women s health issues
Overview of Postpartum Care
Continuing From Hospital to Home
Coping with some changes begins in the hospital, depending on how soon hospital discharge occurs, and continues at home. New mothers have a discharge from the vagina. Staff members give them pads to absorb it. Staff members also check the amount and color of the discharge. Usually, it appears bloody for 3 or 4 days. Then it becomes pale brown, and after about 2 weeks, it becomes yellowish white. The discharge may continue for up to about 6 weeks after delivery. About a week or two after delivery, the scab over the site where the placenta was attached in the uterus comes off, causing vaginal bleeding of up to about a cup. Sanitary pads, changed frequently, may be used to absorb this discharge. Tampons should not be used until the woman's practitioner approves their use. If women are concerned about heavy bleeding, they should contact their doctor. Mothers who are not breastfeeding may safely take drugs to relieve pain. are relatively safe pain relievers. Many other drugs appear in breast milk. Women who need to take Medication and Substance Use During Breastfeeding should talk to their doctor about it. The area around the vaginal opening is usually sore, and the area may sting during urination. Tears in the perineum or episiotomy repairs can contribute to the soreness and cause swelling. Immediately after delivery and for the first 24 hours, ice or cold packs may be used to relieve the pain and swelling. Anesthetic creams or sprays can be applied to the skin. Later, washing the area around the vagina with warm water 2 or 3 times a day may help reduce tenderness. Warm sitz baths can help relieve pain. Sitz baths are taken in a sitting position with water covering only the perineum and buttocks. Women should be careful when sitting down and, if sitting is painful, use a doughnut-shaped pillow. Pushing during delivery can cause or worsen hemorrhoids. Pain caused by hemorrhoids can be relieved by warm sitz baths and applying a gel containing a local anesthetic. The breasts may be enlarged, tight, and sore because they are engorged with milk. Engorgement occurs during the early stages of milk production (lactation). Formothers who are not going to breastfeed, the following can help: Wearing a snug-fitting bra to elevate the breasts and thus help suppress milk production Applying ice packs and taking analgesics (such asacetaminophenoribuprofen) to help relieve discomfort until milk production stops on its own Refraining from manually expressing milk, which can increase milk production because expressing milk tells the body more milk is needed. Formothers who are breastfeeding, the following can help until milk production adjusts to the baby’s needs: Feeding the baby regularly Wearing a comfortable nursing bra 24 hours a day If the breasts are swollen and very uncomfortable, expressing milk by hand in a warm shower or using a breast pump between feedings (however, this measure tends to stimulate milk production and prolong engorgement) If the breasts are very swollen, the mother may have to express her milk just before breastfeeding to enable the baby’s mouth to fit around the areola (the pigmented area of skin around the nipple). When breasts are engorged with milk, expressing milk between feedings temporarily relieves the pressure but overall tends to make engorgement worse because it tells the body more milk is needed. Sadness (baby blues) is common during the days after delivery. Women may also feel irritable, moody, or anxious and may have difficulty concentrating or sleep problems (too much or too little). These symptoms usually disappear after 7 to 10 days. However, if these symptoms continue for longer than 2 weeks or interfere with taking care of the baby or doing daily activities, new mothers should talk to their doctor. In such cases, Postpartum Depression or another mental health disorder may be present. 