What’s Normal (or not) After You Give Birth? When to See Your doctor + When to Chill
This article originally appeared on clevelandclinic.org.
The process of birthing can be something of a roller coaster ride. You’ve waited a long time in line, some parts are going to be scary, and the ride does eventually come to an end. Giving birth is this fine line between magic and mayhem. The birthing process is an experience unlike any other. But as magical as it is, your body might end up feeling like the roller coaster crashed and burned. Plus you have to take care of your baby while your manage this pain. We want to let you know that it’s OK to complain a little. Or a lot. We get it. We have been through it and want to coach you through this process too.
So, what can you expect during those first days and weeks at home after a vaginal delivery? We talked to Ob/Gyn Katie Propst, MD, about what’s normal — and the red flags that signal something isn’t quite right.
Postpartum recovery: What is normal and what’s not:
BLEEDING
What’s normal: You might be thinking, how much bleeding should I expect postpartum? Well, most first-time moms should expect some postpartum bleeding. The keyword here is “some.” In medical circles, normal postpartum bleeding is, by volume, not that much. Still, YOU might be a little stunned by the size of the pad that the nurse hands over while you’re still reeling from labor and delivery. (This probably wasn’t the diaper-changing you envisioned when you signed up for parenthood, right?) Don’t stress — you won’t be wearing gargantuan pads for long. If everything proceeds normally, you won’t be heavily bleeding postpartum for very long at all.
However, you should know what it is you’re dealing with and what kind of bleeding you should expect postpartum. Vaginal discharge after delivery (called lochia) can be heavy at first and is usually dark red. After three days or so, it should lighten up, both in color and in volume. Light bleeding and discharge can last up to six weeks.
When to get help: We’ve covered what to expect with normal postpartum bleeding, so let’s talk about abnormal postpartum bleeding. Bleeding should be pretty light by the time you leave the hospital, depending on how long your stay is and what, if any, other operations were performed. Talk to your Ob/Gyn if you still have to change pads multiple times per hour after you’ve been discharged from the hospital. Also check in with your doctor if bleeding increases again after initially slowing down. This could be a sign of something unrelated to normal postpartum bleeding (lochia) and needs to be brought to your doctor’s attention.
CRAMPING
What’s normal: How much postpartum cramping is normal? Let’s not forget that your uterus just expanded to the size of a watermelon. It’s no wonder that it needs to recover! You can expect some cramps as it works its way back to its pre-pregnancy size and location. Sometimes the pain can be pretty intense, almost like a contraction. (And you thought you were done with those!) But each cramp should go away after about five minutes. You should have relief in between periodic cramping. Also know that if you’re breastfeeding, expect normal cramping while nursing for the first few weeks. Breastfeeding triggers normal cramping, so don’t think it’s anything that you’re doing wrong!
When to get help: Now let’s talk about abnormal postpartum cramping. Make sure to let your doctor know if you have significant pain that is steady (rather than cramps that come and go). It is not normal to have a constant and intense cramp postpartum.
TEARS AND EPISIOTOMIES
What’s normal: You should expect some amount tearing postpartum. Yep, most women tear during childbirth. (Sorry if that made you cringe!) And sometimes, doctors make a cut, called an episiotomy, to aid in delivery. That means many women go home with tender parts (and often, some stitches). Most of the time, the tears are minor and heal without issue. Stitches will dissolve on their own. Some discomfort should be expected with tearing and episiotomies, but nothing severe.
When to get help: What you should not be feeling is intense pain. Or seeing discoloration. Tears and episiotomies may become infected. Larger tears are more prone to infection than smaller tears. Big or small, though, seek medical attention if you have a fever, notice foul-smelling discharge or if your pain gets worse instead of better. These are all signs that something could be wrong with the childbirth tearing and/or an episiotomy. Please let your doctor know.
INCONTINENCE (LEAKAGE OF URINE OR BOWEL MOVEMENTS)
What’s normal: You should expect your peeing habits to be a bit off postpartum. These habits were already a bit weird early on during pregnancy, but a lot of women have some urinary leakage at the end of pregnancy and can continue for a few weeks after birth. Kegel exercises can help tighten things up and stop the leaking. Discuss with your doctor if Kegel exercises are right for you postpartum.
When to get help: Here’s what’s not normal postpartum: bowel leakage. We’re talking about poop, not pee here. Bowel leakage is a more serious condition than urinary leakage postpartum. Women who experienced larger tears during delivery are at greater risk of bowel leakage, so be aware. If you have leaking gas or bowel movements, talk to your doctor. In this case, Kegels can make things worse, so make sure to get medical advice before you take up a squeezing regimen.
Postpartum care and healing
We know you want to spend your postpartum time snuggling with that wonderful new addition to your family instead of worrying about your own health, i.e. what’s going on below the belt. So, we’ve tried to simplify things into an easily digestible list to help you out. In order to keep yourself comfortable, and to help speed up the healing process, Dr. Propst offers these tips:
Ask questions: Before you head home from the hospital, talk to your doctor about whether you had any tearing or if they performed an episiotomy. There is a lot going on during delivery and there is a chance that you missed some important information. If you did have tearing or an episiotomy, ask how serious it was and what you should expect as you heal.
Wash gently: Clean sensitive parts with a squirt bottle after using the bathroom. If this is uncomfortable you to do, or you just need some help, ask your partner or someone willing to help you with this. It’s also good to have this other person monitoring the situation down there to help ensure that everything is healing as it should.
Keep your bowel movements soft: Use a fiber supplement or a stool softener to help keep your bowel movements soft. Eating plenty of fresh fruits and veggies is better, but we understand that you might not have an appetite or deal with the preparation. Why soft bowel movements, you ask? It can be very uncomfortable to make a bowel movement after delivering a baby. Make this process as easy on yourself as possible.
Treat pain: Use ice packs and over-the-counter pain relievers to ease discomfort. Your doctor might have also prescribed you something from the hospital or from a subsequent checkup. There is a LOT to deal with after childbirth. If you want to make yourself a little more comfortable, try some pain management. Do not, however, try to mask severe pain with pain medication. Talk to your doctor if you are experiencing severe pain postpartum.
Try a sitz bath: A sitz bath is like making tea in your bathtub. Only you’re the tea bag. Ease your discomfort by soaking in a tub filled with a few inches of warm water. Feel free to soak up to four times a day. Use these baths to structure some time away from it all and relax. Postpartum moms need an extra minute. Let yourself have it.
Get help: If you have concerns that you’re not healing as you should, call in the experts. It’s always better to play it safe than sorry. Make sure you’re talking to your support system and hear from them what is normal and what to expect. Have them monitoring you for healing and to help give you some perspective. Always educate yourself by doing your own reading, preferably before the baby comes (it gets rough). And when in doubt, talk to your doctor. They are there for a reason and will help you get pointed in the right direction.
“If you have concerns about your healing, reach out to your obstetrician who may offer advice or provide a referral to a urogynecologist,” Dr. Propst says. “If you feel something isn’t right, you deserve to get help.”
We couldn’t have said it better, Dr. Propst. Take all the help you have access to and make sure you stay safe, happy, and healthy.
This article originally appeared on clevelandclinic.org.