Abdomen
You may be surprised that your tummy still looks pregnant for a few weeks after delivery. Your uterus is still enlarged and the muscles supporting it need time to become taut again. Within six weeks, in a process called involution, your uterus will contract back to its normal state — about the size of a small pear.
During involution, you'll experience mild cramping, or after pains, that are instrumental in clamping off blood vessels and reducing postpartum bleeding. If you are breastfeeding, you may feel these after pains as your baby nurses since this activity stimulates oxytocin, the same hormone that causes the uterus to contract.
Vagina
Your body's blood volume doubled during pregnancy. Now that it's no longer needed, the excess blood will be released through vaginal discharge, called lochia. For the first four or five days, the flow will be bright red and heavy, and may contain clots of blood. The color will gradually lighten, and may change to yellowish-pink, then creamy white. The flow should taper off within two weeks. Occasionally, it may return to a reddish color, especially when breastfeeding. If the discharge becomes heavy, remains red in color, or has an unpleasant odor, contact your midwife or physician.
Other stored fluids are eliminated through your urine which explains your seemingly endless trips to the bathroom. Some new mothers experience heavy perspiration — another way that your body chooses to eliminate excess fluids.
Constipation
One of the more undesirable side effects of childbirth is constipation which, if not prevented, can affect new mothers for at least a few days, maybe even weeks. A number of factors are responsible for this sluggish intestinal behavior beginning with out-of-shape abdominal muscles, swollen tissue following delivery, use of anesthesia, epidurals and some pain relievers. New mothers are also leery of putting pressure on the stitched perineal area and may inadvertently create a logjam.
There are several things you can do to lessen these problems: keep moving; don't sit for long periods of time; drink plenty of water; eat high-fiber foods, such as raw fruits and vegetables; and choose whole grains products.
Skin
If your skin took on the proverbial glow of pregnancy, don't be alarmed when all of that changes after childbirth. Coupled with fatigue and a host of other physical changes, your skin may feel drier and less radiant. Rest assured, your skin will regain its normal tone once your menstrual cycle begins again.
Any skin discoloration that occurred during pregnancy, such as pregnancy mask or linea nigra, should disappear about three months after delivery. Eliminating sun exposure to these areas will keep the color from darkening. Stretch marks will also begin to fade.
Exercise
You probably haven't yet been given the green light to enter into a full-fledged exercise program (and mustering the energy to even think about it is unlikely right now), but starting with simple movements soon after childbirth will boost your energy and speed your recovery.
Begin with Kegel exercises as you did during pregnancy. These will help strengthen the pelvic floor, increase blood flow to the perineum, and promote healing. They will also help prevent incontinence and help your body to regain vaginal tone.
Walking is a perfect warm-up to more aerobic exercise later on. "Walk gently, 15 to 20 minutes per day, and get out into the fresh air," suggests Hope. "By eight weeks you should be ready to resume your regular exercise routine."
Sex
If you're like most new mothers, it may take a while for your desire for sex to return. There's good reason: your hormones are still at work; you may be experiencing perineal tenderness, vaginal dryness and fatigue; and your thoughts are preoccupied with caring for your baby. "Most women say they're never having intercourse again, and certainly not by six weeks," declares Heathcote. However, she finds that the majority have resumed sex by their six-week checkup.
Waiting six weeks after delivery to resume intercourse will allow your uterus to heal and reduce the risk of infection. However, depending on the type of labor you had, this time frame may be altered.
Six-week check up
Your midwife or doctor will typically schedule you for a six-week checkup after delivery. By this time, your body is on the mend, and you've had time to adjust, though not fully, to your new lifestyle. Any concerns, both physical and emotional, should be discussed now, if not sooner.
The physical examination will include checks of the following:
* Shape, size, and location of uterus to insure that it has returned to its prepregnant state
* Episiotomy or c-section stitches have healed
* Vaginal discharge is clear
* Blood pressure
* Weight — down by about 20 pounds since before delivery
* Cervix, vagina, ovaries, fallopian tubes and perineum
* Abdominal wall if you had a c-section
* Breasts • Hemorrhoids
* Birth control
* Urine sample
* Legs for swelling or varicose veins
* Pap test
You'll be encouraged to discuss parenting issues, social support, sex, birth control, exercise, diet, breastfeeding and emotional concerns. Prior to your visit, write down questions of concern so that you won't forget them.
* taken from "Road to Recovery," Every Baby magazine, Issue Four Every Baby magazine was a publication of the American College of Nurse-Midwives, copyright 2004. To learn more about midwives and midwifery, and to find a midwife in your local community, visit www.midwife.org |
