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Family Birthing and Maternity Services, St. Vincent's Medical Center, Bridgeport CT

Post Partum Home Care for Mom

St. Vincent's Medical Center, Bridgeport CTPregnancy changes your body in more ways than you may have guessed, and it doesn't stop when the baby is born. Postpartum care involves managing sore breasts, skin changes, hair loss and more. Here's what to expect after a vaginal delivery. Most postpartum changes usually last up to six weeks.

Contractions

You may feel contractions, sometimes called afterpains, during the first few days after delivery. These contractions — which often resemble menstrual cramps — help prevent excessive bleeding by compressing the blood vessels in the uterus. Afterpains tend to occur during breast-feeding sessions and seem to be more noticeable with second or third babies. Your healthcare provider may recommend an over-the-counter pain reliever, if necessary.

Contact your healthcare provider if you have a fever or if your abdomen is tender to the touch. These signs and symptoms could indicate a uterine infection. 

Vaginal discharge

You'll have a vaginal discharge (lochia) for up to six weeks after delivery. Expect a bright red, heavy flow of blood for the first few days. If you've been sitting or lying down, you may notice a small gush when you get up. The discharge will gradually taper off, changing from pink or brown to yellow or white. To reduce the risk of infection, use sanitary napkins rather than tampons. Don't be alarmed if you occasionally pass blood clots. 

Contact your healthcare provider if:

  • You soak a sanitary pad within an hour while lying down
  • The discharge has a foul odor
  • You pass clots larger than a golf ball
  • You have a fever of 100.4 F (38 C) or higher

Menstruation - Begins 4-12 weeks postpartum for bottle-feeding mothers. Menstruation may not reoccur until after breastfeeding ceases. 

Mood changes

Childbirth can trigger powerful emotions. Mood swings, irritability, sadness and anxiety are common. Many new moms experience a mild depression, sometimes called the baby blues. The baby blues typically subside within a week or two. In the meantime, take good care of yourself. Try to get as much sleep as possible. If your depression deepens or you feel hopeless and sad most of the time, contact your healthcare provider. Prompt treatment is important. 

Urination problems

Swelling or bruising of the tissues surrounding the bladder and urethra may lead to difficulty urinating. Fearing the sting of urine on the tender perineal area may have the same effect. To encourage urination, contract and release your pelvic muscles, while sitting on the toilet. It may help to place hot or cold packs on the tissue between the vaginal opening and anus, or pour water across your vulva, while you urinate. 
Difficulty urinating usually resolves on its own. Contact your healthcare provider if you have any symptoms of a urinary tract infection.

Symptoms of a UTI

  • It hurts to urinate
  • You don't think you're emptying your bladder fully
  • You have an unusually frequent urge to urinate

Pregnancy and birth stretch the connective tissue at the base of the bladder and may cause nerve and muscle damage to the bladder or urethra. You may leak urine when you cough, strain or laugh. Fortunately, this problem usually improves within three months. In the meantime, wear sanitary pads and do your Kegel exercises. Drink plenty of fluids. Report burning on urination or urinating small amounts frequently to physician.

Bowel movements

You may find yourself avoiding bowel movements out of fear of hurting your perineum or aggravating the pain of hemorrhoids or your episiotomy wound. To keep your stools soft and regular, eat foods high in fiber, drink plenty of water and remain as physically active as possible. Ask your healthcare provider about a stool softener or fiber laxative, if needed. 

Another potential problem for new moms is the inability to control bowel movements (fecal incontinence) — especially if you had an unusually long labor. Frequent Kegel exercises can help. If you have persistent trouble controlling bowel movements, consult your healthcare provider. 

Bathing 

Tub baths are not recommended until your physician is consulted. Showering is permissible at any time. Hair washing is also acceptable.

Exercise:

  • You will tire easily with the decreased demands on your energy and time.
  • Plan naps the same time your baby sleeps.
  • Usually permissible with physician approval - Kegels, low impact walking.
  • Strenuous exercise to be avoided until after first postpartum visit.

Sex:

  • Pelvic rest for 6 weeks. 
  • Discuss with physician. 

Nutrition

Eat well-balanced meals, emphasizing four food groups (meat, milk products, fruits and vegetables)

Breast Care

Several days after delivery, your breasts may become heavy, swollen and tender. This is known as engorgement. To ease the discomfort, nurse your baby or use a breast pump to express milk. You may also want to apply cold washcloths or ice packs to your breasts, or take a warm shower. Over-the-counter pain relievers may help, too.

If you're not breast-feeding your baby, wear a firm, supportive bra. Compressing your breasts will help stop milk production. In the meantime, don't pump your breasts or express the milk. This only tells your breasts to produce more milk. 

