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Recovery from a Vaginal Birth

Frequently a doctor hears new parents remark in relief, "It's over!" following delivery of their baby. It's true the long months of pregnancy and the labor and delivery are over, but another very exciting and perhaps more challenging part of life has just begun!

In the Hospital
One of the first things you may notice after delivery is how tired you are. Some women have compared their feeling of exhaustion to how a person feels after running a marathon.

After the excitement of the birth passes, it isn't unusual to be worn out. Rest and recover while you're in the hospital. Take advantage of the "built-in" room service and babysitting provided in the hospital. You probably won't have this luxury when you go home, especially if you have young children.

For the first hour after delivery, the nurses will check you frequently for bleeding, pain, fever, blood-pressure problems and other warning signs while you and your partner bond with your new baby. The baby is also being evaluated.

During this time you will probably only be allowed ice chips and sips of water, even though you may be anxious to eat some food and to drink some fluids. Restriction of food and drink is for your safety; if there are problems, such as heavy bleeding (postpartum hemorrhage), it is sometimes necessary to perform minor surgery, such as a D&C. It is safer for you to have your stomach empty if this procedure is necessary.

Dealing with Contractions, Pain and Bleeding
You may have thought that once you delivered, contractions would disappear. Your uterus actually continues to contract. These contractions are important because they cause your uterus to shrink to its normal size and help prevent excessive bleeding. Nursing your baby makes contractions stronger and helps control bleeding.

Another source of discomfort after you deliver will be in the vagina and between the opening of the vagina and the rectum. This is the area where an episiotomy was done or where tearing may have occurred with the delivery of the baby's head or shoulders. You will be offered medicine and ice packs to help with pain and swelling. Your nurse will show you how to take care of this area while you are in the hospital and when you go home.

Medication is available to help with contractions and pain. It is not given routinely; it is ordered for you and all you have to do is ask for it. Initially pain medicine may be in the form of an injection until you are allowed to drink and to eat. After that, you will usually be offered pain pills, such as ibuprofen or acetaminophen, as well as stronger pain medications, such as Tylenol #3.

It's normal to bleed for several days up to a couple of weeks after delivery. Your nurses and doctor will check your bleeding to make sure it is not excessive. After delivery, bleeding should gradually slow down, but you will still be bleeding when you go home from the hospital. Most often, medication is given to you at the time of delivery of the baby, by I.V. or injection, to help your uterus contract to prevent excessive bleeding.

If there is concern about infection, you may be given antibiotics. If bleeding is excessive, you may be given vitamins and iron. If you are Rh-negative, you may be given RhoGAM®.

Laxatives and stool softeners may be prescribed to help avoid constipation. An enema at the beginning of labor may also help lessen the problem of a painful bowel movement after delivery.

Passing urine may be uncomfortable, or it may hurt. This discomfort usually doesn't last very long and doesn't necessarily mean you have a bladder or urinary-tract infection (UTI). Just take it easy, and take your time when you have to go to the bathroom. Meeting Visitors
Friends and family will probably want to visit you in the hospital. This time can be enjoyable for everyone and can be very valuable for you and for them. But don't be afraid to limit the time spent with visitors—either in person or on the telephone. Put a hold on your phone calls or hang a "Do not disturb" sign on your door when you want to rest. Ask visitors to check with the nurses before coming into your room. Most people are very understanding about this, particularly if they have also had a baby.

Going Home
Before you leave the hospital, your doctor and pediatrician will talk to you about making appointments for checkups for you and your baby. These appointments are very important, so be sure to keep them.

When you leave the hospital, you will still be bleeding, but the amount of bloody discharge should be decreasing. Sometimes when you go home and are more active, bleeding may be a little heavier at first, but this shouldn't last more than a few hours before it slows down again.

It is normal to have cramps or pain in the area of the episiotomy. Discomfort should lessen every day. Usually you will be given a prescription for mild pain medications. It's OK to take these medicines, but usually they are not needed as often once you are home.

