Heal­ing af­ter birth

Your Pregnancy - - Pregnancy Files -

Dur­ing preg­nancy, we tend to fo­cus on deal­ing with the pain and dis­com­fort that labour and birth will bring and ways to deal with that. But many women aren’t pre­pared for the dis­com­forts of the post­par­tum pe­riod. Here’s what you can do to help, writes Tina Otte

AF­TER AN AC­TIVE LABOUR, you’ll most likely find you feel stiff and ten­der in your en­tire body. This is due to you adopt­ing dif­fer­ent po­si­tions and push­ing your baby out, es­pe­cially if you had fun­dal pres­sure from the doc­tor or mid­wife. Your hips may be sore from squat­ting or hold­ing your legs up dur­ing push­ing, and if your legs were placed in stir­rups for a lengthy pe­riod of time. Your back might be sore if you had an epidu­ral or if you had peo­ple us­ing counter-pres­sure to al­le­vi­ate back pain in labour.


If you had a cae­sarean birth you may feel pain in one shoul­der. This is caused by air that en­tered your ab­dom­i­nal cav­ity dur­ing surgery. Af­ter a vagi­nal de­liv­ery, your shoul­ders may ache be­cause of the ten­sion and ef­fort you ex­erted dur­ing labour and de­liv­ery. It will take sev­eral days to ease off no mat­ter what kind of de­liv­ery you had. Try these aids: Shoul­der mas­sage or a to­tal back mas­sage from your part­ner, fam­ily mem­ber or friend. Con­scious re­lax­ation of shoul­der muscles when breast­feed­ing and do­ing shoul­der cir­cles to re­duce pain caused by ten­sion. Ap­ply heat or cold to the high­est point on your shoul­der and sit in a rock­ing chair with both feet on the floor to steady your­self.


As the lac­ta­tion hor­mones kick in you may feel some dis­com­fort as your milk “comes in” and you ex­pe­ri­ence let down. Learn­ing to breast­feed may mean sore nip­ples and en­gorged breasts, while try­ing to get it right. Breast or nip­ple pain must be ad­dressed im­me­di­ately, be­fore it gets out of hand and a small is­sue be­comes a big con­cern. Cor­rect latch­ing of baby onto breast is of ut­most im­por­tance for successful, pain-free breast­feed­ing. If baby is not cor­rectly latched, breast­feed­ing may be­come painful which can lead to a num­ber of prob­lems. If you sus­pect that your baby is hav­ing a latch­ing prob­lem, it is worth the time and the money (which is usu­ally claimable from med­i­cal aid) to en­gage the help of a lac­ta­tion ex­pert who can often sort out the prob­lem in one or two visits. Other breast care tips in­clude cool com­presses, some gen­tle mas­sage and above all rest and re­lax­ation. You may need to sleep with a soft bra in the early days. Cab­bage leaves for en­gorge­ment and iced gel rings work won­ders on swollen, hot breasts. Some hos­pi­tals of­fer the ser­vice of a laser or in­frared treat­ment ther­apy for ten­der nip­ples. This form of treat­ment may also be used for treat­ing mas­ti­tis or nip­ple in­fec­tions, and is usu­ally done by a spe­cial­ist phys­io­ther­a­pist.


You may be sur­prised to find your­self strug­gling with con­sti­pa­tion in the early days af­ter birth. There are a num­ber of


rea­sons why this may hap­pen: you did not eat much dur­ing labour or went with­out food be­fore your cae­sarean. If you have had a cae­sarean, it is very likely that you will ex­pe­ri­ence all sorts of gas­troin­testi­nal dis­com­forts due to the fact that your in­sides have been han­dled and ex­posed to air. There may also be tem­po­rary af­ter-ef­fects of pain med­i­ca­tion or anaes­the­sia. Dur­ing a vagi­nal birth your rec­tum is under great pres­sure and there may be swelling due to this, or, if you have a per­ineal tear or stitches, you may have fear that a bowel move­ment may hurt, and this causes you to tense up when you should be re­lax­ing. Drink warm liq­uids to stim­u­late in­testi­nal ac­tiv­ity. Start­ing your day like this should get you go­ing. Drink enough liq­uids (six to eight glasses a day) – this is also very im­por­tant if you are breast­feed­ing. Add bulk to your diet by eat­ing plenty of whole grains and raw or lightly steamed fruits and veg­eta­bles. Mas­sage your ab­domen in a clock­wise di­rec­tion ev­ery night be­fore go­ing to sleep. Be sure to use oil that al­lows your hands to glide over your skin.


