intercourse.
• Fatigue: Caring for your newborn baby is demanding and you may not feel like having sex. Talk to your partner about these feelings. Getting enough rest, emotional support, and eating a well-balanced diet can help boost your energy level.
• Birth control: When you decide to have sex, choose a good birth control method. You can become pregnant in the first month after delivery. Breastfeeding does not prevent pregnancy. Ask your health care provider for more information about birth control methods for the postpartum period.