The baby is out...now what?! Post partum is the time following the delivery of the baby and placenta. It is usually considered to include the first 6 weeks after delivery but you may hear this phrase used up to a year later.
POST PARTUM FAQ
How long will I stay in the hospital after delivery?
For an uncomplicated vaginal delivery, usually 24 hours. Some parents stay up to 48 hours to get additional help with newborn care and breastfeeding. If you have a c/section, you will stay 2-4 days following surgery depending on your individual situation.
What happens in the hospital after delivery?
In the hospital, you are closely observed for bleeding, infection, fever, and high or low blood pressure. It is also a time of education where you will learn how to breastfeed the baby, wrap the baby, change diapers, etc. Post partum nurses teach you how to care for yourself and baby at home and what danger signs to watch for. The baby is examined by a pediatrician for any newborn conditions such as jaundice. If you want your male child circumcised, this is usually done in the hospital prior to going home. Please note that sometimes circumcision is done later in the doctor's office instead of the hospital. If you have vaginal stitches from delivery or a c/section incision, you will be taught specifically about wound care. Of course there is paperwork to complete for the birth certificate, medical insurance, and employer leave of absence as well. If you choose, the baby will have his/her first vaccines (usually Hepatitis B) and you may be offered a Tdap, flu vaccine, or Rubella booster vaccine depending on your personal medical history. If your blood type is Rh negative, and the baby's is Rh positive, you will be given a Rhogam injection before you leave the hospital.
When will my next appointment be?
If you have a c/section you will usually have an appointment within 2 weeks to check your incision and then a routine post partum visit at 6 weeks. If you have a vaginal delivery, you will usually be seen 6 weeks after delivery. If you have any problems such as fever, excessive bleeding, severe pain, breast infection, or depression then call your doctor for a sooner appointment.
When will my baby's next appointment be?
Usually within a few days of delivery. The follow up for your baby will be determined by the baby's doctor.
Will my stitches be removed?
If you have vaginal stitches from a vaginal delivery, these usually dissolve on their own and there is nothing you have to do. If you have staples or small metal clips in your belly from a c/section, these are removed sometime during the first week after surgery, often on the day you leave the hospital.
What are my limitations after a c/section?
No lifting anything heavier than the baby for 6 weeks. No sex, tampons, douche or anything in the vagina for 6 weeks. No driving if you are taking narcotic medications for pain relief. Activity such as walking is okay but avoid strenuous exercise for 6 weeks. Notify your doctor immediately if you have a fever, drainage of blood or pus from the incision, or expanding redness around the wound. It is okay to get the incision wet in the shower but be sure it is dried well afterwards. Do not apply lotions, creams, or medications to the incision unless instructed to do so by your doctor.
What are my limitations after a vaginal delivery?
No sex, tampons, douche or anything in the vagina for 6 weeks.
Does my c/section incision need to stay covered?
No. It can be open to air unless you have been instructed to cover it by your doctor. The only reason to keep it covered would be to protect your clothing from any blood or liquid drainage that may come out of the incision during healing.
Can I take a bath?
Every doctor has a different opinion on this so ask your specific physician if it is okay for you to take a bath during the 6 weeks following delivery. Personally, I think it is okay after the first week or so but there are many different opinions on this topic.
When will my baby boy be circumcised?
Usually this is done in the hospital prior to the baby going home; however, some physicians prefer to do this procedure in the office a few days later.
What is done at my 6 week post partum office visit?
This visit will review your general health and medications, any issues with nursing, birth control options, and check for post partum depression. Sometimes a pap smear is also done at this appointment.
When should I start birth control?
It is possible to become pregnant in the first month after delivery. Do not assume that just because you are breastfeeding or just because you had a baby that you cannot become pregnant. It is important to start contraception 6 weeks after delivery unless you are planning another pregnancy.
What types of contraception can I use while breastfeeding?
