Recovering after birth

Dreaming of feeling slim and sexy, instead of big and bloated? Can’t wait to get your body back? Many women say that while they understood the changes pregnancy brought, they weren’t expecting the time after birth to be so uncomfortable and challenging. H

THE FEELS DOWN THERE

If you have had a vaginal birth, with or without an episiotomy, you’ll be feeling a little tender down there. This may last for a few days or perhaps a few weeks after the birth. This is understandable if you think about what has happened to the vaginal and perineal tissues as they stretched over your baby’s head. If you tore slightly or if you were cut, then the stitches can feel uncomfortable. Remember, the vagina is a muscle, and muscles stretch and can bounce back. Continue to do your Kegel exercises. After a vaginal birth, the thought of having a bowel movement is enough to cause immediate constipation. You’re not sure if you want to sit on the bidet the entire day or to lie legs open with a hot infrared lamp on your perineum until you look like a prune. Haemorrhoids may be more painful after the birth than before. No heat here – only cold compresses. These normally disappear within a few weeks.

CAESAREAN BIRTH

If you had a c-section don’t think you get off scot-free. The tenderness from the caesar scar is nothing compared to the pain you will feel when body gases are moving around under the wound.

It is also normal to feel pain under the ribs after major abdominal surgery, so be prepared.

This is due to trapped air in the thoracic area post-surgery. Keep a pillow handy because when you cough, sneeze or laugh in those early days, it may feel as if you will literally burst your sides if you do not support yourself.

It’s important to get up (with help) and move around after a caesarean birth. Try not to hunch over as you walk, straighten up as much as you can, but take it slowly. No heavy lifting for many weeks to come.

JOINT PAIN

The effects of pregnancy may last as long as three to five months post birth. This means that joint pain may not ease off immediately but may take a little time. It is important to remember this when getting back to exercise or jogging. Carpal tunnel symptoms usually disappear very quickly as your swelling subsides, which is one of the first things you will notice. Wrist pain that does not subside may need intervention in the form of a small operation to ease the pressure that is causing the pain. Visit a physio or chiropractor to make sure that your spine is aligned, and get exercises to do that will strengthen your core.

BLOOD LOSS

Blood loss from the vagina, known as lochia, comes from the place where the placenta was attached to the uterus. This will happen whether you have had a vaginal birth or a caesarean.

It will initially be heavy with blood clots, gradually changes colour and consistency and becomes less. Passing lochia is not painful. What is painful are the afterbirth contractions you will feel when you breastfeed. These contractions will diminish and disappear altogether after about two weeks.

While blood loss is to be expected, bright-red blood escaping from the vagina and a uterus that’s bloated after a week is not normal. If bleeding does not subside, and there’s a feeling of a swollen uterus, you may have bits of placenta that have been retained, or the placental site that is not healing. Sudden and heavy blood loss or increasing blood loss, including clots, could be a sign of postpartum haemorrhage. Other signs include shaking, dizziness, elevated heart rate and sweating. These are signs of shock and you need immediate medical attention.

Any pus, pain and bad smell may indicate that you have an infection – be it an episiotomy, tear or caesarean wound. High fever accompanied by shivering and abdominal pain could be a sign of severe infection somewhere in your body. Infections could occur in the area between your vagina and rectum (perineum), around your caesarean scar, in your urinary tract or your womb. If you have a perineal or caesarean wound that is slow to heal, it could be because it’s infected. If you have a urine infection, you may have pain when you wee or find it difficult to wee. If you have an infection in your uterus, you may also have pain in your tummy and/ or smelly discharge from your vagina.

BREAST DISCOMFORT MAY SURPRISE YOU

As your milk comes in, your breasts may prickle, and the skin may feel taut. Breastfeeding shouldn’t hurt. If it hurts, something is wrong! Hard, swollen breasts that can’t be touched and are accompanied by fever and flu-like symptoms may indicate the start of mastitis. You’ll need prompt treatment in the form of antibiotics, and getting advice from a lactation specialist will help you continue with breastfeeding through this potentially rough time. Cracked nipples are not as serious but can cause unbelievable pain, so get help. Immediately. Don’t wait – it’s usually a simple matter of correcting the way the baby takes the breast that dissipates the pain within minutes. If your baby latches or is positioned incorrectly, it’s vital that this be corrected immediately, otherwise it may lead to cracked and bleeding nipples and engorged breasts.

INABILITY TO PASS URINE

You’ll be expected to pass urine within six hours after birth. If you’ve been unable to do so, you may be suffering from something called urine retention. While not life threatening, it can cause a great deal of pain and anxiety. Often listening to or watching water running or having a warm bath or shower will get things moving. If not, you’ll need medical intervention.

LONG-TERM SADNESS OR DEPRESSION

Feeling down for three months or longer is worrying and should be brought to your doctor’s attention immediately. This can affect the way you manage and bond with your baby and doesn’t mean that you’re failing as a mother. Sometimes just talking it out with some counselling is all that’s needed, but sometimes medication may be necessary for a while.

YOU MIGHT FEEL LIKE YOU’RE LOSING YOUR MIND

Insomnia and feeling like you’re going crazy are to be expected after birth, due to the heavy demands of a newborn causing sleep disruption. Lack of sleep makes any difficult situation worse. Trying to cope with the demands of a baby as well as recuperate from birth takes its toll when you’re not getting sleep.

The old saying, “sleep when your baby does” is something to abide by. Some moms experience dramatic changes in their emotional and mental health. Thought disorders, severe agitation, confusion, hallucinations and delusions can be symptoms of a rare condition called postpartum psychosis. Mild symptoms can develop into serious mental illness within a matter of hours, so it’s imperative that you get treatment.

In order to be a good mommy, looking after yourself and taking some time out in your busy day is vital. Don’t feel guilty if you’re not with your baby all the time. You need time away to catch your breath in order to gather strength and resilience – so necessary to cope with the demanding work of motherhood. The physical (and sometimes emotional) pain of birth and postpartum will subside and fade into memory as the joys of being a mother start to unfold for you.