Postpartum Care

Whether you had a vaginal delivery or a cesarean section, your body will go through a number of changes over the next several weeks.

Breasts – Breast changes are common after delivery. Watch for engorgement (fullness and tenderness) even if you are not breastfeeding. Apply ice packs and take anti-inflammatory pain medication to relieve the pain of engorgement. If pain, redness, fever or severe tenderness develop, contact our office so you can be evaluated for mastitis (infection of the breast). If you have difficulty breastfeeding, contact the lactation consultants or our office for assistance.

Urination – Occasional leakage of urine is normal. It usually resolves itself. After delivery, do Kegel exercises to help strengthen the pelvic muscles.

Bowel movements – Constipation is common after pregnancy, and it may take several weeks after delivery to resume normal bowel movements. Eat fiber-rich foods and drink plenty of water. Take a stool softener (if needed) to avoid constipation. You may use Tucks pads or Preparation H if you develop hemorrhoids.

Uterus – It takes about six weeks for the uterus to return to its pre-pregnancy size. It should remain firm and will gradually get lower in your abdomen. Cramping is normal, especially with breastfeeding.

Lochia – Vaginal flow (lochia) will gradually decrease and become lighter in color. First it will be dark red (with clots), then pink, then white in color.

Menstrual period – Return of ovulation varies, but it may resume before your first normal period, so use birth control if sexually active.

Circulation –Swelling, especially in the feet and legs, is to be expected. If you develop redness or pain in either leg, notify your physician so that you can be evaluated for a blood clot.

Mood – Some feelings of depression are normal after delivery. Notify your clinician if these feelings last longer than several days or if you are unable to cope.

Additional Postpartum Instructions for Vaginal Delivery

General activity – You may gradually increase your activities as your strength and comfort permit. The first week you return home, you should rest and care for only yourself and your baby.

Take frequent naps. Avoid heavy chores, lifting greater than 25 pounds, straining or prolonged standing. Walking, however, will help prevent many complications and assist in healing. You may walk up and down stairs if necessary, but go slowly and hold the handrail for support. Avoid intercourse until cleared by your physician at your follow-up visit in six weeks.

Bathing – You may shower and wash your hair. Short baths in warm water are permissible.

Diet – Eat a well-balanced diet. Drink plenty of fluids. Avoid constipation.

Driving – Short car rides are OK, but avoid long car trips until cleared by your physician at your follow-up appointment. Do not drive until after you have stopped taking narcotic pain medications and you are able to twist your body quickly to look over your shoulder and step on the brakes without hesitation. This usually requires at least two weeks.

Perineal care – Clean your perineum with every trip to the bathroom. After using the toilet, wipe gently from front to back. Rinse with a peri bottle filled with warm water and pat dry with a clean towel or tissue. Change your peri pads frequently. You may use Tucks pads or Dermaplast/Epifoam to ease episiotomy discomfort. You may soak briefly in a tub of warm water to ease discomfort, but avoid soap, bubbles or shaving the area.

Medications – Mild over-the-counter pain medications (like ibuprofen and naproxen) and stool softeners/laxatives may be used as necessary unless otherwise instructed. You may also be prescribed a mild narcotic to use for breakthrough pain in combination with ibuprofen or naproxen. Resume all other home medications on discharge. Follow your clinician’s advice regarding medication precautions while breastfeeding.

Returning to work – Most patients choose to take six to eight weeks off work for infant care and bonding. You will probably feel ready to return to work in two weeks, but it may take six weeks for your body to return to a pre-pregnancy state.

Follow-up appointment – Call for an appointment if not already scheduled. You will be seen for your final post-partum appointment four weeks after delivery.

Problems or questions – Do not hesitate to call if you have any problems or questions. If your physician is not available, one of the others will help you. Promptly report any of the following problems: fever (temperature >100.5 degrees), problems with the episiotomy, severe pain or nausea, red or painful breasts, pain or burning on urination, severe depression, foul-smelling vaginal discharge, excessive bleeding or passage of clots larger than an orange or any other unusual symptoms you may be experiencing.

Additional Post-operative Instructions for Cesarean Section

General activity – You may gradually increase your activities as your strength and comfort permit. The first week you return home, you should rest and care for only yourself and your baby. Avoid heavy chores, lifting greater than 25 pounds, straining or prolonged standing. Walking, however, will help prevent many post-operative complications and assist in healing. You may walk up and down stairs if necessary, but go slowly and hold the handrail for support. Avoid intercourse until cleared by your clinician at your follow-up visit.

Bathing – You may shower and wash your hair. Avoid baths. Keep the incision clean and dry.

Diet – Eat a well-balanced diet. Drink plenty of fluids. Avoid constipation.

Driving – Short car rides are OK, but avoid long car trips until cleared by your clinician at your follow-up appointment. Do not drive until after you have stopped taking narcotic pain medications and you are able to twist your body quickly to look over your shoulder and step on the brakes without hesitation. This usually requires at least two weeks.

Care of the incision – Abdominal incisions heal gradually. Gently cleanse the incision with soap and water in the shower. Pat the incision dry with a clean towel. Do not rub. No dressing is necessary, but you may choose to keep a loose dressing over the wound to avoid staining your clothing with secretions during the healing process. If steri-strips remain on an abdominal incision after one week, you may remove them. If redness or drainage develop in the incision, use warm, wet compresses to promote healing several times a day for 20 to 30 minutes. Expect vaginal discharge and spotting for up to four weeks. You may wear a feminine pad, but avoid tampons, douching and other intra-vaginal products until cleared by your physician at your follow-up visit.

Medications –Mild over-the-counter pain medications (like ibuprofen and naproxen) and stool softeners/ laxatives may be used as necessary unless otherwise instructed. You may also be prescribed a mild narcotic to use for breakthrough pain in combination with ibuprofen or naproxen. Resume all other home medications on discharge. Follow your clinician’s advice regarding medication precautions while breastfeeding.

Returning to work – Most patients recover sufficiently to return to work and resume all normal activities in six weeks, but complete recuperation may take eight to twelve weeks.

Follow-up appointment – Your first post-operative appointment should be one to two weeks after surgery. Call for an appointment if not already scheduled. You will be seen for your final post-partum appointment 6 weeks after delivery.

Problems or questions – Do not hesitate to call if you have any problems or questions. If your surgeon is not available, one of the other physicians will help you. Promptly report any of the following problems: fever (temperature >100.5 degrees), problems with the incision, heavy bleeding, severe pain or nausea or any other unusual problems you may be experiencing.