AFTERBIRTH

AFTERBIRTH

Postnatal Body

You have just had your gurgling beauty or little boy-wonder or maybe you even had multiple blessings. Whatever it is you are no doubt feeling relieved and quite overjoyed. Seasoned mums might not be awash with the bouquet of different feelings that first time mums have but they know that they have a task of care in the months ahead. Most airlines advise that parents should attend to their own safety first during an emergency, before attending to that of their kids. While you may be concerned about your baby or just plain old pleased to see him/her, you should ensure that your body is fit for the task ahead and that there are no lingering issues from your recent pregnancy or delivery.

Some women spring up immediately after birth while some others may need some time to recuperate. The mode of delivery (natural or cesarean) as well as other factors may determine how quickly you can be up and about after giving birth.

After birth (about 2 – 6 weeks), your midwife or doctor should assess you to see how you are doing during your first postpartum visit. If you are travelling immediately after delivery or engaging in any activity that may require you to sit for long periods of time (usually over 5 hours), make sure that you inform your primary health care provider. Deep Vein Thrombosis (DVT) is a condition that can arise with prolonged sitting. In this condition, a blood clot can develop in the leg’s blood vessels or deep veins and if this clot travels to the lungs, it can lead to disastrous consequences.

The recovery period varies from woman to woman. Some cultures even have prescribed recovery durations. Some have a 40 day (about 2 months) stay at home rule while this recovery time can be up to three months or more in some other regions. Some tribes also have special naming ceremonies during this recovery period (between 7 – 14 days.  It is believed that this recovery period will be used by the mother to recuperate properly and also reduce the chances of the new baby (or babies) being infected by airborne or contagious diseases. During this period, a mother is typically exempted from going out or doing house chores (depending on the region/tribe) and she spends her time resting, eating to aid lactation and feeding her baby. There are different foods for mums who have just had a baby and typical foods include: pap (ogi/akamu), starchy foods/swallow and soups. There is usually some form of celebration to mark the end of this period.

Pregnancy and childbirth require a lot from a woman’s body. So do not feel like an under achiever if you cannot jump up and start pounding yam immediately. Again, all women are different and some people will recover faster than others but most women will experience one of the following:

Toileting Jitters

If you have had a vaginal delivery, you may feel a bit sore and tender down there. Passing urine or faeces may feel like a herculean task to you. The perineal area (the area just after the vagina and before the anus), can be sensitive after a natural delivery; especially after an episiotomy. During vaginal delivery, the perineum might have a small tear which typically heals naturally without stitching. If you had a major tear due to an episiotomy (a medically assisted cutting of the perineum to aid delivery) and consequently have had to be stitched by your doctor, then you may have discomforts depending on the way the procedure was performed. The discomforts associated with having stitches after an episiotomy may be reduced if the stitches are neatly tucked away in your vagina. In any case, you need to ensure that the area is kept clean to prevent infections from setting in.

Some women may not get the usual urge to pass urine after delivery especially if they have:

  • Gone through a cesarean section
  • Had an assisted delivery (forceps)

Women who don’t relieve themselves naturally after delivery might need a catheter to aid them. The anesthetics given during a cesarean can also restrict bowel movements so be sure to drink lots of water if you are feeling constipated. A bladder that isn’t emptied after delivery can eventually lead to increased difficulty in urinating, Urinary Tract Infections, after birth pains, bleeding and it may make it difficult for your uterus to contract. Let your doctor know if you find it hard to do a pee easily. The following tips will help you in caring for your perineum and vagina after delivery:

  • Clean your vagina with warm water and mild hypoallergenic soap during baths. Avoid douching and harsh soaps.
  • Do not restrict bowel movements because of the fear of using the toilet. This may be counterproductive and cause you to become constipated. Instead take lots of fluids, fruits and vegetables to ease bowel movements and help with dilution of urine. Some hospitals may give you laxatives (medication) to help soften your poo (faeces).
  • If you are still sore from delivery, you can run clean warm water over your vaginal area while urinating to prevent the stinging (peppery) sensation that you may feel. Running clean warm water regularly will also help to keep the area clean.
  • You may also be prescribed some safe-to-use painkillers which can help ease any pain you may be feeling. Otherwise you can put an ice pack over the affected area.  Ensure that you wrap the ice in a clean towel first though, to prevent ice burns.
  • You might need some time before you resume sexual relations especially if you have had a vaginal delivery or an episiotomy. Your vagina might be a little swollen and sore after birth.
  • You need to talk to your medical practitioner about resuming sexual relations. The use of lubricants can also aid love making as the vagina tends to be dryer after birth due to the lower levels of estrogen in the body.
  • Pelvic/Kegel’s exercises can help with improving your vagina’s muscle tone and elasticity.

