You're no longer pregnant, but your body just isn't the same as it was. You've changed, and it takes time to get back into shape. For example, your breasts are still large (whether you intend to breast-feed or not) and you're probably still padded with a layer of extra fat that your body stored in case the baby needed emergency nutrition. Your pregnancy belly is gone, but it's still not flat. Be patient with the healing process and give your body and yourself some special pampering during the postnatal period.
Your breasts are definitely not the same as they were before you became pregnant. They are still much larger. If you plan to breast-feed, your breasts will stay enlarged for as long as you continue to nurse. Within three days after delivery, they will fill with milk and become hard, heavy, full, and maybe uncomfortable. This is the time to make sure you have a comfortable, supportive nursing bra. Your breast discomfort will be eased each time the baby sucks at the breast and relieves the pressure.
If you are not planning to breast-feed, there's no way to get the message to your body. Your breasts will still fill with milk and become hard, heavy, and full. It takes about 14 days for the glands to stop supplying milk; this is called the "drying up" period. During that time, your breasts might be painful.
Don't try to relieve the pressure by hand-expressing milk; this gives your body a signal to keep producing more, and it will be impossible for the milk supply to dry up. The discomfort is temporary, but you can make this time less distressing if you use cold compresses, wear a supportive bra 24 hours a day, and take ibuprofen pain relievers. Also, try to keep your breasts out of warm water as you shower or bathe; it stimulates more milk production. Unfortunately, there are no safe medications to dry up your milk supply. You will have to wait for Mother Nature to do the job.
Your pregnancy belly is gone—well, not quite gone, but it's certainly much smaller. Don't be disappointed if you can't zip up your jeans the morning after your delivery. It took nine months for your uterus to grow and expand; it will take about six weeks for it to return to its normal size. A post-pregnancy belly is especially common after the births of second and third children, or more. The muscles of the abdomen just don't bounce back like they used to.
If anyone asks, "When is the baby due?" after your baby is born, just smile and say, "Very soon." People who really need to know if you've had the baby already know and will also understand that this is your postpartum shape.
If your body weight after delivery is a bit heavier than your prepregnancy weight, don't get upset. Your breasts alone add extra weight; your uterus might now weigh two pounds instead of its usual two ounces. There's a bit of stored body fat that will quickly fall away now that the baby doesn't need it. Watch your diet and give yourself six weeks to return to your normal weight. (If you're breast-feeding, your body will hang on to pregnancy fat, but don't panic. This will disappear when breast-feeding ends. Those extra five pounds will melt away!)
If your body weight after delivery is much higher than your prepregnancy weight, that's a different story. You've added pounds that have nothing to do with pregnancy. You simply ate more than necessary and now you've got some work to do. The Food Guide Pyramid guidelines are not just for pregnant women. Use them now to help you choose nutritious foods (in the proper serving sizes) to help you lose weight while maintaining your health and energy. You should also talk to your doctor about starting an exercise program. As soon as you are physically able, body movement will not only help you shed extra pounds, it will speed recovery by bringing more oxygen and glucose to cells that are trying to heal.
And you thought your contractions ended with the delivery of your baby! Your uterus will continue to contract in order to shrink back to its usual size and to help push out any leftover tissue. These pains might be hardly noticeable, or quite sharp (especially with the second or third child or when breast-feeding). These pains are most noticeable in the first few days after delivery. If they really bother you, ask your doctor about using a pain reliever.
Although you don't have monthly menstrual periods while you're breast-feeding, this doesn't mean you can't get pregnant again! Talk to your doctor about using contraceptives while breastfeeding.
If you thought one of the great advantages of pregnancy is not having to deal with your period for nine months—it's payback time. After delivery, you will bleed bright red blood that is like a heavy period. To add to the fun, you must use a sanitary pad—not a tampon. This heavy bleeding will continue for about three days. Then it will lighten up and turn a pinkish-brown. Eventually, it will turn white or yellow and then gradually taper off completely. This bleeding might end in about two weeks or it might last as long as four.
Your actual menstrual period probably won't resume until seven to nine weeks after delivery, but it would also be normal if it did not return for three or four months. There is really no such thing as "normal" here. The first period after delivery can be very erratic. It might be heavy or very light. It might start and then stop again for awhile. But within a month or two, your system will regulate itself. If you're breastfeeding, your period might stop for as long as you continue to nurse. (As your baby begins to sleep through the night and feed less often, your menstrual cycle might resume even though you're still nursing.)
Postpartum is a word used to indicate the time following birth.
You might not be able to sit comfortably for about a week after your delivery for two reasons: (1) you've had an episiotomy or a perineal tear with repair, or (2) you have hemorrhoids. Both can be a real pain.
The episiotomy is the surgical opening that is made from the vagina toward the rectum to widen the opening for birth. If your doctor used this technique, it has been stitched up and like any cut with stitches it will hurt at first and might itch later.
If you didn't have hemorrhoids before your delivery, you might very well have them now. The pushing and straining during labor and delivery can force them out and add to your postpartum discomfort.
For the discomfort of an episiotomy or hemorrhoids you can try any of the following remedies:
You might also invest about $20 in a doughnut cushion. This is a pillow with a hole in the center that lets you sit down without putting pressure on your sore spots.
Pushing out your baby at delivery was good practice for your next bowel movement. During labor, bowel activity slows down and if you used pain medication, it can make the bowel sluggish, too. If you've had a cesarean, your bowels will take even longer to recover. All this adds up to large, hard stools that can be difficult to pass. Prepare for this as soon as you're ready to eat and drink after your delivery. Go for high-fiber foods (such as fruits and whole grains) and lots of water. Ask your doctor about using a natural laxative. When you do have the urge, don't strain too much because this will worsen or cause hemorrhoids. If you do not have a bowel movement after three or four days, it's time to get your doctor's okay to use an enema in order to get your plumbing working again. You can buy a simple, packaged and prepared enema at any pharmacy. Don't be afraid to use it—you've given birth to a baby; now you can do anything.
Women who have had a cesarean delivery don't walk—they shuffle. They keep their feet flat on the floor and take tiny steps, shuffling one foot before the other. They do this because it hurts to walk! If you've had a cesarean, you will find out very quickly after your delivery that you don't recuperate from major abdominal surgery in a day or two. It can take two to three weeks just to start walking normally again. Your abdominal muscles have suffered a severe trauma, and even walking might be painful. (Sneezing or coughing is even worse.) In addition to the normal body changes after a delivery, you'll be recovering from surgery. So do yourself a favor and call in as much help as you can possibly get. Your baby will demand all your energy and your body will demand healing time. So get some help, let the dishes pile up, and don't worry about cleaning the house.
About six weeks after delivery, your doctor will want to see you again. This visit is very important. Your doctor will check to make sure the uterus has returned to its normal size and position. She'll look to be sure vaginal stitches have dissolved and the cervix has healed. She will check your breasts for signs of uncooperative milk glands or engorgement (a painful condition that results if the breasts are not emptied of milk during each feeding). She will take time to talk to you about your weight, your feelings and emotions, and about contraception. This is a great opportunity to visit with someone who knows what you've been through and can help you get back on your feet.
Before this checkup you should call your doctor to report any of the following symptoms:
Don't wait until your postpartum checkup to tell your doctor about these symptoms. Call right away.
Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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