The postpartum period

Preparing for the postpartum period

Preparing for the postpartum period is different from preparing for labor and delivery. It is a matter of looking ahead to when you will get back home. It is wise to confer with your friends and family to decide who will be willing and able to help out. Consider blocking out a schedule for helpers. Designate a social director or gate keeper in case the guests get overwhelming.

It is a good idea to have some meals frozen for easy use.
Make sure the baby's things are all ready right down to the last detail.
Make sure the house is clean and stocked.
Take as many childbirth prep classes as you can. Take them with your partner or family.
Make a flexible birth plan and discuss with your doctor.
Realize that your delivery may go as planned, or that something totally unexpected may happen, such as a C section.

Day of delivery

The day of delivery is extraordinary in a variety of ways. It can seem exhausting, exhilarating, and joyful all at once. It can actually seem surreal. You will most likely have some manageable physical discomfort, either in the perineum or in your incision , should you have a C section. Make sure you know if you have to ask for pain meds or if the nurse brings them on a schedule.

You will have more menstrual like cramps when nursing with each baby you have. Devote your energy to resting, eating if you can, and establishing nursing. Don't be surprised if breastfeeding isn't instantly perfect. It usually takes a week or two to be really smooth. Don't overdo it with guests.

Postpartum hospital stay

The normal post partum stay can last one to three days depending on your delivery and how you do. As you feel stronger and better, use the opportunity to move about and regain your steadiness. Oftentimes on the first postpartum day, the elation one feels gives way to exhaustion. This is normal and should be met with some good food and sound sleep. Most of the time the nurses are able to take the baby a bit so you can get caught up on rest. They will probably need to bring the baby in to nurse about every 2-3 hours. Uninterrupted sleep is a thing of the past, but that's ok as long as you get several blocks. Some say sleep when the baby sleeps but that might be a little much.

Once you are feeling better, make sure to take a good soaking jacuzzi, if you had a vaginal delivery. If you had a C section, you may shower. Depending on the type of C section skin closure, you may need to cover it for the shower. The nurses can help you with this.

From post partum day one forward, while you are still in the hospital, take this opportunity to develop and ask all the questions you can think of pertaining to self care or baby care. Take any postpartum classes that are offered and make sure to get all the baby's tests and shots done. Be sure to get your car seat set up checked out with the nurses.

Breastfeeding

Your milk may or may not come in while you are still in the hospital. It should come in sometime around postpartum day three or four. Do not be surprised that you will need help getting the baby to latch or that it may take a day or two to get the hang of it. Do not be surprised if your nipples get sore at first. Have faith that the nipples will develop a reflex of self numbing after a couple days. It is interesting that the nipples get sore, even though what the baby should be grasping is actually the areola, the wider pigmented area around the nipple. If you obtain assistance and make sure baby is latching correctly, you will minimize your soreness. But there is always some soreness for 7-10 days. If you are really sore, you may benefit from temporary use of a nipple shield.

Do not be surprised if your breasts are overly full at first. You may have to express a little milk to make the areola ( the wider pigmented area) easier for the baby to grasp. Remember it is very important to nurse the baby even before the milk comes in. This stimulates the milk TO COME IN. The baby needs the vital colostrum which is extra nutritious, and which contains mother's antibodies which protect the baby from infection. When the milk does come it, the process will get much easier. You will see the skim milk near the nipple and notice the richer milk coming from the back of the breast near your chest wall. See to it that baby drains the breast all the way down on one side, then start on the other breast. That way baby gets both the skim and the rich hind milk.

Don't be surprised if you have to stimulate the baby to stay with the nursing at first. You will learn to strike a balance between nursing on demand and on a schedule. Talk to you pediatrician and lactation consultant about this. To learn more, see our section on Breastfeeding HERE.

The first week home

When you get home, you may be tempted to act as you normally do in your home environment. However, you cannot simply pick up where you left off. You must follow instructions and concentrate on rest, eating and nursing. That is not to say you are on bedrest. Instead, it is careful mix of rest and activity, built around the cycles of nursing.

Do not be surprised if you are emotional or randomly teary. This has to do with all the upheaval, the discomfort, sleep deprivation, and hormone changes. Ideally partner, friends and family should be briefed about this beforehand.

Learn to gracefully accept assistance from others. It is good for them to help and good for you to accept help.

Through 6 weeks postpartum

You will most likely heal rapidly if you follow all your instructions, eat well, rest, nurse and continue your prenatal vitamins. You will become stronger and more confident each week. Soon you will hardly remember what life was like before the baby came. You will not know what you must have been doing with all your free time. You will be really excited if you get four hours of sleep all in a row. You may forget all about everyone else but the baby. However, you should try to stay well connected with them, especially your partner, even though they may seem to relate to the baby so very differently than you do. Try to adopt an attitude of flexibility. Try to be easygoing about things. Reach out and call your doctor and your pediatrician if you have questions. Refer often to your postpartum instruction sheets as they will provide objective suggestions about what to do, watch for and report. Ours are here available for download :

Discharge Instructions: Vaginal Delivery

Cesarean Discharge Instructions