Post-birth: Healing after child birth

While you bond with your new arrival your body is working over time to recover from nine months of pregnancy and giving birth. How your body copes will depend on the type of labour and delivery you had. Long labours, instrumental deliveries and Caesareans can cause your body more physical stress than a normal vaginal delivery. Your general health and fitness will make a difference to your recovery, too.

What’s going on down below?

Even the most straightforward birth can cause tenderness and stinging to your perineum (the area of skin and muscle between your vagina and back passage). If you had stitches or tearing, you’ll probably feel quite uncomfortable.

How long will it last for?

Healing time varies from woman to woman but if you’re just sore and swollen, you should feel better within a couple of days. It you’ve torn or had an episiotomy, you should recover within a few weeks. Your midwife will keep an eye on your recovery and examine your stitches if needs be.

How can I aid my recovery?

  • Take anti-inflammatory arnica tablets immediately after the birth and for the following few days to reduce swelling.
  • Apply soothing compress cloths soaked in cool or warm water with a few drops of tea tree or lavender oil, both of which are antiseptic. Alternatively, pop a couple of drops of tea tree oil on a sanitary towel.
  • Add five drops of lavender oil mixed in milk to a bath 2-3 times a day.
  • Apply a gel pad or ice pack to sooth the area.
  • Drink plenty of water to dilute your urine and pour a warm jug of water over your perineum as you wee to avoid stinging. If the stinging is really bad, weeing in the bath can be easier.
  • Do your pelvic floor exercises as soon as you can as these will strengthen the muscles and improve circulation to the area.
  • Ibuprofen or paracetamol based painkillers are safe to take while breastfeeding and will take the edge off if you’re really uncomfortable.

Why do I keep getting tummy cramps?

After your baby’s born, your tummy and uterus will be swollen. As your uterus starts to contract back to its normal size, you’ll feel period-like cramps known as ‘afterpains’. Some mums experience strong afterpains while they’re breastfeeding. These are caused by the hormone, oxytocin, which is released during breastfeeding and helps the uterus shrink. Breastfeeding’s therefore a great way to help get your tummy back!

Afterpains tend to become more noticeable after each baby you have. This is because the muscles in your uterus will have been stretched by your previous pregnancies and will have to work harder to contract.

How long will they last?

Afterpains usually ease off after three or four days following birth.

Is there a way to ease the afterpains?

  • Massage your lower abdomen (unless you’ve had a Caesarean).
  • Cuddle a hot water bottle.
  • Ibuprofen or paracetamol based painkillers will ease severe discomfort and are safe to use during breastfeeding.
  • If you had a TENS machine for the birth, it’s time to get it out of its box again.

Why am I bleeding?

It’s totally normal to bleed after giving birth and it will happen whether you had a Caesarean or vaginal birth. It’s known as lochia and is simply your body getting rid of the lining of the womb after birth, just like a period. You may get great gushes of blood or a more gentle flow.

The blood will be bright red at first and may have clots in it – let your midwife know if you do notice any clots. As your uterus heals and shrinks back to its normal size the lochia will turn pink, then brown, before tapering off completely.

How long will it last for?

You may bleed for anything from two to six weeks after your baby’s born. The bright red blood should ease off within a couple of weeks. If it comes back, it may be a sign that you’re doing too much too soon and you should take it easy.

Can I help ease the bleeding?

There’s nothing you can do to stop the bleeding sooner, but it’s important to take things easy for six weeks. Stock up on maternity pads before the birth – these are longer, softer and much more absorbent than ordinary sanitary towels. Don’t use tampons for at least six weeks as they can introduce bacteria and cause infection to your healing uterus.

You should keep an eye on your bleeding as there is a rare condition called secondary postpartum haemorrhage. This is caused by an infection or if a piece of placenta is left inside your uterus.

Call your midwife or GP if:

  • Your lochia has an unpleasant smell.
  • The bleeding stays heavy and bright red for longer than a week.
  • You have a fever and/or chills.
  • Your tummy feels sore low down on either side.
  • You pass blood clots bigger than a £2 coin.
  • Your bleeding is bright red and heavy for more than four days after giving birth and resting doesn’t slow the flow.
  • You feel faint.
  • Your heartbeat races or becomes irregular.

Call an ambulance if:

  • Your bleeding becomes incredibly heavy, soaking more than one pad an hour.

Oops, why do I keep leaking wee?

The pelvic floor muscles that support your bladder, bowel and uterus, will have stretched and relaxed during pregnancy and birth to allow your baby out. This means it’s harder for the muscles to hold urine in and it’s incredibly common for new mums to find that when they laugh or cough, a bit of wee escapes. It’s called stress incontinence.

If you had a catheter inserted during birth, you may also find it harder to control your bladder afterwards. However, this should only last a day or so.

How long does stress incontinence last?

Stress incontinence can mend itself within a few weeks after birth. However, it can go on to be a long-term problem.

Can I fast forward recovery?

The best way to aid recovery is to do pelvic floor exercises at least three times a day. These will strengthen the muscles and give you better control. It’s also a good idea to drink more water. That may sound odd but while you were pregnant, your bladder will have been squashed by your baby and grown used to only holding a small amount. By drinking more you can retrain it to hold more liquid. If you’re still having problems after a few weeks and pelvic floor exercises aren’t helping, speak to your GP.

Why am I feeling so low?

Giving birth sends you on an emotional roller-coaster. You feel joy at meeting your baby for the first time, relief it’s all over, and sometimes regret that your birth experience wasn’t quite what you’d hoped. To add to this, your hormones will be going crazy! The high levels of oestrogen and progesterone you’ve had during pregnancy will drop to their normal levels and your thyroid hormones may fall, too. It’s no surprise then that 80% of new mums suffer the ‘baby blues’. You might find you experience a sudden and unexplained drop in mood or feel very tearful. The baby blues will probably hit you hardest on day three or four after birth when your milk comes in.

How long it will last for?

About two or three days.

Is there anything I can do to help?

You’ll have to sit the baby blues out but don’t worry, you should feel right as rain in no time.

If you’re still feeling down weeks or months after the birth, speak to your midwife, health visitor or GP – you could be suffering from postnatal depression (PND). PND is thought to affect 10-15% of new mums. Symptoms include feeling miserable, lonely, exhausted but unable to rest or sleep, and feeling that you can’t cope with the world. Treatment includes counseling and sometimes anti-depressants. It’s important to seek help quickly as PND can have an impact on your baby.

I’ve had a Caesarean, how will I feel?

You’ll probably feel quite sore in the days after a Caesarean. It will hurt to cough, laugh, and pass wind, though painkillers will take the edge off.

Your scar will be bright red at first but will gradually fade to pink, then silver. Avoid putting any pressure on it and wear knickers that don’t irritate it.

How long will it take to recover?

It can take up to six months.

Can I do anything to aid recovery?

It takes time and patience to recover from a Caesarean, after all, it is an operation. Try to move around as soon as possible as this will help circulation and recovery. Keep the scar clean, dry and exposed to the air whenever you can and watch for any signs of infection. Check with your doctor before doing any exercise or driving.

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