You and Your New Body After Childbirth

Pains, bleeding, and discomfort

After Pains

And you thought your contractions ended with the delivery of your baby! Your uterus will continue to contract in order to shrink back to its usual size and to help push out any leftover tissue. These pains might be hardly noticeable, or quite sharp (especially with the second or third child or when breast-feeding). These pains are most noticeable in the first few days after delivery. If they really bother you, ask your doctor about using a pain reliever.

Bleeding

If you thought one of the great advantages of pregnancy is not having to deal with your period for nine months—it's payback time. After delivery, you will bleed bright red blood that is like a heavy period. To add to the fun, you must use a sanitary pad—not a tampon. This heavy bleeding will continue for about three days. Then it will lighten up and turn a pinkish-brown. Eventually, it will turn white or yellow and then gradually taper off completely. This bleeding might end in about two weeks or it might last as long as four.

Your actual menstrual period probably won't resume until seven to nine weeks after delivery, but it would also be normal if it did not return for three or four months. There is really no such thing as "normal" here. The first period after delivery can be very erratic. It might be heavy or very light. It might start and then stop again for awhile. But within a month or two, your system will regulate itself. If you're breastfeeding, your period might stop for as long as you continue to nurse. (As your baby begins to sleep through the night and feed less often, your menstrual cycle might resume even though you're still nursing.)

Vaginal and Anal Discomfort

You might not be able to sit comfortably for about a week after your delivery for two reasons: (1) you've had an episiotomy or a perineal tear with repair, or (2) you have hemorrhoids. Both can be a real pain.

The episiotomy is the surgical opening that is made from the vagina toward the rectum to widen the opening for birth. If your doctor used this technique, it has been stitched up and like any cut with stitches it will hurt at first and might itch later.

If you didn't have hemorrhoids before your delivery, you might very well have them now. The pushing and straining during labor and delivery can force them out and add to your postpartum discomfort.

For the discomfort of an episiotomy or hemorrhoids you can try any of the following remedies:

• Pain medication (ask your doctor)
• Ice packs
• Warm sitz baths
• Chilled witch-hazel pads

You might also invest about $20 in a doughnut cushion. This is a pillow with a hole in the center that lets you sit down without putting pressure on your sore spots.

Bowel Battles

Pushing out your baby at delivery was good practice for your next bowel movement. During labor, bowel activity slows down and if you used pain medication, it can make the bowel sluggish, too. If you've had a cesarean, your bowels will take even longer to recover. All this adds up to large, hard stools that can be difficult to pass. Prepare for this as soon as you're ready to eat and drink after your delivery. Go for high-fiber foods (such as fruits and whole grains) and lots of water. Ask your doctor about using a natural laxative. When you do have the urge, don't strain too much because this will worsen or cause hemorrhoids. If you do not have a bowel movement after three or four days, it's time to get your doctor's okay to use an enema in order to get your plumbing working again. You can buy a simple, packaged and prepared enema at any pharmacy. Don't be afraid to use it—you've given birth to a baby; now you can do anything.

The C-Section Shuffle

Women who have had a cesarean delivery don't walk—they shuffle. They keep their feet flat on the floor and take tiny steps, shuffling one foot before the other. They do this because it hurts to walk! If you've had a cesarean, you will find out very quickly after your delivery that you don't recuperate from major abdominal surgery in a day or two. It can take two to three weeks just to start walking normally again. Your abdominal muscles have suffered a severe trauma, and even walking might be painful. (Sneezing or coughing is even worse.) In addition to the normal body changes after a delivery, you'll be recovering from surgery. So do yourself a favor and call in as much help as you can possibly get. Your baby will demand all your energy and your body will demand healing time. So get some help, let the dishes pile up, and don't worry about cleaning the house.

The Medical Checkup

About six weeks after delivery, your doctor will want to see you again. This visit is very important. Your doctor will check to make sure the uterus has returned to its normal size and position. She'll look to be sure vaginal stitches have dissolved and the cervix has healed. She will check your breasts for signs of uncooperative milk glands or engorgement (a painful condition that results if the breasts are not emptied of milk during each feeding). She will take time to talk to you about your weight, your feelings and emotions, and about contraception. This is a great opportunity to visit with someone who knows what you've been through and can help you get back on your feet.

Before this checkup you should call your doctor to report any of the following symptoms:

• Fever over 100.4°F
• Heavy bleeding (soaking a sanitary napkin every hour)
• Pain and burning during urination
• Persistent pain in vaginal and anal areas
• Painful, hot breasts
• Nausea or vomiting
• The return of bright red bleeding after it had become brownish
• Severe pain in your lower abdomen

Don't wait until your postpartum checkup to tell your doctor about these symptoms. Call right away.