Leaky breasts are another common problem for new moms. You can't do anything to stop the leaking, but nursing pads worn inside your bra can help keep your shirt dry. Avoid pads that are lined or backed with plastic, which can irritate your nipples. Change pads after each feeding and whenever they get wet. 

Nipple care:

  • Do not wash nipples between feedings.
  • Daily shower is adequate for cleaning.
  • May use pure lanolin as discussed with physician.
  • Keep nipples dry between feedings.
  • Wear breast pads to help catch leaking and keep moisture off nipple.

To minimize the discomfort:

  • Wear a bra night and day. 
  • Limit fluid intake to thirst only.
  • Use ice bags to the breast for 15 20 minutes, four times a day.

If you do breast feed, continue to take your prenatal vitamins and increase fluid levels.

Stitches

Dissolve on their own, no removal is necessary. Sitting in 2-3 inches of warm water 2-3 times per day will be soothing if the sutures are sore at home.

Hemorrhoids 

Hemorrhoids are stretched and swollen veins in the anus or lower rectum.  If you notice pain during a bowel movement and feel swelling near your anus, you may have hemorrhoids. They usually regress without medication in several weeks. If they are too sore, a local medication may be prescribed. To ease any discomfort while the hemorrhoids heal, soak in a warm tub and apply chilled witch hazel pads to the affected area. Your healthcare provider may recommend a topical hemorrhoid medication as well.

To prevent constipation and straining, which contribute to hemorrhoids, eat foods high in fiber — including fruits, vegetables and whole grains — and drink plenty of water. Remain as physically active as possible. If your stools are still hard, your health care provider may recommend an over-the-counter stool softener or fiber laxative.

Swelling

You may notice swelling in your legs, hands and face for several weeks, which will also regress spontaneously in time. Do not take “water pills” without consulting your physician; they usually are not necessary.

Vaginal soreness

If you had an episiotomy or vaginal tear during delivery, the wound may hurt for a few weeks — especially when you walk or sit. Extensive tears may take longer to heal. In the meantime, you can help promote healing:

  • Soothe the wound. Use an ice pack or wrap ice in a washcloth. Chilled witch hazel pads may help, too. Witch hazel is the main ingredient in many hemorrhoid pads. You can find witch hazel pads in most pharmacies.
  • Keep the wound clean. Use a squirt bottle filled with water to rinse the tissue between the vaginal opening and anus (perineum) after using the toilet. Soak in a warm tub.
  • Take the sting out of urination. Squat rather than sit to use the toilet. Pour warm water over your vulva as you're urinating.
  • Prevent pain and stretching during bowel movements. Hold a clean pad firmly against the wound and press upward while you bear down. This will help relieve pressure on the wound.
  • Sit down carefully. To keep your bottom from stretching, squeeze your buttocks together as you sit down. If sitting is uncomfortable, use a doughnut-shaped pillow to ease the pressure.
  • Do your Kegels. These exercises help tone the pelvic floor muscles. Simply tighten your pelvic muscles as if you're stopping your stream of urine. Starting about a day after delivery, try it for five seconds at a time, four or five times in a row. Repeat throughout the day.
  • Look for signs of infection. If the pain intensifies or the wound becomes hot, swollen and painful or produces a pus-like discharge, contact your health care provider.

Hair loss and skin changes

During pregnancy, elevated hormone levels put normal hair loss on hold. The result is often an extra-lush head of hair. After delivery, your body sheds the excess hair all at once. Within six months, your hair will most likely be back to normal. In the meantime, shampoo only when necessary, and find a hairstyle that's easy to maintain. Avoid hair dryers, curling irons and harsh chemicals.

Stretch marks won't disappear after delivery, but eventually they'll fade from reddish purple to silver or white. Any skin that darkened during pregnancy — such as the line down your abdomen (linea nigra) — may slowly fade as well. 

Weight loss

After you give birth, you'll probably feel flabby and out of shape. You may even look like you're still pregnant. Don't worry. This is perfectly normal. Most women lose about 10 pounds during birth, including the weight of the baby, placenta and amniotic fluid. During the first week after delivery, you'll lose additional weight from leftover fluids. After that, a healthy diet and regular exercise can help you gradually return to your pre-pregnancy weight.

Situations to report to your physician:

  • Temperature elevation of 100.6 or over.
  • Heavy, bright red bleeding.  
  • Passage of large clots.
  • Painful urination.
  • Abnormally painful breastfeeding.
  • Discharge from abdominal incision.

The postpartum checkup

About six weeks after delivery, your healthcare provider will check your vagina, cervix and uterus to make sure you're healing well. He or she may do a breast exam and check your weight and blood pressure, too. This is a great time to talk about birth control, breast-feeding and how you're adjusting to life with a new baby. 

Share any concerns you may have about your physical or emotional health. Chances are, what you're feeling is entirely normal. Look to your healthcare provider for assurance as you enter this new phase of life. 

Contact us

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