Healing after birth
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.
FEELING BLOCKED UP
You may be surprised to find yourself struggling with constipation in the early days after birth. There are a number of
CORRECT LATCHING OF BABY ONTO BREAST IS OF UTMOST IMPORTANCE FOR SUCCESSFUL, PAIN-FREE BREASTFEEDING
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.
LOOK AFTER YOUR PERINEUM
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.
YOU MAY HAVE FEAR THAT A BOWEL MOVEMENT MAY HURT AND THIS CAUSES YOU TO TENSE UP WHEN YOU SHOULD BE RELAXING