Healing After Childbirth
Birth is a normal physiologic process, but during the days and weeks that follow the baby's arrival, your body must go through a period of healing. How long this takes will depend on your general health, but it can be up to a year before your body completely returns to its pre-pregnancy state. Although there are a couple of differences between healing after a vaginal birth versus a Cesarean birth, the general healing process holds true for both types of delivery.
After Pains and Involution
Soon after the baby is born, the placenta is expelled and the uterus contracts tightly to seal off the open blood vessels on the uterine wall. The area where the placenta was attached is very much like an open wound that needs to be healed. The uterine contractions, sometimes called "after pains," may be felt as strong cramping sensations for the first couple of days. You may also feel these sensations if you are breastfeeding as nipple stimulation promotes uterine contractions. Pain relief medication can help if these cramps are too uncomfortable.
Uterine or afterbirth contractions are an integral part of shrinking your uterus back to its normal size. Your nurse will check this process while you are in the hospital and may massage your uterus to help stimulate it to contract.
It takes up to 10 days for the placental site to heal. During that time you'll notice a bloody vaginal discharge called lochia. It will be bright red for a day or two after birth, very much like a heavy menstrual period. It then decreases in amount and becomes a dark brown color, then a pinkish discharge, and by 10 days a slight white discharge. This signals that the placental site is completely healed.
Until the lochia has disappeared, you should avoid having sex and should use good hygiene in the perineal area (between your vagina and anus) throughout the day to prevent the introduction of bacteria into the vagina.
Incision Site Healing
Whether birth takes place vaginally or by Cesarean, there is likely to be an incision involved that requires healing. With a vaginal birth, you will probably have an episiotomy. This small incision, made to enlarge the vaginal opening just before the baby's head emerges, is then repaired with stitches, and the healing takes a couple of weeks. The body will absorb the stitches, but you may be tender or sore for the first week or so after birth. Infection is possible, but with good perineal care, it can usually be avoided. If the birth is a cesarean, the abdominal incision will take longer to heal — between four to six weeks — and you will usually need pain relief medication. If the stitches are not self-absorbing, they will be removed about five days after birth.
Home Healing Tips
There are many ways you can help with the healing process at home:
To prevent infection of the episiotomy incision, change your sanitary pad often, at least every four to six hours. Cleanse the perineum after urinating or a bowel movement by pouring warm water over the area and patting dry with gauze pads. Remember to always wipe from front to back as well. Sit in a warm bath ("sitz bath") or use warm compresses to promote incision healing.
Do pelvic floor contract / release exercises (Kegels ) that will bring circulation to the area and promote healing.
Keep the Cesarean incision dressings clean and dry and follow hospital care tips.
Eat a healthy diet to support the healing process. Be sure you're getting protein, vitamins, and lots of fluids.
Rest! Try to stay in bed or on the sofa for the first week after birth. Don't do too much too quickly, even though you may feel good. Your only activities should relate to the care of the baby. Let someone else take care of errands, cooking, laundry, and other housework. Plan ahead so help with these activities is available.
Sleep when the baby sleeps. You can expect many nights of interrupted sleep, and you'll need to make up for that by taking naps during the day. Aim to get as many hours of sleep in a 24-hour period of time (although broken into more segments) as you did before the baby was born.
When to Call the Healthcare Provider
Contact your provider if you observe any of these signs, as they could indicate that healing is not progressing as it should, or that you're developing an infection:
A temperature above 100 degrees Fahrenheit that lasts for more than one day.
Bright red or heavy bleeding (lochia) after the fourth day postpartum, or very large blood clots in the lochia.
Lochia that has a foul odor.
Pain in the lower abdominal area after the first few days after birth.
Signs of infection (redness, heat, swelling, an oozing discharge) at the site of the episiotomy or Cesarean incision.
Because having a baby is a normal process, not an illness, your body is programmed to heal quickly. And the few days of some minor discomforts while you're healing will be overshadowed by the joys of having a new baby in your arms!
If you're still in your third trimester, you're probably reading ahead about what to expect after giving birth, but don't forget to take time to relax amid all of that research and preparation. Taking some timeout is good for both you and your baby, and soon enough, you'll be bringing your little of bundle of joy home, and your opportunities for rest will be few and far between.
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