Obstetrics & Gynecology in Augusta, GA

Postpartum changes

It’s over.  The baby is here!  The excitement is only beginning, and then the reality sets in!  Now the real work starts.  Let’s look at some common postpartum concerns.

     Breast feeding has undergone a resurgence over the past two decades and now a majority of women attempt it in the first few months after giving birth, and most are successful.   Ideally, this is something that has been discussed and considered earlier in the pregnancy.  If there is still doubt at this stage, discuss the pros and cons with your pediatrician.

     It may take forty-eight to seventy-two hours after delivery for your milk to actually come in.  There are a few techniques to aid in this process such as warm water massage and the use of certain medications (Reglan).  Consult your pediatrician or lactation consultant if you sense a problem or the baby doesn’t seem to be satisfied.  A common bothersome complication for breastfeeding moms is sore and cracked nipples.  There are various creams that heal and coat the skin, and nipple shields, available at most pharmacies, can be a life saver. In both mastitis (breast infection) and nipple cracking, it is recommended to continue breastfeeding. Persisting with breastfeed in these situations does not jeopardize the health of the baby.

     If you had an episiotomy, vaginal tears, or lacerations, you will probably

experience some discomfort in the immediate postpartum stage.  During your hospital

stay, you were introduced to the wonderful world of sitz baths.  These warm, antiseptic cleansing baths will keep the area clean and promote healing.  They can be continued at home as long as they help. 

    The “lochia” or vaginal bleeding and discharge after the delivery, may continue for four to six weeks.  This is a mixture of blood from the uterine cavity and vaginal secretions.  It is usually heaviest in the first twenty-four to forty-eight hours after delivery and slacks off steadily from there.  If you are breastfeeding, you may see a temporary increase right after the act of breastfeeding as the uterus cramps and expels any remaining tissue.  If you are concerned about the amount of bleeding at any time, don’t hesitate to call your physician. 

     One of the most common questions after delivery is, “How can I lose this weight?”  In

our health conscience, “skinny is better” world this can become an obsession for some

women.  Remember, it took nine months to put this weight on, it will not go away over

night. There are, however, some things you can do to speed up the process. If you had an uncomplicated vaginal delivery, you can begin walking as soon as you feel well and have the energy.  Exercise is the key to healthy weight loss.  You can resume an exercise program within a few days of delivery, especially if you maintained an exercise regimen during the pregnancy.  There are always exceptions.  If you had a large number of stitches from a tear or episiotomy, your physician may request that you temporarily limit your activity.  If you had blood pressure problems or pre-eclampsia, you may need to postpone exercise.  Before you leave the hospital ask your doctor about his recommendations for your activity levels.

     The second component to healthy weight loss is proper nutrition.  This is especially important for breastfeeding mothers.  When you are nursing, you need about 500 calories a day more than you would normally eat in a non pregnant state.  This is assuming you were eating healthy before you got pregnant.  Eat a well balanced diet and focus mainly on fruits, vegetables, and whole grains.  I generally tell new moms to continue to take their prenatal vitamins while nursing as it provides additional nutrients that you may not get in your diet.  Drink plenty of water, a minimum of eight to ten 8 oz glasses a day.  This is critical to allow for the production of adequate milk and is also important in promoting weight loss.

     Another common question that arises postpartum is “When can I resume sexual relations?”  Actually this is the most common question of the husband.  This is not exactly paramount for most women at this stage.  I had one patient who asked me to write her a note that she didn’t have to have sex for a year; however, it became obvious that this request was reflective of a relationship problem more than a physical problem. The leading causes of decreased libido after birth are stress and fatigue. Don’t fret this lack of desire as it is almost universal.  It will vary as to when the desire for intimacy returns.  I would discuss this openly with your doctor and husband as often communicating your feelings fosters understanding and compromise. 

     The birth of a child is God’s way of reinforcing that the world needs to continue.  Embrace it with a heavy dose of both joy and responsibility.