Postpartum is the period of time from immediately after birth until several weeks after delivery. During this time you, your emotions and your body are going through tremendous changes. It takes time for all to return to normal. Plus you have the responsibility of caring for your beautiful and yet very demanding new baby!

Your body changes include a uterus that is shrinking from being ballooned to the size it was at term to eventually about the size of your fist. During the first few days, you will have cramping or afterbirth pains. Usually an over the counter pain reliever will help. You will also have a heavy red flow of discharge and maybe with small clots. The discharge or lochia will gradually decrease and change to lighter pink to brown. Wear pads and no tampons. About 2 weeks after the delivery, your flow is usually light brown or yellow and then will go away within the next few weeks. Your period might return in about 6 to 8 weeks if you are not breastfeeding. You may not have a period if you are breastfeeding. You may have more cramping at first when you are breastfeeding, but this helps get you back in shape faster! It is possible that you may ovulate or release an egg even before your first period, so plan accordingly if you don’t desire another baby right away!

Your perineum or the area between your vagina and rectum may be very sore even swollen or bruised even if you did not have an episiotomy or a tear. It stretched during your baby’s birth. Also you may have hemorrhoids or varicose veins. Applying a cold pack in the first 24 to 48 hours may help. Keep the area clean by wiping from front to back. Use a squirt bottle with warm water to cleanse. Soak in a few inches of warm water in your tub about 3 to 4 times a day. Apply witch hazel pads like Tucks medicated pads for relief. Store them in your refrigerator and they will be even more soothing. Also do your Kegel exercises. Kegel exercises will not only help your perineum heal but also tighten the vagina and tone the pelvic floor muscles which will help prevent leaking of urine. To do the Kegel exercises, while you urinate try to stop the flow of your urine. The muscles you use to stop your urine are the muscles you need to tighten for Kegels. Tighten and hold to a count of ten and then relax, repeat 10 - 20 times at least 3 times a day.

Your abdomen also will gradually shrink and tighten. Exercises will help. Talk to your health care provider to know when it will be safe for you to begin exercising.

You may have constipation. Or the first bowel movement may be difficult or painful. This may be from your stretched abdominal muscles, slowed bowels due to pain medicines or decreased foods and fluids during labor. Drink lots of fluids, eat more fruit and grains, and get moving- walk! Consider a stool softener like docusate sodium.

Your breasts may be swollen and painful. Usually about 2 - 4 days after you delivered, your breasts fill with milk and become firm and tender. You may run a low fever. The best treatment is to breastfeed! It does get better! Your body will gradually adjust the amount of milk you make to the amount baby needs. Nurse your baby often. Apply a warm moist washcloth to your breasts and massage before each feeding. Express a small amount of milk from each breast before each feeding to soften the breast around the nipple to make it easier for your baby to latch on. After baby has nursed, apply a cold wet washcloth for several minutes. If your nipples are sore or to prevent problems, be sure that baby latches on correctly, see breastfeeding techniques. Let your nipples air dry before pulling your bra back up. Use cotton nursing pads and change them when they are wet. If you do not breastfeed your baby, the engorgement of your breasts will go away after several days. In the meantime, don’t express the milk from your breasts (this will stimulate more milk to come in), use cold packs and wear a good supportive bra.

You will probably be very tired. Sleep and nap when your baby does! You need the extra sleep to recover from the huge job you just completed! There will be plenty of time for other activities later. Accept help from family and friends, especially if you have other children at home. If you have someone to watch the children for even an hour or two, you can rest up and feel better throughout the busy days and nights. Limit other visitors, avoid unnecessary trips out of the house, and don’t worry about the housekeeping right now. Eat right and take your vitamins.

Call your doctor if you have any of these warning signs during the postpartum:

• Fever over 100.4 degrees
• Nausea and vomiting
• Severe dizziness
• Excessive bleeding — heavier than a period or more than 1 pad in an hour
• Large blood clots (size of a lemon or larger) or excessive smaller clots
• Foul odor to blood or discharge
• Redness or drainage from episiotomy, tear or incision
• Pain that continues or worsens after first few days from episiotomy, tear or incision
• Severe pain in abdomen
• Chest pain or shortness of breath
• Pain, redness, warmth or swelling in leg
• Burning or pain when urinating
• Painful lumps or red streaks in breasts
• Severe sadness, depression, anger or hopelessness