Congratulations! You have had one of life's most profound experiences. If this is your first child, your life will be turned upside down! It is important to give yourself time to adjust. You have a new person in your life, new roles for you and your partner, and changes in your body.

• Physical Changes
• Emotional Changes

Physical Changes

Vaginal Discharge

You will have vaginal discharge after birth for several weeks. It is a combination of the uterine lining and blood called "lochia." It is common for the drainage to stop and start, and in the early days it may contain small blood clots. The drainage will gradually decrease and become pale pink and finally white. Use sanitary pads rather then tampons. If you are having bright red, heavy bleeding, using more then one sanitary pad in less then an hour or having large clots, please call your doctor or nurse practitioner immediately.

Breastfeeding

Your milk supply will "come in" in 48 to 72 hours after delivery. Your breasts will become firm and tender. This is called "breast engorgement." If you are breastfeeding, frequent nursing will help prevent engorgement. You can call a lactation consultant if you have questions or problems.

If you are not breastfeeding, a snug fitting bra will help minimize breast engorgement. Avoid nipple stimulation and milk expression. Apply ice packs to decrease the swelling. Consider a mild pain reliever, such as Tylenol. Avoid warm water directly on your breasts when you shower.

Perineum

Keeping your perineum (tissue between the vagina and rectum) clean and dry will promote healing. Wash your hands before changing pads. Always wipe from front to back. Wash daily with soap and water. Change sanitary pads whenever you use the rest room. If you had an episiotomy, the stitches used to repair the incision will dissolve in about two weeks. Use an ice pack for comfort. You may also use a portable Sitz Bath or sit in a shallow amount of warm bather water. Alternating heat and cold may be helpful. Again, it is important to keep the area clean and dry.

Constipation

Avoid constipation by adding fruits, vegetables and whole grains to your diet. Drink plenty of fluids You may try Metamucil® or a stool softener such as Colace® to avoid straining with bowel movements and cause pressure on the stitches.

Hemorrhoids

Many women develop hemorrhoids during pregnancy. Avoid constipation by drinking plenty of fluids, fruits and vegetables. Using ice packs and cold pads containing witch hazel may relieve the pain of hemorrhoids.

After Birth Pains

As your uterus returns to its pre-pregnancy size, you may notice cramping pains called "after birth pains." Immediately after delivery, while in the hospital, nurses will apply deep massage to the uterus to help it contract. Keeping the uterus firm in this way also helps prevent excessive vaginal bleeding. Cramping is sometimes more painful for women who have had other pregnancies, as the uterus needs to compensate for the previous stretching to return to pre-pregnancy size.

Lack of Energy

All mothers feel fatigue in the early recovery period. This tired feeling may last weeks or even months. Your body needs time to recover and adjust to parenthood. Treat yourself kindly. Lower expectations for you and your partner. Give up as many household responsibilities as you can for now. Consider hiring help. It may take months to recover from pregnancy and delivery. In the meantime, you must devote yourself to baby's needs, which occur at all hours of the day and night. Avoid dieting in the early recovery period, especially if you are breastfeeding. Your body needs a healthy, sensible diet to aid healing. Drinking plenty of fluids and getting exercise daily will also help manage fatigue and reduce tension and frustration.

Sex

Sexual intercourse may be resumed after healing has taken place and vaginal discharge has stopped, usually in three to four weeks. Do not be surprised if sex is uncomfortable the first few times. Your vagina may be dry and tender. You will be fatigued and may be distracted by the baby. Rest assured that your sexual relations with your partner will return to normal. If you do not wish to become pregnant again right away, you must use some type of birth control. Breastfeeding will not prevent you from becoming pregnant again.

You may try using a water soluble lubricant, such as K-Y jelly or AstroGlide, especially for breastfeeding moms. When breastfeeding, maternal estrogen levels are very low and ongoing dryness and discomfort can be an issue.
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Emotional Changes

Many mothers feel postpartum blues in the weeks after delivery. You may feel overwhelmed with the responsibilities of caring for an infant, changes in your relationship with your partner and exhaustion. Feelings are also affected by the hormonal changes your body is undergoing. It is normal to experience insomnia, tearfulness, mild anxiety, sadness, and irritability. These feelings are normal, and will usually subside as you and your family adjust. If, after two to three weeks, you do not feel better, please contact your health provider.
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