Bleeding

After delivery, the body gets rid of a mixture of cell-tissues, bacteria, mucus and blood from the lining of the uterus called lochia, though the vagina. This bodily fluid (lochia) is usually reddish for the first few days after birth and you would feel like you are having a menstrual period (might even be heavy!). The colour of the fluid should become lighter and its volume reduced as the days go by. The discharge should stop between a few days and a month (or two) after delivery. Ensure that you have good maternity towels or highly absorbent sanitary pads to help with the bleeding. See your obstetrician if you think that the bleeding is too heavy or foul smelling.

After Pains

The contractions you felt before delivery will continue after delivery. Ouch, sorry ye! These postnatal cramps are called After Pains and they usually don’t last long. They usually cease within a few weeks after delivery. The reason you are having these cramps is because your uterus (womb) is slowly contracting back to its pre-pregnancy size, this is quite a big deal considering that it is going from about the size of a watermelon to the size of a tiny fist. These cramps are similar to period cramps and you may notice that you feel them more whenever you breastfeed. This is because the hormone oxytocin which is responsible for uterine contraction, is also the same one responsible for release of breast milk. Ahan! On the plus side, a well contracted uterus is a plus for your tummy.

Tummy

This might come as a bit of shock to you (thanks to Hollywood) but right now your tummy might have some folds and look wrinkly with your belly button sunken in. Many women might still have a big post-delivery bump. However some women may have tummies that spring back into shape much like a well-made sponge cake after just a few short weeks, lucky them! Most women will still have pot bellies (of varying degrees) after birth. Women who have undergone a cesarean section may have a swelling as well due to the incision made during the operation. Whatever your state, remember that your body has just been through a challenging nine month journey and it can take several weeks or months (years even!) to get back in shape. Proper exercise, diet and life style changes can help move the process along though some women never really look the same. So if you still have a post-delivery bump then you are in plenty of good company.

During pregnancy, the abdominal muscles that run on either side of your belly may become separated leaving a space in between that can cause a pouch, back aches, incontinence, the need for assisted deliveries in subsequent pregnancies, or in severe cases hernia. This is called Diastasis Recti (abdominal separation) which is loosely translated to mean separation of muscles. Your obstetrician or GP should check this after 6-8weeks of pregnancy but you can also do a quick self-check to see if these muscles have separated.

  • Lie on your back with your feet flat on the ground (your legs would need to be arched to achieve this)
  • Lift your head up slightly using your shoulders so that you can see your tummy. Locate your belly button. The abdominal muscles can be found on either side of your belly button. Place as many fingers as would fit in between the space above or below your belly button. This will help you measure how wide the space is.
  • Do this frequently in the weeks post birth to see if it is closing up or not. If the number of fingers you place start to reduce then it may mean that the gap is closing up.
  • Avoid heavy lifting or doing exercises that can widen the space. There are some exercises that can help with abdominal separation.

If the gap between your stomach muscles have not returned to normal after about eight weeks after delivery, your doctor might need to refer you to a physiotherapist. Do not do normal sit ups if you have split abdominal muscles (Diastatis recti), this may make it worse.

Weight

Just like your tummy, your pregnancy weight may not disappear overnight. Thankfully, much of your pregnancy weight was due to the baby (or babies), amniotic fluid and umbilical cord so you should have lost between 4 – 6 kg by now. You should also expect to lose more weight because your body retained quite a bit of fluid (mostly water) especially if you underwent a cesarean section (you would probably have been given fluid intravenously). Getting back to shape will require exercise and the right diet.  If you have gone through a cesarean section or have, your body may need more time to heal.

Breasts

Whether you choose to breastfeed or not, your breast will produce milk. Your breast fills up with milk and becomes engorged if they are not emptied. The first milk produced after birth called colostrum is quite rich in a lot of essential nutrients and helps to pass some immunity to the baby. The first few hours of birth can be a great time to help you and your baby practice proper latching. Don’t worry if you don’t get it at first, relax and get proper help if you need it. Breast feeding can also set off pelvic cramps called after pains. If you decide not to breastfeed, you might need to take prescribed pain killers and apply ice packs to your breasts to ease the discomfort from your engorged breasts and prevent increased swelling. Find out more about breastfeeding here.

Skin and hair

If you had acne, darker skin, tags or any other skin break outs during pregnancy, you may start to get some relief right about now. Stretch marks may start to fade but might not disappear altogether. Fair skinned women who grew darker during pregnancy may find that their colour starts to return just a few days after birth. On the flip side, hormonal fluctuations plus new baby responsibilities may also cause break outs and skin acne. Skin luster can be improved with proper diet, rest and skincare products. Check out some natural ways of improving your skin after pregnancy.

The surge in hormones, diet and other factors can help with hair growth during pregnancy. Your hair may be fuller, thicker and longer now. Many women retain this hair and even sustain the growth spurt after delivery. Some others however may start to lose some of their hair.  Check out some natural ways of taking care of your hair after pregnancy.

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