You may want to continue to take prenatal vitamins or iron. Many doctors will encourage you to take stool softeners or laxatives, as already discussed.

Resuming Activities
If you had an epidural, it takes a few hours for it to wear off before you are able to get out of bed. Within a few hours, you'll be able to get out of bed and walk around or go to the bathroom. Don't try to do too much. Most doctors don't want you just to sit in bed (we often describe this as "sitting in bed watching TV, eating bon-bons and taking pain pills"). Get out of bed and go for a walk, but don't push it at this time.

When you go home, gradually increase your activities. You can walk around, eat more normally and become more active each day. You may also feel like you need to rest frequently—that's normal. Pay attention to your body. Most doctors recommend you wait until your 6-week postpartum checkup before you begin any strenuous activity or exercise or become sexually active again.

Many women ask about driving and going up and down stairs. If you're still taking pain medicines or are having problems, such as dizziness, don't drive. It's OK to use stairs, but plan ahead so you're not running up and down the stairs all day. Park yourself where you are comfortable, are close to the baby and have food and beverages near at hand.

Taking Precautions
The nurses and your doctor will go over any precautions before you go home. This includes instructions about normal bleeding and what to do about pain. If you have any problems, it's helpful when you call your doctor to give information about bleeding, such as how many pads you are using, if there are there clots and what you have done or what you have taken to help deal with the problem. See Some Warning Signs After Birth. Getting Back on Your Feet
Full recovery is different for every woman, but there are some basic guidelines. If you had complications or problems, it may be different for you. From 2 to 6 weeks, you should be feeling a little better every day. You probably won't be taking pain medicine any longer, and bleeding will be decreasing or will have stopped. You have a full-time job taking care of your newborn, but you should be able to find some time for yourself and for your partner.

Following a normal pregnancy and delivery, the 6-week postpartum checkup is usually a turning point. Talk to your doctor about contraception. You'll probably get an OK to resume routine activities, such as exercise, sexual intercourse or returning to work.

If you are returning to work, make plans weeks before you start working again for childcare, nursing and your own recovery. You need to decide whether you are going to work full time or part time. See New Moms Returning to Work for a discussion on returning to the workplace.

Taking Care of Baby
In the first 24 hours after delivery, you and your baby will probably still be in the hospital. Your baby's pediatrician will come to the hospital to do a physical on the baby, then see you to discuss making an office appointment. If you have a boy, the pediatrician will talk to you about circumcision. Your signature is required before this procedure can be done. In some hospitals, your obstetrician will do this, while in other areas, it is done by the pediatrician or family practitioner.

While you are in the hospital, much of your time is spent getting to know your baby. You thought it was difficult to sleep at night during the pregnancy because you were uncomfortable. At least then you didn't have to feed someone or change any diapers!

At home, during the first week after birth, you will probably try to establish some kind of schedule for you and your baby. Don't be surprised if the baby isn't a willing participant; this can take weeks or months. During this time, try to nap or rest whenever you can. When your baby sleeps, take a rest. Try to avoid the temptation to catch up on your housework or other tasks.

If you can't rest during the day when your baby sleeps, go to bed earlier at night to get some rest.

The first 6 months after delivery may seem like hard work. It is a challenging time but also very enjoyable and rewarding. As your baby grows and starts to react to you and to your partner, it is a wonderful time of your life. Enjoy it. It is also a time of many changes. If you work outside of the home, you will be going back to work. If you exercise, each week you should see results.

During the first year, you spend a lot of time with your baby and a lot of energy caring for the baby, but you should be able to find time for yourself. This may take some effort; you may want to trade babysitting with another new mom on a regular basis so that you can exercise or participate in other activities you like.

By the end of the first year after delivery, you will have this "baby thing" down. A sure sign of this achievement is that you may even be talking about another pregnancy.

About 80% of all women have baby blues after giving birth; the feelings usually appear sometime in the first 4 to 6 weeks after the baby is born.