It is important to learn as a new mother that you must take care of yourself so that you can take care of your family.
Signs to take seriously and seek emergency medical help:
For the first three to four days after your baby is born you may experience “after birth pains”. These pains generally occur whilst breastfeeding your baby, and are caused by the hormone oxytocin causing contraction of your uterus. This is a good sign that your uterus is attempting to returning to pre-pregnancy size.
Afterbirth pains are more common in women that have had other babies than in women having their first baby.
The pain may be felt in your lower abdomen, back or your thighs. You can take paracetamol and/or apply a hot pack to the area where the pain is experienced (taking care not to allow the hot pack to come in contact with the baby). These pains will cease after a few days.
Regardless of whether you have a vaginal birth or caesarean section birth, your bleeding afterwards will be like a period. It will be heavy and bright at the beginning. It is advised that you wear maternity pads. If you are soaking a pad in less than an hour or two it is important to let the midwife know.
Maintaining good hygiene is important post birth so it is recommended that pads be changed every 2-3 hours. After 1-2 days your bleeding will settle become darker and be more mucousy.
In the early days you can expect that your bleeding may be brighter or slightly increased after a feed. Eventually the bleeding will stop altogether.
Sometimes when your placenta is delivered small pieces of placenta and or membranes may remain inside of your uterus. Your midwife on your discharge paperwork will note if your placenta and or membranes were thought to be complete at the time of your birth.
You should contact your hospital or family doctor if;
After seeing a doctor you may be prescribed antibiotics, need to have an ultrasound and sometimes you may need to have an operation called a curette to remove any tissue that may be remaining within your uterus.
This varies between women, if you are breastfeeding without using any formula then your period may not return for four to twelve months.
Breastfeeding is not a reliable method of preventing pregnancy. If you do not wish to become pregnant please discuss your contraception options with your midwife or doctor.
If you are formula feeding your baby and wanting to avoid another pregnancy then a reliable method of contraception should be used 21 days after giving birth. It is advised to wait 3-6 weeks before starting combined oral contraceptive pill due to increased risk of blood clots during this time.
Your vagina and perineum may be sore and swollen for a week or so after your birth.
At the time of your baby’s birth you may have had some stitches placed in your vaginal muscles and the skin to hold the edges together while healing takes place.
With your permission a midwife will check your stitches while you are in hospital and when you are seen in your own home.
After ten to fourteen days the stitches will dissolve and fall out.
Hygiene:
Diet and water:
Opening your bowels:
Pain and discomfort
After having any tear, it is normal to feel pain or soreness after giving birth, particularly when walking or sitting. The skin part of the wound usually heals within a few weeks of birth, and after that you should feel much less raw and tender. Passing urine can cause stinging depending on where your tear is.
If you have stitches, they can cause irritation as healing takes place, but this is normal.
It is helpful to:
Perineal tears: What you need to know during pregnancy – Australian Commission on Safety and Quality in Health Care
Third and fourth degree perineal tears – Australian Commission on Safety and Quality in Health Care
Perineal tears: How to reduce the risk – Australian Commission on Safety and Quality in Health Care
This too is very individual. Some women will return to their pre-pregnancy body quickly while it may take several months or longer for other women.
Six weeks after your baby’s birth your uterus will be returned to its normal pre-pregnant size. It will take longer to lose the weight gained in pregnancy and for your body to feel firm again.
Helping your body get back into shape:
A healthy diet is always important, but it’s especially important if you are breastfeeding.
Breastfeeding uses a lot of energy and nutrients. It is important that your diet supplies the nutrients you need during breastfeeding, such as protein, calcium, iron and vitamins. You need these nutrients for your own health and wellbeing. Try to eat regularly and include a wide variety of healthy foods.
For more information, visit the Better Health Channel.
Resuming sex after birth is very much up to individual couples. There may be physical and emotional barriers to overcome before resuming sex after birth.
For some couples waiting until the woman is ready may not be an issue however for other couples this may cause unhappiness and put strain on the relationship.
If you do not wish to have another baby in the immediate future, you will need to use contraception.
Another name for contraception is birth control or family planning. There are many choices of contraceptives to choose from.
It is important to select the one that will be suitable for you. You could discuss your options with your doctor, a midwife at the hospital, your family doctor or your Maternal and Child Health Nurse.
Some of your choices are;
Family Planning Victoria: Contraception after pregnancy
The Royal Women’s: Your contraception choices.
As a new mother your sleep will probably be interrupted and exhaustion is common. You will no longer have control over when and how long you sleep.
Your sleep will depend on your baby’s sleep patterns.
