Being in hospital
If you have your baby in hospital, you’ll probably be moved to the postnatal ward after the birth to be with other mothers who have also had their babies. Some mothers enjoy their stay in hospital and find it restful and easy. Others find it tiring and rather stressful. It depends on how you’re feeling, whether you like the company of other mothers or miss your privacy, and on how the ward is organised. In any case, your stay in hospital, if your delivery is uncomplicated, is likely to be short.
It helps if you’ve discussed your postnatal care with your midwife during pregnancy so you know what to expect. Any preferences can then be recorded on your *birth plan so that staff on the postnatal ward will be aware of your wishes.
You’re likely to need quite a lot of help and advice with your first baby. The midwives are there to guide and support you as well as checking that you are recovering from the birth. Don’t hesitate to ask for help if you need it. If you do have a problem with the way things are organised in hospital, talk it over with one of the staff. Perhaps a change can be made.
If all is going well with both you and the baby, then most hospitals will probably give you the option of going home after 48 hours or even earlier, even if it’s your first baby.
The community midwife will visit you at home and continue to help you to care for yourself and your baby. You will need to make sure that your partner or someone else can be there to help you at home and do the cooking and housework.
Stitches
If you’ve had stitches, bathing the area often will help healing. Use a bath, shower or cotton wool and plain warm water. After bathing, dry the vulva carefully.* Pelvic floor exercises can also help healing. If the stitches are sore and uncomfortable, tell your midwife as she may be able to recommend treatment. Painkilling tablets will also help. If there is swelling and bruising, it may be possible to have some ultrasound treatment from the physiotherapist. In any case, remember to sit down gently and lie on your side rather than your back to start with.
If you’ve had stitches, bathing the area often will help healing. Use a bath, shower or cotton wool and plain warm water. After bathing, dry the vulva carefully.* Pelvic floor exercises can also help healing. If the stitches are sore and uncomfortable, tell your midwife as she may be able to recommend treatment. Painkilling tablets will also help. If there is swelling and bruising, it may be possible to have some ultrasound treatment from the physiotherapist. In any case, remember to sit down gently and lie on your side rather than your back to start with.
The thought of passing urine can be a bit frightening at first because of the soreness and because you can’t seem to feel what you are doing. Sometimes it’s easier to pass urine while sitting in a bowl of water or a warm bath. The water dilutes the urine so that it doesn’t sting. If you really find it impossible to pass urine, tell your midwife. Also drink lots of water to dilute the urine.
You probably won’t need to open your bowels for a few days after the birth but it’s important not to let yourself become constipated. Eat fresh fruit, vegetables, salad and brown bread, and drink plenty of water. This should mean that when you do open your bowels you will pass a stool more easily. Whatever it may feel like, it’s very unlikely that you will break the stitches or open up the cut or tear again, but it might feel better if you hold a pad of clean tissue over the stitches when you are trying to pass a stool. Avoid straining for the first few days. Sometimes stitches have to be taken out but usually they just dissolve after a week or so, by which time the cut or tear will have healed.
Piles
Piles are very common after delivery but they usually disappear within a few days. Eat plenty of fresh fruit, vegetables, salad, brown bread and wholegrain cereals, and drink plenty of water. This should make it easier and less painful when you pass a stool. Try not to push or strain as this will make the piles worse. Let the midwife know if you feel very uncomfortable. She will be able to give you an ointment to soothe them.
Bleeding
After the birth you will lose blood and discharge from the vagina. The loss will probably be quite heavy at first which is why you will need super absorbent sanitary towels. Do not use tampons until after your postnatal check since they can cause infections in the early weeks after the birth. During breastfeeds you may notice that the discharge is more red or heavier. You may also have ‘after pains’. These are both because feeding causes the womb to contract. They are a good sign that everything inside you is going back to normal. Bleeding often becomes heavier around seven to ten days after delivery but, if you find you are losing blood in large clots, you should save these towels to show the midwife as you may need some treatment. Gradually, the discharge will become a brownish colour and may continue for some weeks, getting less and less.
After the birth you will lose blood and discharge from the vagina. The loss will probably be quite heavy at first which is why you will need super absorbent sanitary towels. Do not use tampons until after your postnatal check since they can cause infections in the early weeks after the birth. During breastfeeds you may notice that the discharge is more red or heavier. You may also have ‘after pains’. These are both because feeding causes the womb to contract. They are a good sign that everything inside you is going back to normal. Bleeding often becomes heavier around seven to ten days after delivery but, if you find you are losing blood in large clots, you should save these towels to show the midwife as you may need some treatment. Gradually, the discharge will become a brownish colour and may continue for some weeks, getting less and less.
If you’re breastfeeding you may not have another period until you stop feeding or even for some weeks or months after that. If you are not breastfeeding, your first period might start as early as a month after the birth. But it could be much later. You can become pregnant before your period starts even if you are breastfeeding, so make sure you decide on a reliable form of contraception before you and your partner make love again.
Your breasts will be larger at first and while you are breastfeeding regularly. You need to wear a supportive nursing bra if you are breastfeeding. If you are not breastfeeding your breasts will reduce in size in a week or so.
Your abdomen will seem quite baggy after delivery. Despite having delivered your baby plus the placenta and a lot of fluid, you will still be quite a lot bigger than you were before pregnancy. This is partly because your muscles have stretched. If you eat a balanced diet and exercise, your shape should soon return to normal. Breastfeeding helps because it makes the womb contract. Sometimes, because this is happening, you may feel a quite painful twinge in your abdomen or period-type pain while you are feeding. Breastfeeding also uses up more calories so it can help you to lose some of the weight gained in pregnancy. Some women do not return to their normal weight until after they have finished breastfeeding.
*Postnatal exercises will help to tone up the muscles of your pelvic floor and tummy and help you find your waist again! They will also get you moving and feeling generally fitter. You may be able to attend a postnatal exercise class while you are in hospital and afterwards. Ask your midwife or physiotherapist.
It is quite common after having a baby to find it difficult to control your bladder if you laugh, or move suddenly, and to leak some water. * Pelvic floor exercises will help with this. If the problem persists after three months, see your doctor who may refer you to a physiotherapist.
Rhesus negative mothers
If your blood group is rhesus negative and your partner’s is rhesus positive, blood samples will be taken after delivery to see whether your baby is rhesus positive and whether you need an injection to protect your next baby from anaemia. If so, the injection should be given within 72 hours of delivery. Check with one of the doctors or midwives what should happen in your particular case.
Information provided by Health Promotion England.