Piles dur­ing preg­nancy may be­come more both­er­some af­ter birth. Drink plenty of flu­ids and avoid get­ting con­sti­pated. Eat roughage and whole grains. Soak­ing in warm wa­ter helps, as does ex­er­cise. When try­ing to have a bowel move­ment, place your feet on a small stool or box to pro­vide bet­ter lever­age and pre­vent strain­ing. Place some crushed ice and a lit­tle wa­ter in a small plas­tic bag or la­tex glove and then add sev­eral drops of rub­bing al­co­hol. Place in the freezer and place it on your piles to ease the itch­ing and pain. This is known as a slush bag.


If you have had a vagi­nal de­liv­ery, your per­ineum will be ten­der even if you did not have a tear or a cut. If you did need stitches in the per­ineal area, be it for a big or small in­ci­sion or tear, the area causes some dis­com­fort as it heals. As the stitches heal and ab­sorb, you may find bits of su­ture on your pad. This does not mean that the stitches are bro­ken; it means that you are heal­ing. Do­ing Kegel ex­er­cises will speed heal­ing and should be done even if you had a cae­sarean birth. Soak your per­ineum in warm wa­ter in a shal­low bath or use a squeeze bot­tle to spray warm wa­ter on your per­ineum af­ter go­ing to the loo. Try us­ing the “slush bag” on your stitches. (See “Piles”) Us­ing an in­frared lamp on your per­ineum is heav­enly. En­sure you place the lamp about a me­tre away from the area and leave on for 10 to 15 min­utes.


Some women have a prob­lem with pass­ing urine for the first one or two days af­ter birth. This is more likely to be a prob­lem if you had spinal or epidu­ral anaes­the­sia or if you had a large baby or a dif­fi­cult de­liv­ery that caused swelling and bruis­ing around the tis­sues of the blad­der and ure­thra. The prob­lem is usu­ally tem­po­rary and as soon as the swelling sub­sides your sys­tem should go back to nor­mal. With a cae­sarean birth you will prob­a­bly have a uri­nary catheter in­serted and it will stay in place for about 24 hours post-surgery. Once the catheter is out you may have a prob­lem uri­nat­ing on your own, so no mat­ter what the rea­son if you strug­gle, try this: Sit in a tub of warm wa­ter and try to uri­nate into the wa­ter. Use a squeeze bot­tle and squeeze warm wa­ter over your ure­thra while on the toi­let. Re­lax and breathe slowly and deeply.


Wind can some­times be a prob­lem dur­ing the post­par­tum time, es­pe­cially if you re­ceived pain med­i­ca­tion, epidu­ral, spinal or anaes­the­sia dur­ing labour. These drugs slow down your diges­tive sys­tem which can re­sult in a build-up of wind. Dur­ing surgery your in­sides are ex­posed to the out­side and this causes wind build-up as well. Avoid gassy foods and avoid get­ting con­sti­pated. Ex­er­cise – it stim­u­lates the diges­tive sys­tem. Drink a glass of warm wa­ter with the juice of half a lemon in it ev­ery morn­ing. Mas­sage your ab­domen in a clock­wise di­rec­tion. The ho­moeo­pathic prepa­ra­tion Ma­gen helps ab­sorb wind (for ba­bies too). Your doc­tor or mid­wife might also tell you which types of med­i­ca­tions you can take, both over-the-counter and pre­scrip­tion va­ri­eties.


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