Uterus: Your uterus should feel like firm grapefruit. If your bladder is full it may shift to your right. The top of your uterus (fundus) after birth is around your navel and decreases in size daily.
Bleeding: Remember the size of your placenta is initially the size of wound in your uterus. Your bleeding the first 2 days will be like a very heavy period and is normal to feel a gush of blood with nursing or when you stand up. What is abnormal is while at rest you feel your pad soaking. If you soak more than 2 pads in an hour or pass clots which are larger than an egg, put baby to your breast and call me immediately. Your bleeding should in the beginning have the odor of a period, if there is a foul ammonia like odor it could mean an infection, any doubts please call. Sometimes an increase of bleeding will occur as you increase your activity, listen to your body and rest more and you should expect a decrease in flow. Your lochia should gradually change color from red to pale yellow over the next two weeks. There are great variations with the completion of your flow around 6 weeks. Call if you have a 100o temperature for more than 12 hours or so in the week following birth.
Cramps: Afterbirth contractions are normal, typically occurring when breastfeeding your baby. If painful, try emptying your bladder before nursing as a full bladder can be in the way when your uterus contracts. Also try relaxing through these contractions using your breathing techniques. If pain management is needed try CA/MAG, Arnica, Skullcap, a heating pad on your uterus, or Ibuprofen.
Breasts: Typically your milk comes in between 2-5 days of the birth, at which time your breasts may feel uncomfortably full and hard. Hot compresses, and or hot showers to the breast can bring about some relief as well as gentle massage or expressing a small amount of milk. Please remember that your body will adjust to your baby's needs and that engorgement is temporary. It may be difficult for your baby to latch on when your breasts are so full, a small amount of hand expression bringing the milk to the nipple may help. Be patient with yourself and your baby…you are both learning. Most importantly nurse your baby frequently, maintain a good diet, drink plenty of fluids and sleep when the baby sleeps.
For sore or cracked nipples, exposure to sun and air can help facilitate healing. Lanisoh applied to the nipples frequently also seems to work well. At all feedings make sure the baby has a good latch on and is positioned belly to belly. If at any time you notice a hard lump, hot painful areas to your breast, if you develop a fever, or feel flu like, you may be developing a breast infection call immediately. Get plenty of rest, massage the affected area, apply not compresses and nurse the baby most frequently on the affected breast. Taking extra Vitamin C and drinking Echinacea tea can help.
If you are interested in a breastfeeding support group or have questions about breastfeeding or mothering in general you can call or attend your local La Leche League meetings. Call 1-800-525-3234 and ask for the League meeting nearest you.
Perineal Area: Showers and tub baths are encouraged to keep your perineum stay clean, many women find soaking in a shallow, warm bath several times a day eases the discomfort. A cold pack the first 24 hours eases swelling and pain. Simply resting on a blue underpad without wearing a sanitary napkin will allow air to circulate which will help speed up healing
Rest: LISTEN TO YOUR BODY. It is recommended that Mom not be left home alone the first 24 hours following the birth. Labor even the shortest, is like running a marathon. Rest well in the first week, SLEEP WHEN THE BABY SLEEPS, gradually increasing your activities the 2nd week. If possible try to have help arranged prior to the birth, with such things as sibling care, meals, cleaning, errands, etc.
Postpartum depression: Many women feel very emotional after giving birth. Some get sad, worried or irritable for a few days, weeks or in some cases months. You are going through a huge transition and with time and patience you will adjust to the new role. If you feel you are unable to cope with anything, feel numb or dazed, or that it takes an inordinate length of time to manage even the simplest of tasks, please call. It is not something to be ashamed of. There are some nutritional supplements that have helped many women.
Sex: Many people find that after birth their urge to make love seems completely dormant for varying periods - some people for as long as they are not ovulating, whether that is two months or two years. It seems that this is based on some hormonal balance and happens to many people. If it is not understood for what it is, this change in a relationship can lead to hard times. Many women feel all their energy going out to the baby, and the man feels rejected. Touching and affection are often forgotten. If both partners know what to expect, and can understand it, this fear can be removed, and both people can be free to express their affection for each other in whatever way is comfortable for both of them.
Remember your midwives are on call for any questions or concerns about you or your family for the full 6 weeks postpartum.
LAST AND FORMOST - ENJOY FAMILY LIFE!!