After birth, your uterus needs to return to its pre-pregnancy size, but this won’t happen immediately. You may feel contractions during the first few days as your uterus works to shrink down, especially as you nurse. This is normal. Massage your uterus often, especially if it feels soft and boggy. It should feel firm like a grapefruit. If you let it get soft, you risk bleeding too much. If this is your second or subsequent baby, you may have afterpains, which can be quite strong. Try St. John’s Wort tincture, and also laying face down with a rolled-up towel under your uterus. At first the towel will be more painful, but within 5 minutes the pains should subside. If necessary, you can take Ibuprofen (Advil) 600 to 800 mg. every 6-8 hours for the pain. If 800mg ibuprofen is not sufficient, you can add acetaminophen (Tylenol) 500 mg taken 4 hours after each 800 mg dose of ibuprofen, and take the ibuprofen every 8 hours. Keep your bladder empty to help the uterus contract and lessen afterpains.
For the first 24 hours after the birth you need to watch your bleeding very carefully. If you soak more than a pad an hour, you are bleeding too much and you need to take action. Put the baby to nurse, massage your uterus firmly until it feels hard like a grapefruit, and call your midwife. You will bleed like a heavy period for the first week or so after the birth. Then the bleeding will taper off, and become brownish, pinkish, or clear. At first you may pass some small clots, especially when you get up to go to the bathroom in the morning. If you pass a clot larger than an egg, call the hotline. Use undergarments or sanitary pads to absorb the blood; do not use tampons.
If you have stitches, keep them clean and dry. Use your peri bottle after using the toilet to wash off your perineum, and pat dry with toilet paper. Do not rub. Immediately after the birth ice packs can really help reduce swelling. If you have stitches, do not take baths; shower instead as the stitches can dissolve too fast if you sit in water. Short sitz baths are fine, especially with chamomile or comfrey herbs in the water. The stitches may be very sore for the first week or so, but if you smell something foul, if they get very hot or red, call the hotline because they may be infected. Your stitches will dissolve naturally at about 3 weeks postpartum. Try to avoid stressing the stitches as much as possible. Avoid a lot of standing, walking, and especially lifting.
Your legs should be normal after the birth. If you have had varicose veins during the pregnancy, they should slowly return to normal (unless you have them even when you aren’t pregnant). Call the hotline if you develop a hot, red, hard, or swollen area in either leg.
Stay in bed except to use the bathroom for the first 2-3 days, especially if you lost a lot of blood. Let others care for you and other children. Do not cook or clean the house. You need to stay down and focus on the new baby and healing yourself. Sleep when the baby sleeps. Keep visitors to a minimum.
Your hormones go through some radical changes after the birth, and sometimes this causes “baby blues.” You may find yourself crying over insignificant things, or for no reason at all within the first couple of weeks postpartum. This is normal and will subside. Occasionally, postpartum blues turn into depression (deep and prolonged periods of sadness and an inability to cope), and extremely rarely, into psychosis (where you may have suicidal thoughts, or urges to hurt the baby). These conditions are treatable. If you are experiencing more than “blues,” call the hotline and visit our Postpartum Depression page.
It’s up to you, Mom, to determine when you will resume sexual activity. If you have had stitches, NO SEX BEFORE SIX WEEKS POSTPARTUM. Use your comfort level and desire as your guide. Don’t worry if you aren’t in the mood for several weeks. Your hormones have not yet returned to normal and you have a new baby making you very tired. Tell your partner to be patient.
You will feel tired much of the time, but you should feel healthy and well. If you have a fever or feel achy, call the hotline. Continue taking your prenatal supplements and eating well. Drink 6-8 glasses of water a day.
"I've had both my babies here and will continue going with all future babies. I love that I get to go home as soon as I want after the baby gets here and they all do such a great job of keeping you safe and allowing your body to do what it does naturally. It's a wonderful group of women! I'll never birth anywhere else!."
- Kersey June 2013