The weeks immediately after childbirth are called the postpartum period, and during this time your body undergoes many changes. It’s important to understand what is normal so you can recognize any problems that might need your doctor’s attention.

Bleeding and Discharge

After the birth, you’ll need to use sanitary pads to absorb the bleeding and discharge of the uterine lining. This bleeding and discharge will probably last for 4 to 6 weeks. At first, bleeding is usually brighter red and heavier than it is during your regular period. It is common to feel a gush of blood when you stand up. This is because blood pools inside your vagina when you’re lying down and is then comes out when you stand up. Occasional passing of small clots is also considered normal. Within a week, the flow of your vaginal discharge slows down and becomes thin, pink, and watery. After about 2 weeks, the discharge changes to a light-tan color and will then get darker and less over time. As you increase your activity at home, you might notice that your bleeding increases. In this case, you should decrease your activity and notify your doctor.

Caring for episiotomy

If you had an episiotomy, your doctor repaired the area using stitches that dissolve and don’t have to be removed. If the stitches are uncomfortable, you may want to try these measures:

• Use warm tap water and rinse every time you go to the bathroom. Use the plastic “peri-bottle” you were given in the hospital, and rinse from front to back. Rinsing while urinating helps to decrease stinging.
• Place one or two witch-hazel pads (Tucks) next to the stitches before applying a clean sanitary pad. You can also use numbing sprays, ointments, or foams up to 4 times a day.
• Apply ice packs to the area for the first 24 hours after birth.
• After 12 to 24 hours, try sitting in a tub filled with about 6 inches of hot water several times a day. This is called a sitz bath, and it increases blood flow to the area and speeds healing.
• Sit on a soft pillow to help cushion the area.
• Take pain medication as necessary.

To help the stitches heal and prevent infection, you should:

• Shower daily. It’s okay to use soap on your vaginal stitches.
• Change your pad every 2 to 3 hours or every time you go to the bathroom.
• After going to the bathroom, gently pat from front to back to avoid contamination.
• Rinse yourself with a full bottle of warm tap water each time you go to the bathroom, as long as you are bleeding.
• Avoid sexual intercourse, douching, or tampons until after your 6 week postpartum visit with your provider.

Afterpains (cramping)

Afterpains are cramp-like pains that are caused by contractions of the uterus. This is a normal process that helps your uterus return to its pre-pregnancy size. You may experience afterpains during the first few days following a birth, but they lessen after the first 48 hours. If you are breastfeeding, you will probably notice cramping when you’re nursing. If you need pain medication, take it no more often than prescribed. Take the pain medication 30 to 60 minutes before breastfeeding to get the most benefit from it.

Bladder infection

It is normal to have a stinging sensation when you urinate for a week or so after a vaginal birth. However, burning, painful, or frequent urination may be signs of a bladder infection. It’s important to call your doctor if you think you have a bladder infection.

Hemorrhoids

Hemorrhoids (swollen blood vessels in the area around your rectum) are a common problem during pregnancy and after birth. If hemorrhoid discomfort persists, tell your doctor. Sitz baths are helpful to treat hemorrhoids, and Tucks pads, and Anusol or Preparation H may decrease itching/burning. Call the office for a prescription medication if symptoms are not improving.

Constipation

To prevent additional discomfort following a birth, it’s important to avoid constipation. The following suggestions will help:

• Drink at least 6 to 8 glasses of fluids a day, especially if you are breastfeeding.
• Eat fresh fruits, vegetables, whole grain cereals, and breads. Adding a fiber supplement to your diet may help as well.
• You may also consider using a stool softener such as Colace, which is available over the counter to prevent and treat constipation.
• If you have hemorrhoids, don’t strain with a bowel movement.

Physical Activity

Mild activity following birth is beneficial. However, it takes about 4 to 6 weeks for your body to heal after having a baby — so you shouldn’t overdo it. For the first week you should take care of yourself and your baby, and allow others to help with your other children, meals, and laundry. After that, try to allow for frequent rest periods during the day. Avoid lifting younger children. Some form of mild exercise is good not only for the body, but also for the mind, and walking is an excellent choice.

Once you are no longer bleeding and you feel well, you may resume most of your normal activities, waiting until after your 6 week check to resume full activity.