From magic to mayhem: Giving birth to a baby is an experience unlike any other. But as magical as it is, your body might end up feeling like a war zone. (It’s OK to complain a little. Or a lot. We get it.)
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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: Is this normal?
What’s normal: Most first-time moms expect some postpartum bleeding. Still, you might be a little stunned by the size of the pad 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.) Don’t stress — you won’t be wearing gargantuan pads for long.
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, in color and in volume. Light bleeding and discharge can last up to six weeks.
When to get help: Bleeding is usually pretty light by the time you leave the hospital. Talk to your Ob/Gyn if you still have to change pads multiple times per hour after you’ve been discharged. Also check in with your doctor if bleeding increases again after initially slowing down.
What’s normal: Your uterus expanded to the size of a watermelon. No wonder 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. And if you’re breastfeeding, know they’re normal while nursing for the first few weeks.
When to get help: Let your doctor know if you have significant pain that is steady (rather than cramps that come and go).
TEARS AND EPISIOTOMIES
What’s normal: Yep, most women have some tearing 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.
When to get help: 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.
INCONTINENCE (LEAKAGE OF URINE OR BOWEL MOVEMENTS)
What’s normal: A lot of women have some urinary leakage at the end of pregnancy, which 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.
When to get help: Women who experienced larger tears during delivery are at greater risk of bowel leakage. 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
You want to spend these days snuggling your new addition, not worrying about what’s going on below the belt. To keep yourself comfortable and speed healing, Dr. Propst offers these tips:
- Ask questions: Before you head home, talk to your doctor about whether you had any tearing. If you did, 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.
- Keep your bowel movements soft: Use a fiber supplement or a stool softener.
- Treat pain: Use ice packs and over-the-counter pain relievers to ease discomfort.
- Try sitz baths: Ease discomfort by soaking in a tub filled with a few inches of warm water. Feel free to soak up to four times a day.
- Get help: If you have concerns that you’re not healing as you should, call in the experts.
“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.”