Post Partum Information

Congratulations on the birth of your new baby.  Postpartum recovery is designed to have you return to normal activity as soon as possible.  Begin your activity slowly and progress by increasing your activity each day.  Rest frequently and avoid getting overly tired.  The information below can be followed by all patients regardless of whether you have had a cesarean or vaginal delivery.

Additional and specific instructions based on the type of delivery you have had can be accessed by viewing:

RESTRICTIONS
The best guide to follow is to use common sense.  No sexual intercourse until after your four (4) week postpartum checkup with me.  Do not drive an automobile for two (2) weeks following your delivery.

WHEN TO CALL THE OFFICE

  • You have thoughts of hurting yourself or your baby (see Post Partum Depression – below)
  • You have any offensive odor or discharge
  • You have fever greater than 100
  • You have persistent heavy bleed (filling a pad more than once an hour).  Any small amount of continuous bleeding or bleeding, intermittently, for up to 6 weeks postpartum is considered normal.
  • If you develop fever, pain or rash of the breast.  Watch the breasts for excessive leakage, en-gorgement (swelling) or any area that becomes excessively tender, red or hot to the touch.  En-gorgement of the breast may cause slight elevation of temperature – 99 to 100 degrees.  Wear a bra both day and night for two (2) weeks.
  • You have severe lower abdominal pain or worsening symptoms.
  • Burning on urination or feeling that your bladder is still full after voiding.

IF YOU HAVE QUESTIONS, CALL THE OFFICE AND ASK TO SPEAK WITH MY NURSE.

WHEN TO RETURN FOR YOUR POSTPARTUM EXAMINATION

  • Normal Vaginal Delivery: 4 weeks following birth
  • Cesarean Delivery with or without Tubal Ligation: 2 weeks following birth for incision check; 4 weeks later for final postpartum visit
  • Normal Vaginal Delivery With Tubal Ligation: Same as Cesarean section

SHOWERING AND BATHING

WOUND CARE AND HEMORRHOIDS
If you have an episiotomy, laceration or cesarean section incision, the suture used is dissolvable and will not need to be removed.  Watch these areas for signs of infection such as redness, swelling or drainage.

If you have had a vaginal delivery, Sitz baths are soothing for episiotomies or hemorrhoids. Sitting in three (3) to four (4) inches of warm water for 20-30 minutes, three (3) to four (4) times a day, followed by spraying with Dermaplast Spray will be helpful.

Avoid constipation by drinking a large amount of liquids.  Include roughage in your diet and use fiber laxatives like Metamucil, Citrucel or stool softeners like Colace or Surfak.  If absolutely necessary, you may use a laxative, such as Milk of Magnesia or Senokot.

OVULATION/MENSTRUAL CYCLE
Your first period may occur anytime within the first three months after delivery. This means you could become pregnant during this time.

  • Breastfeeding mothers may or may not have a menstrual cycle while breastfeeding.
  • Breastfeeding does not prevent pregnancy although you may have a lower risk in the first 6 months.
  • If you do not wish to become pregnant, you need to use some form of birth control as soon as you are sexually active.

STITCHES

AFTER BIRTH PAINS:
These uterine cramps, which resolve within three (3) to five (5) days, are normally accentuated when breastfeeding.  They should respond to Tylenol or Advil.

POSTPARTUM DEPRESSION
This is a serious condition that generally starts 4-8 weeks after delivery.  We all feel a little overwhelmed or tearful at times, but if a sad or depressed mood continues for several days and starts to affect your function (example: you stop taking appropriate care of your baby or stop getting out of bed) or if you have thoughts of hurting yourself or the baby, it is important that you immediately contact Dr. La.

SLEEP DEPRIVATION AND DEPRESSION
Lack of adequate sleep, hormonal changes, history of previous depression and isolation after delivery can sometimes lead to anything from mild “Postpartum blues” to severe depression.  Adequate sleep, which may be hard to get, and good nutrition are essential to maintain physical and mental health.  If you are breastfeeding, pump you breasts and save it so someone else can feed the baby at least two nights a week so you can sleep.  Accept help whenever possible; take care of yourself and the baby for the first few weeks.  Mild exercise is good for your body as well as your peace of mind.  Do Kegel exercises to help restore bladder control and muscle tone to the vaginal area.  If you feel depressed, this may be normal; however, the depression should last no longer than one week.  If it lasts longer, please call the office.

BLEEDING

  • Will continue for 4-8 weeks which becomes lighter after the first few days
  • 7-10 days following delivery, you may have a return of bright red blood which is normal if it is similar to a period or less
  • You may pass some clots of blood when you stand or move around.
  • Bleeding may seem heavier when you are more active.
  • If you are repeatedly filling a pad more than once an hour, call my office

BREASTFEEDING
Mastitis, a breast infection, commonly gets its start from tender, cracked nipples.  A frequent cause of injured nipples is allowing your baby to fall asleep at the breast especially when you bring the baby back to your bed for the middle of the night feeding.  If you have decided not to breast feed, then you must either wear a very tight bra or bind your breasts with an Ace bandage (wide) and try not to get any milk out of them or stimulate them in any way.  Wear this binder for at least (2) two weeks.  Don’t let the shower hit your breasts.  Use ice packs and Ibuprofen for discomfort and swelling.  If you develop any hard or red areas on the breasts, call the office because it may be an infection.

  • It takes 3-5 days for breast milk to appear.
  • Initially, the baby will be sustained by colostrums which are small in volume but high in nutrition.
  • Your breasts may grow very large and firm when your breast milk “comes in”.  You may also develop a low grand temperature (99-100).
  • If have not experienced significant milk production by the 5th postpartum day, please contact our office.
  • If you feel your milk volume is low (less than 1 ounce/hour total or 3-4 ounces every 3-4 hours when pumping), you may need to contact a lactation consultant.  The phone number for The Women’s Hospital – West Houston (TWHWH) (www.westhoustonmedical.com) lactation consultant is 281-588-7826. This department can also provide you with the names of outside lactation consultants they recommend.

SWELLING IN LEGS AND FEET
This is normal for the first few days postpartum and will resolve in a few days.

SEXUAL ACTIVITY

Nothing should be placed in the vagina (no sexual activity, no douching or tampons) until bleeding stops and you have your four-week checkup with me.  If you are breastfeeding, and sometimes even when you are not, you may find intercourse the first time after your delivery to be uncomfortable or even painful. Use a lubricant such as K-Y Jelly whenever you have intercourse.  Remember, you need some form of contraception even if you are breastfeeding — unless you want to repeat this activity nine months from now.

EXERCISE