You can use one type of birth control pill (commonly named Micronor), Depo Provera injection, Mirena IUD, Paraguard IUD, or condoms. Any estrogen containing method such as most pills, the patch and Nuvaring can dry up your breast milk, so these are not advised. Remember, breastfeeding is not a reliable method of pregnancy prevention.
What are the baby blues?
Baby blues are mood swings, sadness, and tears that can occur in the first 2 weeks following delivery. Delivering a baby is an emotional, exhausting, and life changing experience. Your body will go through huge changes in the first few hours, days, and weeks after delivery. Also, life as you know it will never be the same after childbirth. Your relationships, your routines, your body, and your life outlook all change. It is natural to feel overwhelmed, tearful, and confused about these changes at first. Usually by 2 weeks after delivery your sadness should be improving, and you should be less tearful. If you are not feeling better or if you are feeling worse, you may have post partum depression (see below).
What is post partum depression?
Post partum depression can occur anytime from delivery up to 6-12 months after childbirth. It is more common in women who have depression prior to or during pregnancy and in women with other psychiatric conditions such as Bipolar disorder, or anxiety; however, it can happen to anyone. This condition is often frustrating because people want to feel happy about having a baby but instead find themselves very depressed. They worry that they are not being good parents. Without treatment, bonding with the baby is affected, and symptoms can worsen to an unmanageable level. Some stress is normal after the life changing event of childbirth; however, if your mood is down, please discuss this with your doctor immediately. Signs of post partum depression can be feeling hopeless, depressed, angry, or tearful most of the time, not wanting to take care of yourself or the baby, having trouble doing the things that you normally do, and having thoughts of harming yourself or others. There are many good treatments for post partum depression including counseling, sleep/rest, support, physical exercise, acupuncture, and medication. Call your doctor immediately if you think you may be experiencing this condition.
When will my bladder be normal again?
Many women experience trauma to the underside of the bladder during childbirth. As the baby's head comes under the bladder during pushing, the strong fiberous tissue called "fascia" that normally supports the bladder like a hammock can get torn or stretched. Torn fascia can cause the bladder to bulge into the vagina and to leak urine with cough/sneeze or exercise. If you experience leakage of urine following delivery there are many strategies to help you. Pelvic floor physical therapy and biofeedback can improve most situations. Keeping your bladder empty by urinating every 1-2 hours throughout the day can also help retrain your bladder to hold urine. Avoiding caffeine and carbonation also helps. Some cases require surgery to repair the fascia in order to completely stop the leakage. If you need surgery, we usually recommend that you wait until you are completely done having all your children before having the procedure. If you have the procedure after baby #1, you are likely to tear the fascia again during delivery of baby #2 and be back to where you started.
When can I have sex?
We usually advise people to wait 6 weeks following delivery or c/section to have sex although many couples resume intercourse sooner. If you had stitches placed in your vagina during delivery, they may take longer to heal than 6 weeks. If you attempt to have intercourse and it is painful, stop and wait a few more weeks. If the pain continues, discuss this with your doctor. Pelvic floor physical therapy can be very helpful in reducing pain. Also, you may need to be tested for infection and/or be examined carefully to be sure that your stitches have healed correctly. Also, remember that you can get pregnant even a few weeks after delivery if you are not using contraception. Many people find themselves pregnant at their 6 week post partum doctors appointment. When I ask them why they did not use some form of pregnancy prevention I usually get the response "I thought I couldn't get pregnant because I just had a baby." Funny logic. In fact, the opposite is true. If you just had a baby you have shown that you can indeed become pregnant. Many forms of contraception can be started within a few days of delivery and can be used during breastfeeding. If you plan to have intercourse prior to your 6 week check up, request birth control from your doctor before you leave the hospital.
*The material presented here is intended to be used for information only, not for medical decisions. Each pregnancy and medical history is unique and the information presented may not apply to your individual pregnancy. Please attend routine prenatal and medical care andconsult with your doctor regarding any questions and/or concerns you may have. Also, please note that images are from googleimages.com*