Postpartum Health Issues

Involution and post-delivery pain

If you took any medication before or during pregnancy, ask your doctor about continuing it or resuming it after delivery.

If you have a chronic illness, such as diabetes or asthma, it may affect your recovery. You may need to watch for specific problems or to make particular adjustments. You may need to take medications or to adjust your activities; check with your doctor about your particular situation.

For example, if you had gestational diabetes during pregnancy, your blood-sugar level may need to be tested after delivery. Discuss results with your doctor. If your blood-sugar level is normal, you're OK. If it isn't, you may be referred to a doctor who specializes in treating diabetes. He or she can help you plan a program to deal with your problem. Most of the time delivery cures gestational diabetes, and you are fine until you are pregnant again, when it may recur. Gestational diabetes may also indicate a tendency in a woman for diabetes to occur later in life, so you may wish to ask your doctor about warning signs to watch for.

Changes in the Uterus
After delivery, the uterus shrinks from the size of a watermelon to the size of an orange in 6 weeks!

After baby's birth, your uterus slowly returns to its original shape. Just before birth, the uterus was large enough to accommodate the baby, placenta and amniotic fluid. Immediately after delivery, you should feel your uterus around your navel; it should be very hard. You are checked frequently to make sure it remains hard after delivery. If it feels soft, you or a nurse can massage it so it becomes firm.

The uterus shrinks about a finger's width every day; this is called involution. You will be checked daily while you're in the hospital to ensure that your uterus is shrinking normally. This exam can be a little uncomfortable, but it is necessary for normal control of bleeding.

Afterpains
Afterpains are just what they sound like—pains you experience after the birth of your baby. They are normal; expect to feel them for several days after birth as your uterus contracts. Contractions occur to prevent heavy bleeding and to enable the uterus to return to its normal size. Cramps can be eased by lying on your stomach and by taking mild pain relievers, such as acetaminophen or ibuprofen.

If you breastfeed, your afterpains may intensify when you nurse. The baby's sucking stimulates the pituitary gland to release oxytocin, which makes the uterus contract. These extra contractions are good for you because they help control bleeding, but they can be uncomfortable. Mild pain medication can offer relief.

Perineum Pain
Stretching, cutting or tearing in the area between the vagina and anus during labor and delivery can cause pain in the perineum. An episiotomy can add to this discomfort. Pain doesn't last too long; soreness should diminish daily and disappear in about 3 weeks or by the time you see your doctor for your 6-week checkup.

If you experience severe discomfort, use ice packs, which may offer some relief in the first 24 hours after delivery. Ice numbs the area and helps reduce swelling. After 24 hours, a warm bath or soaking in a sitz tub several times a day can help.

Other remedies for pain include numbing sprays, witch-hazel compresses, walking to stimulate circulation and practicing your Kegel exercises. Pads soaked in hemorrhoid medication (sold over the counter) can be kept in the freezer, then placed on the sore area—they provide excellent relief.

Urinating may be painful because urine can sting the cut area. This burning is not an indication of a UTI or bladder infection. It is caused by the chemicals in the urine that cause stinging along the cut. You may find it less painful to urinate standing or in the shower with running water washing over the area.

It may seem like you're bleeding a lot during and after delivery, but remember, your blood volume increased 50% during pregnancy, so you have extra blood in your body.

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