During the first three months most babies will wake several times a night and even at one year will wake once or twice a night.
More than missing sleep
If you are experiencing physical and emotional difficulties after birth they will compound the tiredness that you already feel. If you are having problems with feeding, back pain, perineal pain, haemorrhoids, sexual or relationship problems it is advisable that you seek help.
Your Maternal and Child Health Nurse or family doctor may suggest ways to help you through this time.
Depression after birth and exhaustion are often linked.
Between 10-30% of women experience some degree of stress incontinence after birth.
This could be to lose a few drops of urine when the laugh, cough, sneeze or jogging. It is also possible to have a sense of urgency to get to the toilet. Discussing these problems is difficult however it is important to be able to so that you can access help.
What causes incontinence?
During birth the muscles that support the bladder, uterus, lower bowel and surround the openings of the vagina, urethra and anus are stretched and may be damaged. These muscles make up the pelvic floor. Forceps, birthing a large baby, a long second stage of labour, having more than one baby and being overweight all make the pelvic floor vulnerable to being weakened.
Will it go away?
It may improve in time however that is not guaranteed. There are some things that you can do to improve your pelvic floor:
If you are having urinary incontinence issues talk to a physiotherapist. Contact SWH Community Health on 5563 4000
If you have faecal incontinence you may have
Faecal incontinence is less common after birth than urinary incontinence. It is caused by damage to the nerves or the muscle that controls the opening of the bowel (anal sphincter). It is more likely to be damaged during a forceps or vacuum assisted birth.
There are some things that you can do;
If you are having faecal incontinence issues talk to a physiotherapist. Contact SWH Community Health on 5563 4000
Some people may refer to haemorrhoids as piles, they are swollen veins around the anus.
Haemorrhoids may begin in pregnancy or appear after labour and birth.
Haemorrhoids are made worse by constipation and straining. They can be incredibly painful but should hopefully settle in a few weeks after your birth.
There are some things that you can do to help:
If there is no improvement consult your doctor.
About 44% of mothers experience back pain after birth. This pain may be caused by postural changes, weakened abdominal muscles, or softening of the ligaments during pregnancy.
If back pain is a problem you can:
It is common for women to experience a separation in their abdominal muscles after giving birth, or in some instances, during pregnancy.
This separation occurs as the hormones soften the abdominal muscles to allow space as the baby grows.
The separation will usually improve on its own over the first 6-8 weeks and beyond after birth.
Sometimes the gap in the muscles may not go away completely. A gap of 2 fingers or less is normal.
It is normal for your emotions to be up and down a bit after the birth of your baby. It is important to take each day one day at a time and enjoy getting to know your new baby.
In the first week after your baby is born you may experience a range of emotions. From the happiness of finally having your new baby, to suddenly feeling miserable and crying.
This is known as the “baby blues”. These feelings may last for a few hours to a few days. Baby blues are very normal, resulting from the hormone fluctuations and sleep deprivation women experience post birth. If the feelings of sadness however does not subside then it is important to speak with your Maternal and Child Health Nurse or your family doctor.
Many women find being at home with their new baby a time of adjustment and at times lonely.
This can be especially so when the women has worked outside of the family home or friends are either at work or do not live nearby. Just getting out of the house can be challenging.
If leaving your home makes you feel panicky or anxious them it is advisable to speak to family, a friend, your Maternal and Child Health Nurse or your family doctor. These feelings may be a sign of depression.
Have your nappy bag packed so that you only have to add a few extra things when you are planning to leave the house.
Join a mothers group. You’re Maternal and Child Health Nurse will introduce all first time mothers to a group of other mothers with babies of similar age to your baby. It is helpful to share experiences and ideas about parenting with to avoid feeling isolated and alone.
Spend time with friends and family.
About one in 6-7 women experience depression in the year after birth.
Commonly depressed feelings start in the early months; however they can start much later. Some women may not be depressed however they can feel emotionally low and distressed for varying lengths of time.
These feelings are not the same as the “baby blues”. Baby blues is a name given to a common experience of being weepy and having mood swings for a brief period of time during the first few days after birth.
Postnatal depression is also very different to another condition known as Puerperal Psychosis. This is a rare and serious psychiatric illness which begins soon after birth and causes the woman to lose touch with reality, become confused and will require hospitalisation for treatment.
Common Symptoms of depression include:
If you find that you are having thoughts about harming yourself or the baby, it is very important to present to the emergency department straight away.
If you’re having these kinds of thoughts, it’s important to seek support.
Beyond Blue- Emotional Health and well-being
Beyond Blue- Maternal mental health and well-being
Perinatal Emotional Health Program