Even though every delivery is different, each woman's labor usually comes with predictable stages that you can read about in any reliable pregnancy book. It's after the baby's born that many women are surprised by how they feel. After you've delivered your baby, you'll have some residual aches and pains -- perhaps some that your friends and relatives might not have talked about. Here's what you can expect after the baby is born.
What can I expect to feel like after labor and delivery?
If you've already taken your childbirth education class, you understand that childbirth and the first few days and weeks afterward are no picnic. Here are some of the issues you may have to deal with after you deliver your baby:
Continued forceful contractions
Your uterus was stretched to capacity during pregnancy, and as it shrinks back to its normal size, you may feel cramps that may be very painful. They usually subside within a few days of delivery. Within about six weeks, your uterus will be back to its normal size and the cramping should disappear (though some women continue to feel cramps for a bit longer, especially when they're breastfeeding). Placing a heating pad on your abdomen may help ease the discomfort, and an over-the-counter pain medication will also help. If your pain is significant, your doctor can prescribe something stronger.
The strain of labor often results in painful hemorrhoids, which are swollen blood vessels that may bulge out of your rectum during labor. (They're also a common side effect of pregnancy.) There are a number of over-the-counter treatments that should bring relief, including witch hazel pads (try refrigerating them before placing them on your bottom), sitz baths, and medicated sprays and ointments. Straining during bowel movements will make hemorrhoids worse, so be sure to include lots of high-fiber foods in your diet and drink plenty of water. Your doctor can also prescribe a stool softener if the other remedies don't work.
Your abdominal muscles have been stretched to their maximum, you may have stitches in your perineum that make you reluctant to move your bowels for fear of tearing open the incision (don't worry, you won't) and you may be in pain from hemorrhoids. Any of these can contribute to constipation. To keep your bowels moving, eat high-fiber foods, drink plenty of water, and get out of bed and walk as soon as possible.
During delivery, a baby can put tremendous pressure on your bladder and urethra. The swelling that results can make it difficult to pass urine. Taking warm sitz baths can relieve some swelling and pain, and spraying warm water on your bottom while you try to urinate may also help stimulate the flow of urine. If you are having problems with incontinence, doing pelvic strengthening exercises -- the same Kegels that are recommended in childbirth classes -- will help strengthen the muscles that were stretched during pregnancy and delivery.
After your baby's birth, your hormone levels will change and your body must adjust accordingly. This can mean that you find yourself sweating even when you're not exerting yourself. There isn't much you can do to avoid this, but drinking plenty of water seems to help.
During pregnancy your uterus was lined with blood and tissue that it doesn't need any more. After your baby is born, this blood and tissue is expelled through your vagina. At first, the discharge may be bright red and heavy at times. It may also have some clots of blood in it. With each day, the flow should lighten until it's light brown or yellowish; it should finally disappear about a month after delivery, although it can last as long as eight weeks. Use sanitary pads to soak up the lochia, rather than tampons.
A sore bottom
When you pushed your baby out, your perineum, the area between your vagina and rectum, stretched to make room for the baby's passage. So afterward, you can expect your bottom to be quite sore, especially if you had an episiotomy or if your perineum tore during childbirth. You can use cold packs or chilled witch-hazel pads to soothe the pain, and you might also ask your doctor for a spray or cream that will numb the area. Sitz baths may also help, and so will pouring warm water on your bottom while you urinate. (Be sure to wipe from front to back when you have a bowel movement to prevent bacteria from getting near your vagina or urethra, where it can cause a bladder infection.)
Sore and swollen breasts.
Within a couple of days after childbirth, your breasts fill with milk in preparation for breastfeeding. This can make your breasts feel very hard and tender. If you are breastfeeding, the soreness will subside once your baby starts nursing consistently. Until then, you can ease the pain by applying ice packs to reduce swelling, and wearing a support bra during the day and perhaps even at night. (Avoid bras with underwires, as they often lead to blocked milk ducts, which can be very painful.) Pumping excess milk is another helpful measure, and some doctors advise women to invest in an electric breast pump.
If you do not plan to breastfeed, the engorgement may last for several days, but if your breasts aren't stimulated to make more milk, the breasts will soon empty. It is safe to use the pain medications acetaminophen and ibuprofen as recommended while breastfeeding.
It is very common to feel sad and anxious after having a baby. What makes it worse is thinking that you're supposed to feel elated. Yet postpartum blues affect the majority of new mothers to one degree or another (as many as 80 percent of moms have some degree of postpartum blues, according to the American Congress of Obstetricians and Gynecologists).
In most cases, the blues fade within a couple of weeks. In the meantime, you might find that it helps to talk about your feelings with your partner, a family member, or a friend who has had a similar experience. You should also make sure you're getting enough rest, eating nutritious foods, and taking at least a few minutes of every day to do something for yourself. Even a 10-minute walk around your neighborhood or a quick session of meditation can help you feel more relaxed and in control.
In some cases, about 10 percent of the time, women have true postpartum depression. If two weeks after your baby's birth you are still experiencing feelings of sadness, doubt, guilt, or helplessness that seem to be getting worse, if you can't sleep even when you are very tired -- or if you're sleeping all the time -- if you have no interest in your baby or your family, or if you're feeling nervous about being alone with your baby, call your health care provider immediately. Postpartum depression is very serious, and your physician will help you find the treatment you need immediately.
What are signs that something is wrong and I should call my doctor?
- A fever that is higher than 100.4 degrees F
- Nausea and vomiting
- Pain during urination
- Bleeding that suddenly increases in volume, which may indicate that parts of the placenta are still attached to your uterus, or another significant problem
- Severe pain -- not just cramps -- in your abdomen
- Pain, swelling or tenderness in your legs
- Pain from an incision or episiotomy that doesn't get better
- Foul-smelling vaginal discharge
- Discharge or redness in the vaginal area
- Red streaks or painful lumps in your breasts
- Feelings of sadness, guilt or hopelessness that linger for more than two weeks after your delivery
Cleveland Clinic Health Information Center. Physical Changes after Delivery. September 2009. http://www.clevelandclinic.org/health/health-info/docs/2800/2804.asp?index=9682
Sutter Health. The New Mom: Physical Changes. http://babies.sutterhealth.org/afterthebirth/newmom/pp_physical.html
American College of Obstetricians and Gynecologists. Your Pregnancy and Birth. Fourth Edition.
Cleveland Clinic Health Information Center. Hemorrhoids. http://www.clevelandclinic.org/health/health-info/docs/0100/0127.asp?index=4242
La Leche League. Breast Problems and Pain. Sept. 2006. http://www.llli.org/NB/NBbreastproblems.html
Merck Manual. Problems Affecting the Woman. Second Home Edition. 2008 http://www.merck.com/mmhe/print/sec22/ch261/ch261d.html