After you return home, consult your doctor right away or go to the emergency room if
- You show signs of haemorrhaging
- You soak one regular sanitary pad an hour for two consecutive hours
- You lose large blood clots (e.g., more than one egg-sized clot)
- Your bleeding increases rather than decreases
- You have a fever—temperature of 38.0 °C (100.4 °F) or higher
- You have severe abdominal pain not relieved by analgesics
- You have difficulty breathing
- You have a new pain in your leg with swelling
Go directly to the emergency room if you show signs of shock: agitation, weakness, paleness, cold and damp skin, or hot flashes and palpitations.
You’re happy, but tired—this is normal! It will take a few weeks to get your usual energy level back. Be patient. Try to take care of yourself and don’t hesitate to ask for help when you need it.
Your body needs some time to recover. Back home, if you show signs which worry you, don’t hesite to contact the CLSC nurse or consult your physician or midwife.
For the first day or two after childbirth your blood loss (lochia) will be heavier than during menstruation. Eventually the bleeding will diminish and the blood will change texture and colour. It may be mixed with mucous (a whitish substance). The colour will gradually change from pink to brown, becoming paler, and it could turn yellow.
Occasionally you may pass a blot clot. This happens generally in the morning after urinating or breast-feeding. So long as the bleeding lessens after passage of the clot there is no need to worry. Be aware that unusual physical effort or a caesarean delivery may cause redder and more abundant lochia.
Lochia usually lasts three to six weeks. During this time, use sanitary pads, not tampons.
You may feel uterine contractions, especially while you are breast-feeding. If this isn’t your first pregnancy, you may experience more contractions than during previous pregnancies. If you need relief from the pain, contact your health professional.
You can take baths safely and as often as you like after giving birth, as soon as you get home. These quiet moments will give you a little time-out for yourself. Hygiene is very important. Here are a few helpful tips:
- Take a shower or bath once a day or more in a clean bathtub without oil or bubble bath.
- Change your sanitary pad at least every 4 hours.
- Always wipe from front to back.
- Wash your hands after using the toilet.
However, don’t give yourself a vaginal douche. You can go swimming as soon as your bleeding is lighter.
After a vaginal birth your perineum will remain sensitive for a while. It’s also normal that the labia are more open and the vulva looks and feels different.
Don’t worry if you have stitches: they will not come loose when you go to the bathroom. After bathing, let the stitches dry before you get dressed.
You can do exercises to tone your perineum. Several times a day contract the pelvic floor muscles as if you were holding in urine and then relax them. You can begin these exercises a few days after delivery even if you have stitches since these exercises stimulate blood flow and promote wound healing. You can gradually work up to 100 contractions per day.
Urinating and bowel movements
It is normal not to have a bowel movement in the first two to three days after vaginal delivery and three to five days after a caesarean. However, if this persists you may be constipated. This often happens after both a vaginal delivery and a caesarean. If this is the case, follow these tips:
- Eat high fibre foods like bran cereal, whole grain bread, raw vegetables, fruits, legumes, and nuts.
- Drink plenty of fluids.
- Go to the bathroom when you feel the need.
- Drink prune juice or eat prunes.
If these measures fail you can try a laxative. Opt for a fibre-based product (e.g., Metamucil®) and drink enough liquid so that your constipation doesn’t worsen. You can also take a stool softener like docusate (e.g., Colace®).
After delivering you may feel a burning sensation when urinating—try spraying your vulva with warm water. It’s normal in the first few days after delivery to have trouble retaining urine and gas. If this annoyance persists, mention it to your doctor during a follow-up visit.
About two weeks after vaginal delivery you can resume your activities gradually. As soon as you feel up to it, it’s a good idea to get out of the house. You’ll feel better for it. It’s best to start with short walks because at the beginning you will tire more quickly and perhaps suddenly.
There are exercise programs designed for new moms and their babies, many of them organized by municipalities. Books and DVDs on postnatal exercise can also be helpful.
Most women get back to their normal weight without any special effort. Within a few months your body will exhaust the fat reserves it accumulated during pregnancy. Eat a healthy diet and be patient! Don’t expect the weight you gained over nine months to disappear overnight.
Resist the temptation to lose weight quickly, especially if you’re breast-feeding. Losing 1 to 2 kg (2 to 4 lb.) a month is reasonable. A woman who is breast-feeding should not follow a strict weight-loss diet. A low-calorie diet can diminish your milk production and energy level.